Final Report available: Cost-Effectiveness as a Criterion for Medical and Coverage Decisions: Understanding and Responding to Community Perspectives.

A single copy of this 32-page report will be mailed on request by contacting [email protected] or calling (916) 851-2828. For multiple copies, there is a $2.00 per copy charge for shipping/handling. SHD will invoice, if requested. The report includes the surveys and discussion tools described below, as well as the stakeholder-specific strategies recommended by the project leaders.

The Project. Visible Fairness provided an opportunity for the public as health plan members and as citizens to participate in a community-wide dialogue on the role that cost plays in healthcare treatment and coverage decisions.

Consumers weighed in on one of society's most difficult dilemmas: how to balance the medical needs of individuals with those of the larger community.

In 2000/2001, Visible Fairness undertook several activities:

Physician Survey. The purpose of this survey was to understand their perspective and experience in making cost-effectiveness decisions in clinical practice.

A written survey was mailed in June to 1,000 randomly-selected physicians in the five counties of Sacramento, Yolo, El Dorado, Placer and Nevada.

Over 500 surveys were returned for a 52% response rate. In its December issue, the Western Journal of Medicine published an article that describes the project and includes the survey results.

Discussions with consumers.
The goal of these discussions was to identify consumer views and values about how decisions should be made when healthcare providers consider the use of medical treatments that have marginal benefit at great cost. The project conducted 25 small-group discussions with the public between November 2000 and February 2001. Using an interactive discussion format, Visible Fairness challenged 263 individuals to consider some of the priority conflicts facing patients, consumers, and citizens. Meetings were held in workplace and faith settings, individuals' homes, classrooms, and community organizations.

Consumer Phone Survey. A 500-person phone survey was conducted in April 2001 to identify how a random sampling of the public views the issue of the rising cost of healthcare and reactions to various cost-containment strategies.

Balancing Act Forum. In June, 260 individuals representing a variety of healthcare interests attended a half-day forum in Sacramento on the results of Visible Fairness to date. Statewide healthcare leaders discussed the results in a provocative panel discussion

This 18-month project was funded by the California HealthCare Foundation and included the following partners:

AARP Stephanie Zack, LCSW, Associate State Director
CalPERS Nancy Welsh, Chief, Health Program Development
Health Net Steven Raffin, MD, Chief Medical Officer for Government Programs
Health Rights Hotline Shelley Rouillard, Program Director
Kaiser Foundation Health Plan Edward S. Glavis, Senior Vice President
Landmark Healthcare Fred Simmons, VP for Business Development
Mary J. Griffin & Associates Mary Griffin, President
MedClinic/CHW Medical Foundation Jennifer Nuovo, MD, Associate Medical Director for Managed Care
The Permanente Medical Group Jack Rozance, MD, Physician-in-Chief, Sacramento
UC Davis Medical Center Robert Chason, Chief Operating Officer
Sierra Sacto. Valley Medical Society William A. Sandberg, Executive Director
Sacramento Healthcare Decisions Marjorie Ginsburg, Executive Director
Sutter Physicians Alliance Gary Fields, MD, Medical Director
Western Health Advantage Don Hufford, MD, Chief Medical Officer

For more information, contact Project Director Marge Ginsburg at (916) 851-2828. or [email protected].

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