According to findings from the California Medicare CHAT Collaborative, which conducted live chats with over 810 Californians on how to design Medicare, 85% of participants included in their Medicare plan a mechanism for incorporating rewards and penalties. Most of the group discussions centered on which approach, penalties or rewards, would be more effective in encouraging compliance. Some objected to the idea of rewarding people for doing what they should be doing anyway. Others preferred a tier that only provides rewards (it was not available with MedCHAT), but chose the penalty/reward option because they believed it was better than doing nothing. Over all, there was strong sentiment that people needed to be more accountable for their health, especially since everyone else was helping to “pay the bills.” Others believed this was too much intrusion into people’s lives.
The Center for Healthcare Decisions (CHCD) in partnership with LeadingAge California developed the California Medicare CHAT Collaborative (“MedCHAT”) to encourage public input on Medicare. MedCHAT is an interactive, computer-based simulation, in which participants create a benefits package when potential coverage options exceed current Medicare funding. For the past year, 82 three-hour MedCHAT sessions were conducted throughout the state involving 810 Californians: seniors, younger adults, healthcare professionals, community leaders and those working in senior services.