Under a 1985-1987 cooperative agreement with HCFA, HealthChoice, Inc. (HCI), which is the nonprofit arm of Portland, Oregon-based Benova, implemented a demonstration "independent broker" program at three sites: Los Angeles, Portland, and San Francisco. The demonstration was initiated to test the efficacy of having an independent broker work cooperatively with participating health plans to inform and educate Medicare beneficiaries about the health service options available to them. HCI coordinated HMO fairs, produced and distributed comparative information, and performed beneficiary counseling and enrollment and received remuneration from HMOs for beneficiaries who enrolled as a result of their efforts (Davidson, 1988).
In an evaluation of the demonstration at the Los Angeles and San Francisco sites, researchers found an increase in the level of knowledge of key HMO concepts among beneficiaries attending HCI health fairs; however, they had little or no impact on enrollment behavior (Langwell et al., 1989). Researchers also found differing objectives: the HMOs viewed HCI as a marketing tool, whereas HCFA perceived it as an educational program. They concluded that independent brokers were not effective in markets (such as the two evaluated) where HMO penetration was high, although they may be effective in markets where the HMO option is just being introduced.
In addition to disseminating information to consumers through the newspaper (referenced above), the Minnesota Health Data Institute also held a series of three community meetings to present the findings on consumer satisfaction with Minnesota health plans. The meetings, which were coordinated with the state office of AARP, were held in Duluth, Rochester, and St. Cloud, Minnesota, in October 1995. In St. Cloud and Rochester, information on health plan survey results was included on the agenda of already planned conferences, whereas in Duluth, the information was presented as part of a health fair sponsored by a local television station. According to staff in-