“Choosing Healthplans All Together” (CHAT) is a small group simulation exercise which has been tailored to meet the needs of the public by allowing them to engage in the process of determining health care spending priorities.
Problems and Purpose
"Choosing Healthplans All Together" (CHAT) is a small group simulation exercise designed to give the public a voice in setting health or health care spending priorities. It has been used for research, policy and teaching purposes. The exercise can be tailored and adapted to the needs of the populations/communities. Departments of Insurance in various states in the U.S. have used CHAT to determine public opinion about what should be included in basic health insurance packages for the uninsured. Some U.S. municipalities have used it to assess public priorities for direct service delivery to the uninsured. CHAT has been used in other countries to engage the public in decisions about health or healthcare spending. Current versions include content for Medicare, Medicaid, Health research priorities, and patient-centered outcomes research priorities. Research demonstrates that participants finds CHAT informative, easy to use, and a fair process, and, consistently, over 85% would be willing to abide by the decision reached by their groups. Participants also increase in their understanding of limited resources and necessary tradeoffs.
CHAT has been translated into Spanish, Arabic, French, German, Italian and other languages. Web-based version available in English, Spanish and Arabic.
Origins and Development
How it Works
Analysis and Lessons Learned
 Experience in the United States With Public Deliberation About Health Insurance Benefits Using the Small Group Decision Exercise, CHAT: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691997/
Choosing Healthplans All Together: a deliberative exercise for allocating limited health care resources: https://www.researchgate.net/publication/7451190_Choosing_Healthplans_All_Together_a_deliberative_exercise_for_allocating_limited_health_care_resources
The CHAT Project: Choosing Healthplans All Together: https://www.bioethics.nih.gov/research/chat/chat.pdf [BROKEN LINK]
A decision exercise to engage cancer patients and families in Deliberation about Medicare Coverage for advanced Cancer Care: https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-14-315