Background and objectives. Increasing emphasis is being place on greater consumer involvement in health care, but there is little understanding of what this new role entails. This research (1) explores the concept of consumer involvement in health care in the medical literature; (2) assesses the extent to which Medicare beneficiaries engage in selected behaviors related to involvement in care; and (3) examines the relationships of the selected measures of consumer involvement to utilization and costs in Medicare.

Methods. Data is from the 2001–2004 Access to Care files of the Medicare Current Beneficiary Survey. The behaviors examined in this research are reported likelihood of switching doctors if dissatisfied with communication, likelihood of expressing disagreement with a doctor, and frequency of reading about health conditions in newspapers, magazines, or on the Internet. The relationships of these behaviors to population characteristics and to utilization and costs are assessed using a single year of data. The relationship of health-information-seeking over time to population characteristics and to utilization outcomes are examined using all four years of data.

Results. A substantial proportion (42–58%) of Medicare beneficiaries report engaging in the behaviors included in this research; engagement was consistently associated with younger age, White race, higher education levels, geographic region, and often associated with female gender, higher income levels, better health status and physical functioning, and tobacco use. In analyses of health information-seeking using four years of data, reporting frequent reading about health conditions was associated with greater use of non-urgent and preventive services and higher cost to Medicare.

Conclusions. Medicare beneficiaries reported engaging in certain behaviors related to consumer involvement in health care. Some groups, however, were less likely to do so, including older, less well-educated and less healthy beneficiaries. Analyses using a single year of data failed to show significant relationships between the reported behaviors and utilization and cost outcomes, although some trends were identified. In analyses using four years of data, frequent health information-seeking was associated with the greater use of non-urgent (e.g., doctor's visits) and preventive services (e.g., mammograms). More research is needed to understand the impact of greater consumer involvement in care.