4.5 Article

More intelligent designs: Comparing the effectiveness of choice architectures in US health insurance marketplaces

Journal

Publisher

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.obhdp.2019.02.002

Keywords

Health insurance; Health reform; Behavioral economics; Consumer choice

Funding

  1. Robert Wood Johnson Foundation
  2. Urban Institute

Ask authors/readers for more resources

This study found that sorting health plans by total expected costs in ACA marketplaces led to the greatest improvements for more vulnerable consumers, such as those with worse health or lower literacy levels. Highlighting total expected costs when sorting plans can improve plan choices, potentially saving money for consumers and the government.
We examine the effectiveness of alternate choice architectures for health plan choice in US marketplaces under the Affordable Care Act (ACA) using three experiments based on the Health Reform Monitoring Survey: two experiments tested how choice architectures used in presenting information on health plans influenced plan choices and how existing designs could be improved; the third experiment checked the robustness of the choice architecture effects to more naturalistic choice scenarios in which consumers select plans when future medical spending is uncertain. More vulnerable consumers (e.g., worse health, lower literacy) experienced the largest relative improvements when ACA marketplace plans were displayed and sorted by total expected costs for the year rather than premiums (Experiment 1). The benefits of sorting plans by total expected costs was not improved further by making the importance of total expected costs more salient or by providing just-in-time education about such costs (Experiment 2). However, just-in-time education increased the likelihood consumers did not choose a plan, suggesting they may be in the process of updating their plan selection strategy given the new information. Broadly, these results were consistent across alternative scenarios where total expected costs were subject to uncertainty and consistent with expected patterns of consumer behavior under risk aversion (Experiment 3). Thus, a policy-feasible mechanism?sorting health plan options by and highlighting total expected costs?may improve health plan choices, saving money for consumers and the government.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.5
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available