The effect of quality information on consumer health plan switching: Evidence from the Buyers Health Care Action Group

Abraham, Jean M.; Feldman, Roger; Carlin, Caroline; Christianson, Jon B.

doi:10.1016/j.jhealeco.2005.11.004

Cited by 49 publications

(50 citation statements)

References 31 publications

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“…A health plan becomes less attractive when the price increases [14]. In addition, an increase in the availability of CQI makes a health plan more attractive.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Selective Contracting with Positive Incentives on the Choices of Dutch Consumers for Health Care Options: Results of an Experiment

Enzerink¹,

Lako²

2016

Health

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Since the introduction of the Health Insurance Act in the Netherlands in 2006, insurers are incentivized to compete on price for basic health insurance, and on price and quality for supplementary insurance. It is possible for health insurers to implement a differentiated deductible since the first of January 2009. This paper describes an experiment. It is designed to study this differentiated deductible as a financial policy instrument. It focuses on the effect of selective contracting with positive incentives on the choice-behaviour of the insured. The goal of this study is to gain insight in the working mechanism of this financial policy instrument that is meant to reduce healthcare costs. The study is designed as a vignette study. The vignettes are presented in pairs of two to the respondents. The vignettes contain various elements including premium costs, deductible, degree of selective contracting and availability of quality-information (CQI). As the respondents in the design of this choice experiment have to choose between confronting health plans, it is understandable that they value these policies on their characteristics (so-called attributes). Subsequently, a statement can be formulated on the relative value assigned to these attributes by the respondents, clearly preferring one health plan over the other. Finally 99 respondents were included in our study. Logistic regression analysis was performed. This study shows that the deductible as choice-influencing instrument has less influence as age increases. The proclaimed cost savings of this deductible might be lower than expected. Generally, it can be concluded that healthier people are less likely to choose the extensive health plan. However, this effect reverses when the most extensive and less extensive are presented to the participants. The results thus show a clear demarcation in the preferences of consumers. A similar demarcation also has been found in the data concerning travel distance. When contracted care is within 30 minutes, this health plan is preferred over the more extensive and expensive one. However, this study also shows that this effect reverses when the travel distance increases to 45 minutes. Consumers in this situation are reluc-F.-W. Enzerink, C. Lako 774 tant to choose selective care and choose for the extensive and expensive option. Premium costs have a negative effect. A health plan becomes less attractive when the price increases. In addition, an increase in the availability of CQI makes a health plan more attractive. It can be concluded from this study that the deductible as choice-influencing instrument seems to work for young and healthy people, provided that they do not have to travel more that 30 minutes.

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“…A health plan becomes less attractive when the price increases [14]. In addition, an increase in the availability of CQI makes a health plan more attractive.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies suggest that premium costs are decisive in the choice of a health insurer [14]. This might entail several risks.…”

Section: Supply-side Factorsmentioning

confidence: 99%

Effects of Selective Contracting with Positive Incentives on the Choices of Dutch Consumers for Health Care Options: Results of an Experiment

Enzerink¹,

Lako²

2016

Health

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“…After reporting, we assume that high-SES patients respond to the quality reports (N H is a function of Q), an assumption supported by the literature (Abraham, Feldman, Carlin, & Christianson, 2006;Angelelli, Grabowski, & Mor, 2006;Miller & West, 2007). We assume N L is independent of agency quality after reporting, because the same sources have shown that low-SES consumers are not as responsive to quality information.…”

Section: Agencies' Service Area Choicesmentioning

confidence: 99%

Public Reporting and Market Area Exit Decisions by Home Health Agencies

Jung

Feldman

2012

MMRR

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Principal Findings:We found a small and weak effect of public reporting on selective exits: a 10-percent increase in reporting (reporting one more indicator) increased the probability of leaving an area with lesseducated people by 0.3 percentage points, compared with leaving an area with high education. Conclusion:The small level of market-area exits under public reporting is unlikely to be practically meaningful, suggesting that HHC did not lead to a disruption in access to home health care through selective exits during the initial year of the program.

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“…These studies found that more aggressive employer information dissemination was associated with greater awareness, and that females and people at higher education levels were more likely to be aware, as were individuals who Christianson, J., Maeng, D., Abraham, J., et al had a chronic illness (Abraham et al, 2006). However, study participants consisted entirely of employees of large employers in a single metropolitan area.…”

Section: Introductionmentioning

confidence: 99%

“…We were able to locate only two studies in the peer-reviewed literature that examined factors influencing awareness of PQI (Abraham, Feldman, & Carlin, 2004;Abraham, Feldman, Carlin, & Christianson, 2006). These studies found that more aggressive employer information dissemination was associated with greater awareness, and that females and people at higher education levels were more likely to be aware, as were individuals who Christianson, J., Maeng, D., Abraham, J., et al had a chronic illness (Abraham et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

What Influences the Awareness of Physician Quality Information? Implications for Medicare

Christianson¹,

Maeng

Abraham³

et al. 2014

MMRR

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Objective: Examine the factors that are associated with awareness of physician quality information (PQI) among older people with one or more chronic illnesses and the implications for Medicare.Data Sources/Study Setting: Random digit-dial survey of adults with one or more chronic illnesses.Research Design: Structural equation modeling to examine factors related to awareness of PQI.Results: Awareness of PQI is low (13 percent), but comparable to findings in general population surveys. Age, race, education, and self-reported health status are associated with PQI awareness. Trust in the Internet as a source of health care information and not trusting one's physician as a source of information both are associated with a greater likelihood of being aware of PQI. Patients with high levels of activation have greater trust in physicians as information sources, but this is not associated with awareness, nor is degree of satisfaction with their care experience. Conclusions: Awareness of PQI among olderpersons with chronic illnesses is relatively low across all socio-economic and demographic subgroups. Changes in population characteristics over time are unlikely to improve awareness in this population, nor are changes in patient activation or satisfaction with care. Medicare would need a broad-based effort if it wishes to raise PQI awareness among Medicare beneficiaries in the near term. Before undertaking resource-intensive efforts to increase awareness, Medicare may want to consider what level of awareness actually is needed to accomplish the overall objective for PQI transparency, which is raising the quality of care received by beneficiaries. It may be that relatively low levels of awareness are sufficient. Keywords

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The effect of quality information on consumer health plan switching: Evidence from the Buyers Health Care Action Group

Cited by 49 publications

References 31 publications

Effects of Selective Contracting with Positive Incentives on the Choices of Dutch Consumers for Health Care Options: Results of an Experiment

Effects of Selective Contracting with Positive Incentives on the Choices of Dutch Consumers for Health Care Options: Results of an Experiment

Public Reporting and Market Area Exit Decisions by Home Health Agencies

What Influences the Awareness of Physician Quality Information? Implications for Medicare

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