Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation.

Background: The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices.Objective: To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online...

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Publicado en:JGIM: Journal of General Internal Medicine Vol. 33; no. 8; pp. 1400 - 1411
Autores principales: Wong, Charlene A., Kulhari, Sajal, McGeoch, Ellen J., Jones, Arthur T., Weiner, Janet, Polsky, Daniel, Baker, Tom
Formato: research tables/charts Journal Article
Publicado: Springer Nature Aug2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2018
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      pub: Springer Nature
      place: New York, New York
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        atl: Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation.
      aug:
        au:
          Wong, Charlene A.
          Kulhari, Sajal
          McGeoch, Ellen J.
          Jones, Arthur T.
          Weiner, Janet
          Polsky, Daniel
          Baker, Tom
        affil: Department of Pediatrics, Margolis Center for Health Policy, Duke Clinical Research Institute, Duke University, 100 Fuqua Drive, Box 90120, 27708-0120, Durham, NC, USA
      sug:
        subj:
          Insurance, Health Economics
          Health Insurance Exchanges Standards
          Decision Support Techniques
          Business
          United States
          Patient Protection and Affordable Care Act
          Human
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Personal Resource Questionnaire
          Funding Source
      ab: Background: The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices.Objective: To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison.Design: In November-December 2016, we examined the public and private online health insurance exchanges. We navigated each site for "real-shopping" (personal information required) and "window-shopping" (no required personal information).Participants: Public (n = 13; 12 state-based marketplaces and HealthCare.gov ) and private (n = 23) online health insurance exchanges.Main Measures: Features included consumer decision aids (e.g., total cost estimators, provider lookups) and plan display (e.g., order of plans). We examined private health insurance exchanges for notable features (i.e., those not found on public exchanges) and compared the total cost estimates on public versus private exchanges for a standardized consumer.Results: Nearly all studied consumer decision aids saw increased deployment in the public marketplaces in OEP4 compared to OEP3. Over half of the public exchanges (n = 7 of 13) had total cost estimators (versus 5 of 14 in OEP3) in window-shopping and integrated provider lookups (window-shopping: 7; real-shopping: 8). The most common default plan orders were by premium or total cost estimate. Notable features on private health insurance exchanges were unique data presentation (e.g., infographics) and further personalized shopping (e.g., recommended plan flags). Health plan total cost estimates varied substantially between the public and private exchanges (average difference $1526).Conclusions: The ACA's public health insurance exchanges offered more tools in OEP4 to help consumers select a plan. While private health insurance exchanges presented notable features, the total cost estimates for a standardized consumer varied widely on public versus private exchanges.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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