Comparing The Effects Of Nudges And Automatic Plan Switching On Choice Errors Among Low-Income Marketplace Enrollees.

During the 2022 open enrollment period in California's Affordable Care Act Marketplace, we tested two interventions designed to reduce choice errors among low-income households enrolled in bronze plans that were eligible for zero-premium cost-sharing reduction (CSR) silver plans with more generous b...

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Publicado en:Health Affairs Vol. 42; no. 7; pp. 1002 - 1011
Autores principales: Wolf, Emory, Feher, Andrew, Ravel, Katie, Menashe, Isaac
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Health Affairs Publishing, LLC Jul2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2023
      vid: 42
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      pub: Health Affairs Publishing, LLC
      place: Washington, District of Columbia
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        10.1377/hlthaff.2022.01672
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        atl: Comparing The Effects Of Nudges And Automatic Plan Switching On Choice Errors Among Low-Income Marketplace Enrollees.
      aug:
        au:
          Wolf, Emory
          Feher, Andrew
          Ravel, Katie
          Menashe, Isaac
        affil: Covered California, Sacramento, California
      sug:
        subj:
          Poverty California
          Medicare California
          Socioeconomic Factors California
          Health Insurance Exchanges California
          Decision Making California
          Human
          Income
          Health Care Costs
          Health Services Accessibility
          Cost Savings
          Descriptive Statistics
          Pretest-Posttest Control Group Design
          Comparative Studies
          Health Policy
          Randomized Controlled Trials
          Random Assignment
          Quasi-Experimental Studies
          Writing
          Email
          Insurance, Health Economics
          California
          Multivariate Analysis
          Linear Regression
          Data Analysis Software
      ab: During the 2022 open enrollment period in California's Affordable Care Act Marketplace, we tested two interventions designed to reduce choice errors among low-income households enrolled in bronze plans that were eligible for zero-premium cost-sharing reduction (CSR) silver plans with more generous benefits. A randomized controlled trial nudge intervention used letter and email reminders to encourage consumers to switch plans, and a quasi-experimental crosswalk intervention automatically enrolled eligible households from bronze plans into zero-premium CSR silver plans with the same insurers and provider networks. The nudge intervention led to a statistically significant 2.3-percentage-point (26 percent) increase in CSR silver plan take-up relative to the control group, but nearly 90 percent of households remained in nonsilver plans. The automatic crosswalk intervention resulted in an 83.0-percentage-point (822 percent) increase in CSR silver plan take-up compared with the control group, with more than 90 percent of households enrolled in CSR silver plans. Our findings can inform health policy debates on the relative effectiveness of different approaches to reducing choice errors among low-income households in the Affordable Care Act Marketplaces.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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