The way insurers present cost and quality information, along with the use of decision support tools on state and federal healthcare exchanges, strongly influence the way consumers select an optimal health plan.
According to a study published in this month's Health Affairs, consumers are much more likely to select a high-value plan with a moderate price point and high quality ratings when cost information is distilled into monthly premiums and estimated total cost, rather than a detailed summary that includes annual deductibles, out-of-pocket maximums and primary copays. Customers who viewed a detailed summary of costs also took longer to select a plan and had less confidence that it was the right choice.
The placement and labeling of quality star ratings was equally important. Researchers found that just 24 percent of respondents understood that star ratings referred to the quality of medical care. Labeling star ratings "doctor quality" led to improved comprehension, and subsequently led more participants to select a high-value plan. Additionally, placing star ratings adjacent to cost data and marking high-value plans with a check mark or ribbon had a similar impact.
A second study, also published in Health Affairs, found that decision support tools, such as cost estimators and provider lookups, were a key factor in allowing consumers to select a satisfactory plan on state and federal health exchanges. Researchers found that although none of the marketplaces offered total cost estimators during the first enrollment period in 2013, five marketplaces offered the tool this year, including Healthcare.gov. Eight of the 14 marketplaces researchers reviewed had providers lookups, compared to three in the first enrollment period. Both tools were helpful as consumers transitioned from "window shopping" for plans to "real shopping," according to researchers.
Although the majority of healthcare plans have integrated price transparency into their enrollment process, consumers have expressed frustration with the accuracy of cost estimators, Some insurers have even offered financial incentives to consumers that use cost estimator tools when selecting plans. Over the past several years, researchers have shown consumers seek out Medicare Advantage plans based on high star ratings.
To learn more:
- read the Health Affairs study on cost and quality information
- here's the Health Affairs study on decision support tools
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