Determinants of coverage decisions in health insurance marketplaces: Consumers' decision-making abilities and the amount of information in their choice environment

Health Services Research

Volumn 50, Issue 1, 2015, Pages 58-80

  Barnes, Andrew J ^a   Hanoch, Yaniv ^b   Rice, Thomas ^c  

^a VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF PLYMOUTH   (United Kingdom)

^c UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

Affordable Care Act; health insurance comprehension; health insurance exchanges marketplaces; insurance choice; numeracy; uninsured

Indexed keywords

ARTICLE; COMPREHENSION; CONSUMER; COST; DECISION MAKING; ENVIRONMENT; HEALTH CARE NEED; HEALTH INSURANCE; HUMAN; LOWEST INCOME GROUP; MEDICALLY UNINSURED; PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY BALLOON; QUESTIONNAIRE; ADULT; COMPARATIVE STUDY; FEMALE; HEALTH CARE POLICY; INFORMATION LITERACY; INSURANCE; INTERNET; MALE; MIDDLE AGED; SOCIAL CLASS; VIRGINIA; YOUNG ADULT;

ADULT; CHOICE BEHAVIOR; CONSUMER PARTICIPATION; DECISION MAKING; FEMALE; HEALTH INSURANCE EXCHANGES; HUMANS; INFORMATION LITERACY; INSURANCE COVERAGE; INSURANCE, HEALTH; INTERNET; MALE; MEDICALLY UNINSURED; MIDDLE AGED; PATIENT PROTECTION AND AFFORDABLE CARE ACT; SOCIAL CLASS; SURVEYS AND QUESTIONNAIRES; VIRGINIA; YOUNG ADULT;

EID: 84921768625     PISSN: 00179124     EISSN: 14756773     Source Type: Journal    
DOI: 10.1111/1475-6773.12181     Document Type: Article

References (47)

1. Abaluck, J.; and, J. Gruber,. 2013. Evolving Choice Inconsistencies in Choice of Prescription Drug Insurance. Working Paper 19163. National Bureau of Economic Research, [accessed on August 7, 2013]. Available at: http://www.nber.org/papers/w19163.
2. Barnes, A.; Y. Hanoch, S. Wood, P. J. Liu, and, T. Rice,. 2012. " One Fish, Two Fish, Red Fish, Blue Fish: Effects of Price Frames, Brand Names, and Choice Set Size in Medicare Part D Insurance Plan Decisions." Medical Care Research and Review 69 (4): 460-73.
3. Blais, A.-R.; and, E. U. Weber,. 2006. " A Domain-Specific Risk-Taking (DOSPERT) Scale for Adult Populations." Judgment and Decision Making 1: 33-47.
4. Bollen, K. A.; and, R. Stine,. 1990. " Direct and Indirect Effects: Classical and Bootstrap Estimates of Variability." Sociological Methodology 20: 115-40.
5. Camerer, C.; and, R. Hogarth,. 1999. " The Effects of Financial Incentives in Experiments: A Review and Capital-Labor-Production Framework." Journal of Risk and Uncertainty 19 (1-3): 7-42.
6. Commonwealth Fund. 2013. " Covering Young Adults under the Affordable Care Act: The Importance of Outreach and Medicaid Expansions " [accessed on August 12, 2013]. Available at http://www.commonwealthfund.org/Publications/Issue-Briefs/2013/Aug/Covering-Young-Adults-Under-the-Affordable-Care-Act.aspx
7. Congressional Budget Office. 2013. " CBO's February 2013 Estimate of the Effects of the Affordable Care Act on Health Insurance Coverage " [accessed on August 20, 2013]. Available at http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900-ACAInsuranceCoverageEffects.pdf
8. Consumers Union. 2011. " Measure Consumers' Health Insurance Literacy " [accessed on August 3, 2013]. Available at http://consumersunion.org/news/measure-consumers-health-insurance-literacy/
9. Finucane, M. L.; C. K. Mertz, P. Slovic, and, E. S. Schmidt,. 2005. " Task Complexity and Older Adults' Decision-Making Competence." Psychology and Aging 20 (1): 71-84.
10. Goodnough, A.; and, A. Chosick,. 2013. " Clinton Urges Americans to Sign Up for Health Care Exchanges " [accessed on September 5, 2013]. Available at http://www.nytimes.com/2013/09/05/us/politics/clinton-urges-americans-to-sign-up-for-health-care-exchanges.html?hp
11. Greenwald, L. M.; L. A. McCormack, J. D. Uhriq, and, N. West,. 2006. " Measures and Predictors of Medicare Knowledge: A Review of the Literature." Health Care Finance and Review 27 (4): 1-12.
12. Hanoch, Y.; T. Rice, J. Cummings, and, S. Wood,. 2009. " How Much Choice Is Too Much?: The Case of the Medicare Prescription Drug Benefit." Health Services Research 44 (4): 1157-68.
13. Hanoch, Y.; S. Wood, A. Barnes, P.-J. Liu, and, T. Rice,. 2011. " Choosing the Right Medicare Prescription Drug Plan: The Effect of Age, Strategy Selection and Choice Set Size." Health Psychology 30 (6): 719-27.
14. Hayes, M.; and, M. Scharkow,. 2013. " The Relative Trustworthiness of Inferential Tests of the Indirect Effect in Statistical Mediation Analysis: Does Method Really Matter? " Psychological Science [accessed on July 20, 2013]. Available at http://pss.sagepub.com/content/early/2013/08/16/0956797613480187
15. Hibbard, J. H.; J. J. Jewett, S. Engelmann, and, M. Tusler,. 1998. " Can Medicare Beneficiaries Make Informed Choices? " Health Affairs 17: 181-93. doi: 10.1377/hlthaff.17.6.181.
16. Hibbard, J. H.; P. Slovic, E. Peters, M. L. Finucane, and, M. Tusler,. 2001. " Is the Informed-Choice Policy Approach Appropriate for Medicare Beneficiaries? " Health Affairs 20: 199-203. doi: 10.1377/hlthaff.20.3.199.
17. Hibbard, J.; E. R. Mahoney, J. Stockard, and, M. Tusler,. 2005. " Development and Testing of a Short Form of the Patient Activation Measure." Health Services Research 40 (6 Part 1): 1918-30.
18. Hibbard, J. H.; E. M. Peters, A. Dixon, and, M. Tusler,. 2007. " Consumer Competencies and the Use of Comparative Quality Information: It Isn't Just About Literacy." Medical Care Research and Review 64: 379-94.
19. Kaiser Family Foundation. 2013. Kaiser Health Tracking Poll [accessed on August 31, 2013]. Available at http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-April-2013/
20. Khwaja, A.; D. Silverman, and, F. A. Sloan,. 2007. " Time Preferences, Time Discounting, and Smoking Decisions." Journal of Health Economics 25 (5): 927-49.
21. Kim, J.; B. Braun, and, A. D. Williams,. 2013. " Understanding Health Insurance Literacy: A Review." Family and Consumer Sciences Research Journal 42 (1): 3-13.
22. Lipkus, I. M.; G. Samsa, and, B. K. Rimer,. 2001. " General Performance on a Numeracy Scale among Highly Educated Samples." Medical Decision Making 21 (1): 37-44.
23. Lockwood, C. M.; and, D. P. MacKinnon,. 1998. " Bootstrapping the Standard Error of the Mediated Effect." Proceedings of the 23rd SAS Users Group International Conference, pp. 997-1002. Cary, NC: SAS Institute.
24. Loewenstein, G. L.; J. Y. Friedman, B. McGill, S. Ahmad, S. Linck, S. Sinkula, J. Beshears, J. J. Choi, J. Kolstad, D. Laibson, B. C. Madrian, J. A. List, and, K. G. Volpp,. 2013. " Consumers' Misunderstanding of Health Insurance." Journal of Health Economics 32: 850-62.
25. Lusardi, A.; and, O. S. Mitchell,. 2011. " Financial Literacy and Planning: Implications for Retirement Wellbeing." NBER Working Paper Number 17078. [accessed on August 22, 2013]. Available at: http://www.nber.org/w17078.
26. MacKinnon, D. P.; and, J. H. Dwyer,. 1993. " Estimating Mediated Effects in Prevention Studies." Evaluation Review 17: 144-58.
27. Mangan, D.; 2013. " Insurance Exchange Deal Signed with Web Insurer Sites." CNBC. [accessed on July 29, 2013]. Available at http://www.cnbc.com/id/100925732
28. Marquis, S. M.; 1983. " Consumers' Knowledge about Their Health Insurance Coverage." Health Care Financing Review 5: 65-80.
29. McCormack, L.; C. Bann, J. Uhrig, N. Berkman, and, R. Rudd,. 2009. " Health Insurance Literacy of Older Adults." Journal of Consumer Affairs 43 (2): 223-48.
30. Mechanic, D.; 1989. " Consumer Choice among Health Insurance Options." Health Affairs 8: 138-48.
31. MedPAC. 2006. Report to Congress: Increasing the Value of Medicare [accessed on September 4, 2013]. Available at http://medpac.gov/publications%5Ccongressional-reports%5CJun06-Ch08.pdf
32. Nease, R. F.; S. G. Frazee, L. Zarin, and, S. B. Miller,. 2013. " Choice Architecture Is a Better Strategy than Engaging Patients to Spur Behavior Change." Health Affairs 32 (2): 242-9.
33. O'Neill, J. E.; and, D. M. O'Neill,. 2009. " Who are the Uninsured? " Washington, DC: Employment Policies Institute [accessed on July 14, 2013]. Available at http://www.epionline.org/studies/oneill-06-2009.pdf
34. Paolacci, G.; C. Chandler, and, P. G. Ipeirotis,. 2010. " Running Experiments on Amazon Mechanical Turk." Judgment and Decision Making 5 (5): 411-9.
35. Peters, E.; L. Meilleur, and, M. K. Tompkins,. 2013. Numeracy and the Affordable Care Act: Opportunities and Challenges. Washington, DC: Institute of Medicine.
36. Peters, E.; J. Hibbard, P. Slovic, and, N. Dieckmann,. 2007. " Numeracy Skill and the Communication, Comprehension, and Use of Risk-Benefit Information." Health Affairs 26: 741-8.
37. Reyna, V.; W. L. Nelson, P. K. Han, and, N. F. Diekman,. 2009. " How Numeracy Influences Risk Comprehension and Medical Decision Making." Psychological Bulletin 135: 943-73.
38. Simon, H. A.; 1955. " A Behavioral Model of Rational Choice." Quarterly Journal of Economics 69: 99-118.
39. StataCorp. 2011. Stata Statistical Software: Release 12. College Station, TX: StataCorp LP.
40. Steinberg, L.; 2008. " A Social Neuroscience Perspective on Adolescent Risk Taking." Developmental Review 28: 78-106.
41. Steinberg, L.; S. Graham, L. O'Brien, J. Woolard, E. Cauffman, and, M. Banich,. 2009. " Age Differences in Future Orientation and Delay Discounting." Child Development 80: 28-44.
42. Szrek, H.; and, M. K. Bundorf,. 2011. " Age and the Purchase of Prescription Drug Insurance by Older Adults." Psychology and Aging 26: 308-20.
43. Szrek, H.; and, M. K. Bundorf,. 2013. " Enrollment in Prescription Drug Insurance: The Interaction of Numeracy and Choice Set Size." Health Psychology doi: 10.1037/a0032738. [Epub ahead of print].
44. U.S. Department of Health and Human Services. 2009. Medical Expenditures Panel Survey. [accessed November 13, 2012]. Available at http://meps.ahrq.gov/mepsweb/data-stats/quick-tables-results.jsp?component=1&subcomponent=0&tableSeries=1&year=-1&SearchMethod=1&Action=Search
45. Ware, J. E.; M. Kosinski, M. S. Bayliss, C. A. McHorney, W. H. Rogers, and, A. Reczek,. 1995. " Comparison of Methods for the Scoring and Statistical Analysis of SF-36 Health Profile and Summary Measures: Summary of Results from the Medical Outcomes Study." Medical Care 33 (4): 264-79.
46. Wood, S.; Y. Hanoch, A. Barnes, P. J. Liu, J. Cummings, C. Bhattacharya, and, T. Rice,. 2011. " Numeracy and Medicare Part D: The Importance of Choice and Literacy for Numbers in Optimizing Decision Making for Medicare's Prescription Drug Program." Psychology and Aging 26 (2): 295-307.
47. Zhou, C.; and, Y. Zhang,. 2012. " The Vast Majority of Medicare Part D Beneficiaries Still Don't Choose the Cheapest Plans that Meet Their Medication Needs." Health Affairs 31: 2259-64.