Health Plan Choice and Information about Out-of-Pocket Costs: An Experimental Analysis

2001 ◽  
Vol 38 (1) ◽  
pp. 35-48 ◽  
Author(s):  
Michael Schoenbaum ◽  
Mark Spranca ◽  
Marc Elliott ◽  
Jay Bhattacharya ◽  
Pamela Farley Short
Keyword(s):  
Health Care ◽  
Health Plan ◽  
Good Health ◽  
Health Plans ◽  
Support Materials ◽  
Health Plan Choice ◽  
Plan Choice ◽  
Working Age ◽  
Care Costs ◽  
Out Of Pocket Costs

Many consumers are offered two or more employer-sponsored health insurance plans, and competition among health plans for subscribers is promoted as a mechanism for balancing health care costs and quality. Yet consumers may not receive the information necessary to make informed health plan choices. This study tests the effects on health plan choice of providing supplemental decision-support materials to inform consumers about expected health plan costs. Our main finding is that such information induces consumers to bear more risk, especially those in relatively good health. Thus our results suggest that working-age, privately insured consumers currently may be over-insuring for medical care.

Health Plan Choice and the Utilization of Health Care Services

1991 ◽  
Vol 73 (1) ◽  
pp. 85 ◽  
Author(s):  
Bryan Dowd ◽  
Roger Feldman ◽  
Steven Cassou ◽  
Michael Finch
Keyword(s):  
Health Care ◽  
Health Plan ◽  
Health Care Services ◽  
Health Plan Choice ◽  
Care Services ◽  
Plan Choice

Health Finance in Rural Henan: Low Premium Insurance Compared to the Out-of-Pocket System

2005 ◽  
Vol 181 ◽  
pp. 137-157 ◽  
Author(s):  
Sukhan Jackson ◽  
Adrian C. Sleigh ◽  
Li Peng ◽  
Liu Xi-Li
Keyword(s):  
Health Care ◽  
Good Health ◽  
Government Support ◽  
Hospital Charges ◽  
Services Utilization ◽  
Limited Government ◽  
Health Finance ◽  
Rural Services ◽  
Township Hospitals ◽  
Care Costs

China's health reforms of the 1980s led to privatization of rural health care with adverse impact on farmers. A decade later a new rural co-operative medical scheme (RCMS), was piloted throughout many provinces to promote better equity. Although many schemes later collapsed owing to inadequate funding, some continue to the present. This article compares such a scheme with the out-of-pocket system in Henan province. We study the township hospitals, focusing on cost of services, utilization rates and impact of RCMS on hospitals' financial sustainability. Our results derive from monthly hospital records and a survey of four hospitals in two adjacent counties, one county with low-premium RCMS and the other with the out-of-pocket system.All hospitals charged for preventive activities (such as antenatal care, immunization), an unfortunate consequence of limited government support. It was not clear that on average, the total cost of individual patient visits in RCMS hospitals was lower than non-RCMS hospitals. Farmers were generally unaware of their insurance entitlements, except the catastrophic illnesses for which there was a real benefit from refund of US$100 or more. Although the effect of the RCMS on hospital charges was unclear it was notable that the utilization rates in RCMS areas were twice those in non-RCMS.We conclude that RCMS hospitals were better funded because of re-imbursements from the insurance scheme and therefore were more viable as sources of good health care. Thus, health care could become more equitable under RCMS than the out-ofpocket system. China is now beginning to test a revised form of RCMS with pooling at the county level, increased premiums (10 yuan per person) and increased government funding. However, it must be followed closely to determine the effect on rural services and health care costs for farmers.

A model of health plan choice:

1998 ◽  
Vol 89 (1-2) ◽  
pp. 131-157 ◽  
Author(s):  
Katherine M. Harris ◽  
Michael P. Keane
Keyword(s):  
Health Plan ◽  
Health Plan Choice ◽  
Plan Choice

scholarly journals Pricing and Welfare in Health Plan Choice

2008 ◽  
Author(s):  
M. Kate Bundorf ◽  
Jonathan Levin ◽  
Neale Mahoney
Keyword(s):  
Health Plan ◽  
Health Plan Choice ◽  
Plan Choice

scholarly journals Consumer price sensitivity and health plan choice in a regulated competition setting

2018 ◽  
Vol 27 (9) ◽  
pp. 1366-1379
Author(s):  
Tamara Bischof ◽  
Christian P.R. Schmid
Keyword(s):  
Health Plan ◽  
Price Sensitivity ◽  
Health Plan Choice ◽  
Plan Choice ◽  
Regulated Competition

Assessing The Impact Of Health Plan Choice

2001 ◽  
Vol 20 (1) ◽  
pp. 267-275 ◽  
Author(s):  
Barbara Steinberg Schone ◽  
Philip F. Cooper
Keyword(s):  
Health Plan ◽  
Health Plan Choice ◽  
Plan Choice ◽  
The Impact

Retrospective claims analysis of palliative care costs and survival in a U.S. metastatic renal cell (mRCC) population.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 433-433
Author(s):  
Henry J. Henk ◽  
Connie Chen ◽  
Agnes Benedict ◽  
Jane Sullivan ◽  
April Teitelbaum
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Plan ◽  
Index Date ◽  
Claims Data ◽  
Cohort Analysis ◽  
Hospital Costs ◽  
Best Supportive Care ◽  
Study Cohort ◽  
Care Costs

433 Background: Survival and costs outcomes for patients with mRCC receiving palliative or best supportive care (BSC) after stopping active therapy have been poorly characterized. This information is important to understand how resources are utilized at the end of life and to put current treatment costs into perspective. The objective of this retrospective database analysis was to examine survival and costs associated with BSC after receiving 1 or 2 lines of mRCC treatment. Methods: A retrospective cohort analysis using claims data from commercially insured or Medicare Advantage (MCR) enrollees of a large US health plan, with medical and pharmacy benefits. The study cohort consisted of patients with an index diagnosis for RCC [ICD-9-CM 189.0] from 1/1/07 to 6/30/10 initiating any of the following treatments from 30 days prior to index date through disenrollment: sunitinib, temsirolimus, sorafenib, bevacizumab, everolimus, pazopanib, cytokines. Patients were required to have a 6 mos. continuous enrollment ± index date (patients disenrolling due to death within the 6 mos. were retained). Lines of therapy (LOT) were identified based on prescription fill and administration dates, began following the last LOT and continued until disenrollment. Health care costs reported represent the health plan + patient paid amount. Results: The overall study cohort (n=274) was 73% male; mean (±SD) age 63.3 ± 11.1 yr. with the majority of patients commercially insured (80% vs 20% MCR). The majority started BSC following 1st LOT (68% vs 32%). Median survival from start of BSC was similar following 1st and 2nd LOT (126 and 118 days). The mean (median) duration of BSC after 1 LOT was 223 (114) days and 176 (109) days for 2 LOT. Total health care costs incurred during BSC averaged $50,187 ± 96,984 and $37,294 ± 51,101 and monthly costs were similar ($10,284 ± 17979) after 1 and 2 LOT, respectively. In both cases, inpatient hospital costs represented the largest proportion of these costs (47%) while outpatient costs represented 36%. Conclusions: Our study estimating BSC survival and costs in patients with mRCC based on US claims data found monthly cost of $10, 284. These estimates suggest that BSC costs are not insignificant.

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