Evidence map›Paper›PMID 29845467›Full record

ArticleJournal of general internal medicine2018

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

Charlene A Wong, Sajal Kulhari, Ellen J McGeoch, Arthur T Jones, Janet Weiner, Daniel Polsky, Tom Baker

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. The application of artificial intelligence in health financing: a scoping review.Cost effectiveness and resource allocation : C/E · 2023
    Article
  2. Article
  3. Article
  4. Article
  5. High Deductible Health Plans and Use of Free Preventive Services Under the Affordable Care Act.Inquiry : a journal of medical care organization, provision and financing
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Charlene A WongDepartment of Pediatrics, Margolis Center for Health Policy, Duke Clinical Research Institute, Duke University, 100 Fuqua Drive, Box 90120, Durham, NC, 27708-0120, USA. charlene.wong@duke.edu.
Sajal KulhariLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
Ellen J McGeochLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
Arthur T JonesLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
Janet WeinerLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
Daniel PolskyLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
Tom BakerLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.

Funding

Financial and Social Behavioral Economic Incentives to Increase Physical Activity in Adolescents and Young Adults for Cardiovascular HealthK23HL141689 · NHLBI · DUKE UNIVERSITY · PI WONG, CHARLENE · 2018 to 2019
$245k
NHLBI NIH HHS K23 HL141689
6 · The paper itself

Abstract

backgroundThe design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices.

objectiveTo 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.

designIn 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).

participantsPublic (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.

resultsNearly 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).

conclusionsThe 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.

Indexed as

CommerceDecision Support TechniquesHealth Insurance ExchangesHumansInsurance, HealthPatient Protection and Affordable Care ActUnited StatesAffordable Care Actconsumerismdecision supporthealth insurancehealth insurance marketplace

Identifiers

PMID29845467
PMCPMC6082189

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.