Do consumer reports of health plan quality affect health plan selection?
OBJECTIVE
To learn whether consumer reports of health plan quality can affect health plan selection.


METHODS
A sample of 311 privately insured adults from Los Angeles County.


METHODS
The design was a fractional factorial experiment. Consumers reviewed materials on four hypothetical health plans and selected one. The health plans varied as to cost, coverage, type of plan, ability to keep one's doctor, and quality, as measured by the Consumer Assessment of Health Plans Study (CAHPS) survey.


METHODS
We used multinomial logistic regression to model each consumer's choice among health plans.


RESULTS
In the absence of CAHPS information, 86 percent of consumers preferred plans that covered more services, even though they cost more. When CAHPS information was provided, consumers shifted to less expensive plans covering fewer services if CAHPS ratings identified those plans as higher quality (59 percent of consumers preferred plans covering more services). Consumer choices were unaffected when CAHPS ratings identified the more expensive plans covering more services as higher quality (89 percent of consumers preferred plans covering more services).


CONCLUSIONS
This study establishes that, under certain realistic conditions, CAHPS ratings could affect consumer selection of health plans and ultimately contain costs. Other studies are needed to learn how to enhance exposure and use of CAHPS information in the real world as well as to identify other conditions in which CAHPS ratings could make a difference.
Spranca
M
M
RAND Health, Santa Monica, CA 90407-2138, USA.
Kanouse
D E
DE
Elliott
M
M
Short
P F
PF
Farley
D O
DO
Hays
R D
RD
D000293:Adolescent; D000328:Adult; D002755:Choice Behavior; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D003363:Cost Control; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007255:Information Services / Q000592:standards*; D007348:Insurance, Health / Q000145:classification / Q000592:standards*; D016015:Logistic Models; D015141:Los Angeles; D008297:Male; D008389:Marketing of Health Services; D008875:Middle Aged; D008960:Models, Psychological; D011795:Surveys and Questionnaires; D014481:United States; D016270:United States Agency for Healthcare Research and Quality