Physician trainees' decision making and information processing: choice size and Medicare Part D

Area of Science:

• Health Policy
• Decision Science
• Medical Education

Background:

• Patients often rely on physicians for guidance when selecting Medicare prescription drug plans.
• The impact of choice set size on clinician decision-making for Medicare Part D plans is not well understood.

Purpose of the Study:

• To investigate how the number of Medicare prescription drug plan choices affects physician trainees' decision processes, strategies, and ability to select the lowest-cost plan.
• To compare the decision-making performance of physician trainees with varying numbers of drug plan options.

Main Methods:

• Seventy medical students and internal medicine residents participated in a within-subject study using Mouselab software.
• Participants evaluated either 3 or 9 Medicare prescription drug plans, with price as the primary decision factor.
• Information acquisition processes, decision strategies, and the accuracy of selecting the lowest-cost plan were analyzed.

Main Results:

• Trainees were significantly more likely to identify the lowest-cost plan when choosing from 3 plans versus 9 (67.3% vs. 32.8%).
• Participants faced with 9 plans paid higher excess premiums ($128.51 vs. $60.00) and spent less time on each attribute.
• After adjustments, trainees were 10.75 times more likely to choose the lowest-cost plan with 3 options compared to 9.

Conclusions:

• Increasing the number of Medicare Part D choices complicates decision-making for physician trainees, similar to older patients.
• Simplifications to the Medicare Part D selection process are necessary.
• Physicians can best assist patients by helping forecast medication needs and directing them to resources like the Medicare website.