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A guide to facilitating consumer choice

E W Hoy1, E K Wicks, R A Forland

  • 1Institute for Health Policy Solutions, Washington, DC, USA.

Health Affairs (Project Hope)
|January 1, 1996
PubMed
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Consumer choice models in health insurance can succeed if purchasers standardize benefits, offer limited, vetted plans, provide clear information, and ensure accountability through performance data. This promotes competition and better plan selection.

Area of Science:

  • Health Services Research
  • Health Policy Analysis
  • Consumer Behavior Studies

Background:

  • Purchasers and policymakers are exploring consumer choice models in health insurance.
  • These models aim to improve plan selection and incentivize health plan competition on efficiency, quality, and service.

Purpose of the Study:

  • To review existing consumer-choice models and identify factors for their successful implementation.
  • To determine how to best meet objectives of informed consumer choice and health plan competition.

Main Methods:

  • Review of six distinct consumer-choice models.
  • Analysis of purchaser strategies and their impact on plan selection and competition.

Main Results:

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  • Successful implementation requires purchasers to create a level playing field via standardized benefits and structured enrollment.
  • Offering a limited number of carefully selected plans is crucial.
  • Comprehensive, objective consumer information and educational support are essential.
  • Uniform reporting of performance data is necessary for accountability.

    • Conclusions:

    • Consumer-choice models can achieve their objectives when structured effectively.
    • Key elements include standardization, plan selection criteria, robust consumer information, education, and performance accountability.
    • These strategies foster informed decision-making and drive health plan improvements.