Health plan report cards and insurance choice

This paper examines the relationship between consumers' health plan choices and health plan performance ratings. We make use of an initiative at a large firm to collect, aggregate, and disseminate to employees plan performance ratings. We estimate several statistical models, including share equations--which allow for the presence of important unobserved plan attributes--and logit models. Although report card ratings appear to be related to enrollment choices, the relationship is not uniform. For some dimensions of performance, the results are consistent with the hypothesis that employees respond to the performance ratings. For other dimensions, the ratings seem less influential than other plan attributes that employees likely observed without the data release.