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Evaluating healthcare options tools examined

Monday, July 9, 2012

New Consumers Union Report Examines Consumer Tools for Evaluating Healthcare Options

WASHINGTON, DC – With the establishment of state and federal health insurance exchanges in 2014, consumers will have access to new web-based tools as they select the best insurance plan for their family. To help inform the development of these new web tools, a new study sponsored by Consumers Union, the policy and advocacy division of Consumer Reports, examined popular health plan chooser tools to identify the key design elements that influence consumer health plan selections. The report comes as state-based health exchanges are developed and implemented across the country.

The study emphasized the design process behind the initial set of health plan options displayed, or the default options that consumers see. More often than not, consumers make their decisions based on the default summary without customizing their search results, making that initial default setting that much more important. These design decisions can be thought of as the “choice architecture”– the context in which consumers make their decisions. The study finds that this choice architecture profoundly influences the ultimate health plan selection made by consumers.

“The default display of information radically affects consumers’ shopping experiences because once they see the default, they use that information as a baseline,” said Lynn Quincy, senior policy analyst for Consumers Union. “What consumers see first will frame their understanding of the rest of information. But they won’t always know what they aren’t seeing, which is why the design of these health plan chooser tools is so important.”
Key findings:
· Recognize the importance of choice architecture. Being conscious of how the display of information influences consumers’ health plan selection is important for those responsible designing such tools in the future.
· Define the overall goal of the site upfront. Site design must reflect the overarching goals for the consumer experience as well as a guiding philosophy about “what matters most” to consumers.
· Special attention should be paid to the initial search results screen. This default display of results immediately begins influencing the consumer’s purchasing decision.
· Cost is a critical factor in health plan choice and should be carefully considered by site designers. Consumers readily understand their premium cost but they struggle to understand what they might have to pay out-of-pocket given the myriad health plan provisions that affect this estimate. A majority of tools in this study provide estimates of out-of-pocket costs to help consumers.
· Presenting consolidated provider information is an important challenge. All key informants noted that aggregating information about whether a doctor participates in the plan is difficult due to challenges in collecting/consolidating provider information from disparate sources and normalizing so that it can be used on the site. Carrier relationships and cooperation are critical to creating these directories.
Quincy said, “While there is no one right way to design these tools, these are important issues that designers need to address as exchanges are developed in order for consumers to get the most out of them. Choice architecture not only sets the stage for a decision, it also influences the consumer’s final decision.”
The study used a review of web-based tools and structured interviews with designers to examine the choice architecture in leading health plan chooser tools. The tools included eHealthInsurance, Consumers’ Checkbook, PBGH/CALPERS, the Massachusetts Connector, Medicare Plan Chooser and a new design called Enroll User Experience 2014. The research was conducted by the Kleimann Communication Group, a qualitative research firm specializing in clear consumer communications.
The full version of “Choice Architecture: Design Decisions that Affect Consumers’ Health Plan Choices” is available by clicking here or at http://www.consumersunion.org/pdf/Choice_Architecture_Report.pdf.
Contact: David Butler or Kara Kelber, 202-462-6262