Policy Examples

  • Although the ACA imposed requirements for qualified health plans to make provider network information transparent, many directories have inaccurate information. source & source

Outcome Evidence

  • Medicare publishes a plan finder tool to support consumers with decision making. The tool has helped consumers save on annual health care spending, such as annual premiums and drug spending. A new version of the plan finder tool from CMS was released in August of 2019. source & source
  • According to a 2017 study from the Medical Care and Research Review, prior Medicaid enrollees and the uninsured are more likely to have multiple shopping challenges (e.g., difficulty identifying the best or most affordable plan, fair/poor experience, unmet need for help) than enrollees with prior employer coverage (42.9% vs. 32.5% vs. 16.4%, respectively). source
  • Reported in a 2017 Commonwealth Fund article, several marketplace officials stated total cost estimators were a “critical” component of the enrollment process. source
  • A 2009 Medical Care and Research Review article reported on studies that focus on what consumers value, either through revealed preference or survey, have found that information on access to specific doctors, cost, quality, provider communication, and administrative burden are valuable. source
  • A 2016 report published by Anthem found that consumers may not prioritize health plan quality relative to other competing factors, such as the size of the network, keeping their provider, or availability of medication on drug formularies. source
  • Conveying information on plan quality to consumers is difficult, according to 2016 Rand Corporation Research. Consumers are not familiar with quality metrics and many believe that is part of the issue. source

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