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Insights from behavioral economics for policymakers of choice‐based health insurance markets: A scoping review

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  • Sai Krishnan S.
  • Subramanian S. Iyer
  • Sai Balaji SMR
Abstract
This article uses the systematic scoping review method to summarize literature at the interface of behavioral economics and health insurance. We aim to offer policymakers of choice‐based health insurance markets an understanding of (a) behavioral factors that affect consumer decision‐making in health insurance markets and (b) behavioral interventions that can be used to help consumers make better health insurance decisions. In the process, we reviewed 80 studies from extant literature and found that 18 behavioral factors negatively impact three major aspects of consumer decision‐making: that is, purchasing, quality of plan choice, and switching. We also identify 17 behavioral interventions that policymakers could use to help consumers make better health insurance decisions. However, while using the findings of the field, policymakers must keep in mind that there are limitations to the generalizability of the findings coupled with limitations that behavioral economics comes along with. Based on this study, future research could focus on identifying the segments of the populous that are more likely to be affected by the behavioral factors, and what behavioral interventions can be used to help them. Future research is also needed in settings other than WEIRD (Western, Educated, Industrialized, Rich, and Democratic) nations for the benefit of policymakers of non‐WEIRD nations.

Suggested Citation

  • Sai Krishnan S. & Subramanian S. Iyer & Sai Balaji SMR, 2022. "Insights from behavioral economics for policymakers of choice‐based health insurance markets: A scoping review," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 25(2), pages 115-143, June.
  • Handle: RePEc:bla:rmgtin:v:25:y:2022:i:2:p:115-143
    DOI: 10.1111/rmir.12205
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    as
    1. Kate Ho & Joseph Hogan & Fiona Scott Morton, 2017. "The impact of consumer inattention on insurer pricing in the Medicare Part D program," RAND Journal of Economics, RAND Corporation, vol. 48(4), pages 877-905, December.
    2. repec:mpr:mprres:7375 is not listed on IDEAS
    3. Conor Keegan & Conor Teljeur & Brian Turner & Steve Thomas, 2019. "Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys," International Journal of Health Economics and Management, Springer, vol. 19(1), pages 15-32, March.
    4. Afendulis, Christopher C. & Sinaiko, Anna D. & Frank, Richard G., 2015. "Dominated choices and Medicare Advantage enrollment," Journal of Economic Behavior & Organization, Elsevier, vol. 119(C), pages 72-83.
    5. Marton, James & Yelowitz, Aaron & Talbert, Jeffery C., 2017. "Medicaid program choice, inertia and adverse selection," Journal of Health Economics, Elsevier, vol. 56(C), pages 292-316.
    6. Eric J Johnson & Ran Hassin & Tom Baker & Allison T Bajger & Galen Treuer, 2013. "Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-6, December.
    7. Fuchs, Victor R., 2000. "The future of health economics1," Journal of Health Economics, Elsevier, vol. 19(2), pages 141-157, March.
    8. Jason Abaluck & Jonathan Gruber, 2011. "Choice Inconsistencies among the Elderly: Evidence from Plan Choice in the Medicare Part D Program," American Economic Review, American Economic Association, vol. 101(4), pages 1180-1210, June.
    9. repec:cup:judgdm:v:4:y:2009:i:1:p:92-101 is not listed on IDEAS
    10. Kaufmann, Cornel & Müller, Tobias & Hefti, Andreas & Boes, Stefan, 2018. "Does personalized information improve health plan choices when individuals are distracted?," Journal of Economic Behavior & Organization, Elsevier, vol. 149(C), pages 197-214.
    11. Sinaiko, Anna D. & Hirth, Richard A., 2011. "Consumers, health insurance and dominated choices," Journal of Health Economics, Elsevier, vol. 30(2), pages 450-457, March.
    12. Jeffrey Liebman & Richard Zeckhauser, 2008. "Simple Humans, Complex Insurance, Subtle Subsidies," NBER Working Papers 14330, National Bureau of Economic Research, Inc.
    13. Kunreuther,Howard C. & Pauly,Mark V. & McMorrow,Stacey, 2013. "Insurance and Behavioral Economics," Cambridge Books, Cambridge University Press, number 9780521608268, September.
    14. Benjamin R. Handel & Jonathan T. Kolstad, 2015. "Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare," American Economic Review, American Economic Association, vol. 105(8), pages 2449-2500, August.
    15. Keith Marzilli Ericson & Judd B. Kessler, 2013. "The Articulation Effect of Government Policy: Health Insurance Mandates Versus Taxes," NBER Working Papers 18913, National Bureau of Economic Research, Inc.
    16. Markus Fels, 2020. "Mental Accounting, Access Motives, and Overinsurance," Scandinavian Journal of Economics, Wiley Blackwell, vol. 122(2), pages 675-701, April.
    17. Joseph Henrich & Steve J. Heine & Ara Norenzayan, 2010. "The Weirdest People in the World?," RatSWD Working Papers 139, German Data Forum (RatSWD).
    18. Tibor Besedeš & Cary Deck & Sudipta Sarangi & Mikhael Shor, 2012. "Age Effects and Heuristics in Decision Making," The Review of Economics and Statistics, MIT Press, vol. 94(2), pages 580-595, May.
    19. repec:zbw:rwirep:0537 is not listed on IDEAS
    20. Ericson, Keith M. Marzilli & Starc, Amanda, 2016. "How product standardization affects choice: Evidence from the Massachusetts Health Insurance Exchange," Journal of Health Economics, Elsevier, vol. 50(C), pages 71-85.
    21. Johnson, Eric J & Hershey, John & Meszaros, Jacqueline & Kunreuther, Howard, 1993. "Framing, Probability Distortions, and Insurance Decisions," Journal of Risk and Uncertainty, Springer, vol. 7(1), pages 35-51, August.
    22. Frank, Richard G. & Lamiraud, Karine, 2009. "Choice, price competition and complexity in markets for health insurance," Journal of Economic Behavior & Organization, Elsevier, vol. 71(2), pages 550-562, August.
    23. Jeffrey R. Kling & Sendhil Mullainathan & Eldar Shafir & Lee C. Vermeulen & Marian V. Wrobel, 2012. "Comparison Friction: Experimental Evidence from Medicare Drug Plans," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(1), pages 199-235.
    24. Rice, Thomas & Hanoch, Yaniv & Cummings, Janet, 2010. "What factors influence seniors’ desire for choice among health insurance options? Survey results on the Medicare prescription drug benefit," Health Economics, Policy and Law, Cambridge University Press, vol. 5(4), pages 437-457, October.
    25. Kairies-Schwarz, Nadja & Kokot, Johanna & Vomhof, Markus & Wessling, Jens, 2014. "How Do Consumers Choose Health Insurance? – An Experiment on Heterogeneity in Attribute Tastes and Risk Preferences," Ruhr Economic Papers 537, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    26. Richard H. Thaler, 2017. "Behavioral Economics," Journal of Political Economy, University of Chicago Press, vol. 125(6), pages 1799-1805.
    27. Tom Y Chang & Wei Huang & Yongxiang Wang, 2018. "Something in the Air: Pollution and the Demand for Health Insurance," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 85(3), pages 1609-1634.
    28. Huang, Wei & Luo, Mi, 2015. "Overconfidence and Health Insurance Participation among the Elderly," IZA Discussion Papers 9481, Institute of Labor Economics (IZA).
    29. Daniel Kahneman, 2003. "Maps of Bounded Rationality: Psychology for Behavioral Economics," American Economic Review, American Economic Association, vol. 93(5), pages 1449-1475, December.
    30. Kunreuther,Howard C. & Pauly,Mark V. & McMorrow,Stacey, 2013. "Insurance and Behavioral Economics," Cambridge Books, Cambridge University Press, number 9780521845724, September.
    31. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    32. Richard Domurat & Isaac Menashe & Wesley Yin, 2019. "The Role of Behavioral Frictions in Health Insurance Marketplace Enrollment and Risk: Evidence from a Field Experiment," NBER Working Papers 26153, National Bureau of Economic Research, Inc.
    33. Anna D. Sinaiko & Christopher C. Afendulis & Richard G. Frank, 2013. "Enrollment in Medicare Advantage Plans in Miami-Dade County: Evidence of Status Quo Bias?," NBER Working Papers 19639, National Bureau of Economic Research, Inc.
    34. Benjamin R. Handel, 2013. "Adverse Selection and Inertia in Health Insurance Markets: When Nudging Hurts," American Economic Review, American Economic Association, vol. 103(7), pages 2643-2682, December.
    35. Hendrik Schmitz & Nicolas R. Ziebarth, 2017. "Does Price Framing Affect the Consumer Price Sensitivity of Health Plan Choice?," Journal of Human Resources, University of Wisconsin Press, vol. 52(1), pages 88-127.
    36. Miriam Krieger & Stefan Felder, 2013. "Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice," IJERPH, MDPI, vol. 10(6), pages 1-18, June.
    37. repec:lmu:muenar:19881 is not listed on IDEAS
    38. Andrew J Barnes & Yaniv Hanoch & Thomas Rice, 2016. "Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-19, March.
    39. Florian Heiss & Daniel McFadden & Joachim Winter & Amelie Wuppermann & Bo Zhou, 2016. "Inattention and Switching Costs as Sources of Inertia in Medicare Part D," NBER Working Papers 22765, National Bureau of Economic Research, Inc.
    40. K. P. M. Winssen & R. C. Kleef & W. P. M. M. Ven, 2016. "Potential determinants of deductible uptake in health insurance: How to increase uptake in The Netherlands?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(9), pages 1059-1072, December.
    41. Andreas Richter & Jochen Ruß & Stefan Schelling, 2019. "Insurance customer behavior: Lessons from behavioral economics," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 22(2), pages 183-205, July.
    42. Nyman, John A., 1999. "The value of health insurance: the access motive," Journal of Health Economics, Elsevier, vol. 18(2), pages 141-152, April.
    43. Jonathan D. Ketcham & Nicolai V. Kuminoff & Christopher A. Powers, 2019. "Estimating The Heterogeneous Welfare Effects Of Choice Architecture," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 60(3), pages 1171-1208, August.
    44. Maria Kaneva & Christopher J. Gerry & Nikolay Avxentiev & Valerii Baidin, 2019. "Attitudes to reform: Could a cooperative health insurance scheme work in Russia?," International Journal of Health Economics and Management, Springer, vol. 19(3), pages 371-394, December.
    45. M. Kate Bundorf & Helena Szrek, 2010. "Choice Set Size and Decision Making: The Case of Medicare Part D Prescription Drug Plans," Medical Decision Making, , vol. 30(5), pages 582-593, September.
    46. Wuppermann, Amelie C. & Bauhoff, Sebastian & Grabka, Markus M., 2014. "The Price Sensitivity of Health Plan Choice: Evidence from Retirees in the German Social Health Insurance," Discussion Papers in Economics 21080, University of Munich, Department of Economics.
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    2. Quiroga Gutierrez, Ana Cecilia, 2024. "Picture this: Making health insurance choices easier for those who need it," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 111(C).

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