Rules to Help Consumers Choose a Health Insurance Plan That Meets Their Needs

Consumer decision support rules for health exchanges

Dates of Project: October 2011 through March 2013

Pacific Business Group on Health, in San Francisco, created “decision support rules” to enable state insurance exchanges to help consumers choose the health plan best suited to their needs.

To develop the rules, researchers enrolled 3,000 participants in 12 experiments, and asked them to make hypothetical choices regarding their health plan.

The researchers published the rules—and evidence supporting them—in Consumer Choice of Health Plan: Decision Support Rules for Health Exchanges, and nine issue briefs.

Key Recommendations

  • To encourage consumers to choose the right plan, health insurance exchanges should:

    • Provide a “cost-at-time-of-care” calculator to give consumers an estimate of a plan’s total cost, based on covered benefits, cost-sharing, expected use of medical services, premium, and any tax credit.
    • Use automatic filters and sorting mechanisms to ensure that the initial display of information shows the plans that best match the consumer’s preferences.
    • Offer a shortcut that allows consumers to quickly view a plan comparison; the user has the option to seek the details or to select a plan.
    • Help consumers find health plans that include their providers or allow them to choose their providers.

“Behavioral economics has shown that with a nudge, you can move people’s decision making around. Exchanges should recognize the power of the nudge.”—Ted von Glahn, MPH, Pacific Business Group on Health