Models of health plan choice

This paper considers alternative approaches to accounting for consumer heterogeneity in econometric models of health plan choice. In particular, we compare and contrast approaches used by health economists and marketing researchers to explicitly allow for consumer heterogeneity in assessment of plan provider quality and characteristics. As a result, we are able to identify conditions under which approaches utilized by health economists are preferred over those utilized by marketing researchers, and vice versa. For example, we find that in the absence of data on prior year choice, which is often the case of models estimated in the health economics literature, it would be valuable to estimate random coefficient models, which have not been estimated in such works. And, in the presence of data on prior year choice, which is often the case of models estimated in the marketing literature, a model wherein consumer characteristics simply interact with plan specific constants and premium, and which has not been estimated in that literature, offers better fits than random coefficient, semi-parametric random coefficient, and latent class models which have been previously estimated in that literature. The model offers important managerial insights useful for targeting benefits of various plans to different customer segments.

[1]  Sarah J. Reber,et al.  Paying for Health Insurance: The Tradeoff between Competition and Adverse Selection , 1996 .

[2]  Füsun F. Gönül,et al.  Modeling Multiple Sources of Heterogeneity in Multinomial Logit Models: Methodological and Managerial Issues , 1993 .

[3]  S. H. Long,et al.  Employee Premiums, Availability of Alternative Plans, and HMO Disenrollment , 1988, Medical care.

[4]  Steven P. Cassou,et al.  The Demand for Employment-Based Health Insurance Plans , 1989 .

[5]  William Samuelson,et al.  Status quo bias in decision making , 1988 .

[6]  Selection and the competitive standing of health plans in a multiple-choice, multiple-insurer market. , 1985, Advances in health economics and health services research.

[7]  J. M. Jones,et al.  Removing Heterogeneity Bias from Logit Model Estimation , 1988 .

[8]  Martin R. Holmer,et al.  Tax policy and the demand for health insurance. , 1984, Journal of health economics.

[9]  A. K. Taylor,et al.  Premiums, benefits, and employee choice of health insurance options. , 1989, Journal of health economics.

[10]  T. Mcguire Price and Membership in a Prepaid Group Medical Practice , 1981, Medical care.

[11]  Sunil Gupta Impact of Sales Promotions on when, what, and how Much to Buy , 1988 .

[12]  M. Keane Modeling Heterogeneity and State Dependence in Consumer Choice Behavior , 1997 .

[13]  T. Buchmueller,et al.  The effect of price on switching among health plans. , 1997, Journal of health economics.

[14]  J. Lave,et al.  An analysis of the choice of health benefits plans. , 1980, Inquiry : a journal of medical care organization, provision and financing.

[15]  Greg M. Allenby Hypothesis Testing with Scanner Data: The Advantage of Bayesian Methods , 1990 .

[16]  D. McFadden Conditional logit analysis of qualitative choice behavior , 1972 .

[17]  O. Mitchell,et al.  Workers' Preferences among Company-Provided Health Insurance Plans , 1994 .

[18]  Imran S. Currim,et al.  Using Segmentation Approaches for Better Prediction and Understanding from Consumer Mode Choice Models , 1981 .

[19]  Donald G. Morrison,et al.  Making the Cut: Modeling and Analyzing Choice Set Restriction in Scanner Panel Data , 1995 .

[20]  Imran S. Currim Predictive Testing of Consumer Choice Models Not Subject to Independence of Irrelevant Alternatives , 1982 .

[21]  Peter S. Fader,et al.  Accounting for Heterogeneity and Nonstationarity in a Cross-Sectional Model of Consumer Purchase Behavior , 1993 .

[22]  R. Zeckhauser,et al.  Persistence in the choice of health plans. , 1985, Advances in health economics and health services research.

[23]  D. Bartholomew Latent Variable Models And Factor Analysis , 1987 .

[24]  Gary J. Russell,et al.  A Probabilistic Choice Model for Market Segmentation and Elasticity Structure , 1989 .

[25]  A. Enthoven,et al.  The history and principles of managed competition. , 1993, Health affairs.

[26]  Pradeep K. Chintagunta,et al.  On Using Demographic Variables to Determine Segment Membership in Logit Mixture Models , 1994 .

[27]  J. Lave,et al.  Consumer health plan choice: current knowledge and future directions. , 1997, Annual review of public health.

[28]  Dipak C. Jain,et al.  A Random-Coefficients Logit Brand-Choice Model Applied to Panel Data , 1994 .

[29]  Pradeep K. Chintagunta,et al.  Investigating Heterogeneity in Brand Preferences in Logit Models for Panel Data , 1991 .