Technology Assisted Choice in Medicare Part D Plan Selection

Authors

John H. Schmidt Jr., Florida International UniversityFollow

Document Type

Dissertation

Degree

Doctor of Philosophy (PhD)

Major/Program

Business Administration

First Advisor's Name

Weidong Xia

First Advisor's Committee Title

Committee chair

Second Advisor's Name

Min Chen

Second Advisor's Committee Title

committee member

Third Advisor's Name

Hemang Subramanian

Third Advisor's Committee Title

committee member

Fourth Advisor's Name

Ochieng Walumbwa

Fourth Advisor's Committee Title

committee member

Date of Defense

11-12-2021

Abstract

In 2006, the Centers for Medicare and Medicaid Services (CMS) implemented a new benefit for Medicare enrollees that was under schedule Part D of Medicare. This new benefit, known as Medicare Part D, covered prescription medications for enrollees in the Medicare programs. Medicare beneficiaries had to enroll in this new benefit to access this coverage. A new website, the Medicare Part D Plan Finder, was developed as part of this rollout to allow Medicare beneficiaries the opportunity to view available plan in their area and enroll in those plans. Several years after the original enrollment, several studies were conducted to examine the effectiveness of plan selection. The reviews looked at the financial costs and benefits of the current plans against the available plans for an enrollee. The switching rates for enrollees was not very active. This made the initial choice of plan more important, as once an enrollee signed up for a plan, there was a high level of “stickiness” to stay with that plan even as health circumstances might have changed, available plans might have changed, drug formularies could have been modified or current coverages and benefits were altered. These studies found that enrollees were paying more than they needed to pay because of this lack of switching behavior. Some of these behaviors were attributed to the way that plan information was 7 presented on the Medicare Plan Finder website, which saw the information as confusing, voluminous, and in some circumstances, incorrect. In 2019 a new version of the Medicare Part D Plan finder website was implemented. The new site incorporated feedback from enrollees, policy makers and health insurance experts. The intent was to create a tool that would allow consumers to better review and analyze information to assist them in making plan choices for Medicare Part D. This study used a discrete choice experiment to review and examine how individuals use the new site and if the information presented is helpful in determining the optimal plan choice for a hypothetical patient profile. Participants used a defined set of medications, pharmacy options and beneficiary location to establish a set of available plans. The Plan Finder tool was then used by the participants to select the optimal plan. A post experiment survey also collected information on the decision-making process, information used, the efficacy of the site, and the confidence in the decision. In the experiment, only 35% of the participants made an optimal Medicare Part D Plan choice. There were four groups with different levels of supporting information, as well as online and in-person support. The group that performed the best in determining the optimal plan choice was provided with high levels of information and instruction, but low levels of in-person or inline task support. 50% of this group correctly made the optimal plan choice. Individuals who were 65 or older, which is the target population for Medicare Part D plans, only had a 21% successful selection rate. An individual’s decision-making confidence was a predictor of successful plan selection and low decision making confidence was also predictive of incorrect optimal plan choice.

Identifier

FIDC010484

Recommended Citation

Schmidt, John H. Jr., "Technology Assisted Choice in Medicare Part D Plan Selection" (2021). FIU Electronic Theses and Dissertations. 4876.
https://digitalcommons.fiu.edu/etd/4876