Han Jayoung, Ko Dong Woo, Urmie Julie M
Division of Health Services Research, College of Pharmacy, University of Iowa, S 519 PHAR 115 S. Grand Ave., Iowa City, IA 52242, USA.
Department of Marketing, University of Pittsburgh at Greensburg, FOB 104, 150 Finoli Drive, Greensburg, PA 15601, USA.
Res Social Adm Pharm. 2014 Mar-Apr;10(2):398-407. doi: 10.1016/j.sapharm.2013.06.010. Epub 2013 Aug 27.
Most U.S. states had over 50 Medicare Prescription Drug Plans (PDPs) in 2007. Medicare beneficiaries are expected to switch Part D plans based on their health and financial needs; however, the switching rate has been low. Such consumer inertia potentially has negative effects on both beneficiaries and the insurance market, resulting in a critical need to investigate its cause.
To 1) describe how Medicare beneficiaries who were satisfied with their current Part D plan differed from those who were not satisfied; 2) examine the effect of switching costs on consideration of switching among Medicare beneficiaries who were dissatisfied with their current Part D plan.
Data from the 2007 Prescription Drug Study supplement to the Health and Retirement Study (HRS) survey were used in this study. The satisfied and dissatisfied groups were compared in terms of cost variables, switching costs, and perception of Part D complexity. Structural equation modeling was used to examine relationships among switching costs, Part D complexity, cost variables, and consideration of switching for beneficiaries who were dissatisfied with their current Part D coverage.
Out of 467 participants, a total of 255 (54.6%) were satisfied with their current Part D plan. The satisfied group paid lower out-of-pocket costs ($50.63 vs. $114.60) and premiums ($30.88 vs. $40.77) than the dissatisfied group. They also had lower switching costs. Only 11.3% of the dissatisfied beneficiaries switched plans. Among respondents who were dissatisfied with their current plan, those who perceived Part D as complex had high switching costs and were less likely to consider switching plans. Out-of-pocket cost did not have a statistically significant association with consideration of switching.
Medicare beneficiaries who were satisfied with their current Part D plans had lower out-of-pocket costs and premiums as well as higher switching costs. Among beneficiaries who were dissatisfied with their current Part D plan, those who had higher switching costs were less likely to consider switching Part D plans.
2007年，美国大多数州有超过50种医疗保险处方药计划（PDP）。预计医疗保险受益人会根据自身健康和财务需求更换D部分计划；然而，更换率一直很低。这种消费者惰性可能对受益人和保险市场都产生负面影响，因此迫切需要调查其原因。
1）描述对当前D部分计划满意的医疗保险受益人与不满意的受益人有何不同；2）研究转换成本对不满意当前D部分计划的医疗保险受益人考虑更换计划的影响。
本研究使用了2007年健康与退休研究（HRS）调查的处方药研究补充数据。比较了满意组和不满意组在成本变量、转换成本以及对D部分复杂性的认知方面的情况。使用结构方程模型来研究转换成本、D部分复杂性、成本变量以及对当前D部分覆盖不满意的受益人更换计划的考虑之间的关系。
在467名参与者中，共有255人（54.6%）对他们当前的D部分计划感到满意。满意组的自付费用（50.63美元对114.60美元）和保费（30.88美元对40.77美元）低于不满意组。他们的转换成本也更低。只有11.3%的不满意受益人更换了计划。在对当前计划不满意的受访者中，那些认为D部分复杂的人转换成本高，并且不太可能考虑更换计划。自付费用与考虑更换计划没有统计学上的显著关联。
对当前D部分计划满意的医疗保险受益人自付费用和保费较低，转换成本较高。在对当前D部分计划不满意的受益人中，转换成本较高的人不太可能考虑更换D部分计划。
