Giovannelli Justin, Curran Emily
Center on Health Insurance Reforms, Georgetown University Health Policy Institute, USA.
Issue Brief (Commonw Fund). 2017 Feb;3:1-12.
Issue: Policymakers have sought to improve the shopping experience on the Affordable Care Act’s marketplaces by offering decision support tools that help consumers better understand and compare their health plan options. Cost estimators are one such tool. They are designed to provide consumers a personalized estimate of the total cost--premium, minus subsidy, plus cost-sharing--of their coverage options. Cost estimators were available in most states by the start of the fourth open enrollment period. Goal: To understand the experiences of marketplaces that offer a total cost estimator and the interests and concerns of policymakers from states that are not using them. Methods: Structured interviews with marketplace officials, consumer enrollment assisters, technology vendors, and subject matter experts; analysis of the total cost estimators available on the marketplaces as of October 2016. Key findings and conclusions: Informants strongly supported marketplace adoption of a total cost estimator. Marketplaces that offer an estimator faced a range of design choices and varied significantly in their approaches to resolving them. Interviews suggested a clear need for additional consumer testing and data analysis of tool usage and for sustained outreach to enrollment assisters to encourage greater use of the estimators.
政策制定者试图通过提供决策支持工具来改善《平价医疗法案》市场的购物体验，这些工具可帮助消费者更好地理解和比较他们的健康保险计划选项。成本估算器就是这样一种工具。其旨在为消费者提供其保险选项的总成本（保费减去补贴加上费用分摊）的个性化估算。到第四个开放注册期开始时，大多数州都有了成本估算器。目标：了解提供总成本估算器的市场的经验以及未使用这些估算器的州的政策制定者的兴趣和关注点。方法：对市场官员、消费者注册协助人员、技术供应商和主题专家进行结构化访谈；分析截至2016年10月市场上可用的总成本估算器。主要发现和结论：受访者强烈支持市场采用总成本估算器。提供估算器的市场面临一系列设计选择，并且在解决这些选择的方法上有很大差异。访谈表明显然需要对工具使用情况进行更多消费者测试和数据分析，并持续向注册协助人员进行宣传，以鼓励更多地使用估算器。
