Stronger Nudges: Improving Health Care Quality by Nudging Medicare Beneficiaries Using Targeted Quality Information
*Amelia M Haviland, Carnegie Mellon University
Keywords: Quality, Patient Decision Making, Change Point Analysis, Model Selection
In the past several years, the Centers for Medicare and Medicaid Services (CMS) have implemented new rules regarding those Medicare Advantage (MA) plans with the highest and lowest quality. These rules encourage beneficiaries to enroll in higher-quality plans. It is well known that quality information usually has little direct impact on patient choices. In this work, we investigate the impacts of CMS's targeted rule changes on MA enrollment. With rich data on all MA-PD contracts from 2009-2014, we find robust evidence that sending letters with quality information to beneficiaries in low performing plans is associated with significantly reduced enrollment in such plans, and newly allowing enrollment in top quality plans at any time, not just during the open enrollment period, is associated with significant increases in enrollment during the plan year.