Increasing Health Insurance Enrollment Among Uninsured Americans
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 811,795
- 主要终点
- Percent of individuals enrolling in an ACA plan by the end of the Open Enrollment period.
研究概览
简要总结
This randomized evaluation used behaviorally-informed letters to increase health insurance take-up on the Affordable Care Act (ACA) Marketplaces.
详细描述
During Open Enrollment Periods for the ACA Marketplaces, qualifying individuals can purchase health insurance plans through the Federal Health Insurance Marketplace (FHIM). As of early February 2015, many people had visited HealthCare.gov and started an online account, but not yet selected a plan. The Department of Health and Human Services (HHS), in collaboration with the Office of Evaluation Sciences (OES), developed and sent letters to assist these individuals with completing their enrollment before the deadline.
To evaluate the effect of the letters, the team used a randomized controlled trial.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Those with an English language preference; those who had not enrolled in an ACA plan as of early February 2015
排除标准
- •Those with a Spanish language preference
- •This intervention was a program evaluation and did not go through Human Subjects Protection Review.
研究组 & 干预措施
Control
Individuals in this arm did not receive a letter.
Arm 1: Basic Letter
Individuals received a letter with information about the benefits of enrolling, the February 15th sign-up deadline, the HealthCare.gov website, and the call center phone number.
干预措施: Letter intervention (Behavioral)
Arm 2: Action
Individuals in this arm received a letter that emphasized only minimal marginal effort is required; and used adjectives and verbs connoting action (e.g., "almost done," "quick," "act now," and "fast").
干预措施: Letter intervention (Behavioral)
Arm 3: Action, Implementation
Individuals in this arm received a letter similar to Arm 2, but with the addition of a calendar that draws attention to the February 15th deadline; and provided fill-in blanks in which the recipient can write the planned month, day, and time when they intend to enroll.
干预措施: Letter intervention (Behavioral)
Arm 4: Action, Implementation, Picture
Individuals in this arm received a letter similar to Arms 2 and 3, but with the addition of an image of then HealthCare.gov Chief Executive Officer Kevin Counihan
干预措施: Letter intervention (Behavioral)
Arm 5: Norm
Individuals in this arm received a letter that included the following social norm sentence: "Americans are enrolling but you haven't joined them."
干预措施: Letter intervention (Behavioral)
Arm 6: Norm, Pledge
Individuals in this arm received a letter that included a statement, to be checked in agreement, that "I pledge to Get Covered at Healthcare.gov."
干预措施: Letter intervention (Behavioral)
Arm 7: Loss Aversion
Individuals in this arm received a letter that warned "You risk paying a fee of $325 or 2% of your income-whichever is higher."
干预措施: Letter intervention (Behavioral)
Arm 8: Kitchen Sink
Individuals in this arm received a letter that includes all behavioral dynamics except for the pledge (due to space limitations).
干预措施: Letter intervention (Behavioral)
结局指标
主要结局
Percent of individuals enrolling in an ACA plan by the end of the Open Enrollment period.
时间窗: Two weeks
Percent of individuals enrolling in an ACA plan during the observation period.
次要结局
未报告次要终点
研究者
David Yokum
Director of The Policy Lab
Brown University