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{"title"=>"Can consumers make affordable care affordable? The value of choice architecture", "type"=>"journal", "authors"=>[{"first_name"=>"Eric J.", "last_name"=>"Johnson", "scopus_author_id"=>"7404679960"}, {"first_name"=>"Ran", "last_name"=>"Hassin", "scopus_author_id"=>"57196813119"}, {"first_name"=>"Tom", "last_name"=>"Baker", "scopus_author_id"=>"7402605131"}, {"first_name"=>"Allison T.", "last_name"=>"Bajger", "scopus_author_id"=>"56020431400"}, {"first_name"=>"Galen", "last_name"=>"Treuer", "scopus_author_id"=>"56021077900"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"84893141771", "doi"=>"10.1371/journal.pone.0081521", "pui"=>"372232243", "pmid"=>"24367484", "scopus"=>"2-s2.0-84893141771", "issn"=>"19326203", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "arxiv"=>"arXiv:1011.1669v3"}, "id"=>"3b7f4be4-e83a-36cb-aea7-f0ac28c00a25", "abstract"=>"Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a \"smart\" default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year.", "link"=>"http://www.mendeley.com/research/consumers-make-affordable-care-affordable-value-choice-architecture", "reader_count"=>61, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>8, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>20, "Student > Postgraduate"=>2, "Student > Master"=>7, "Other"=>3, "Student > Bachelor"=>8, "Professor"=>5}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>8, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>20, "Student > Postgraduate"=>2, "Student > Master"=>7, "Other"=>3, "Student > Bachelor"=>8, "Professor"=>5}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Environmental Science"=>1, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>10, "Agricultural and Biological Sciences"=>3, "Business, Management and Accounting"=>11, "Psychology"=>11, "Social Sciences"=>12, "Computer Science"=>1, "Decision Sciences"=>2, "Economics, Econometrics and Finance"=>6}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>10}, "Social Sciences"=>{"Social Sciences"=>12}, "Decision Sciences"=>{"Decision Sciences"=>2}, "Psychology"=>{"Psychology"=>11}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>6}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>11}, "Unspecified"=>{"Unspecified"=>3}, "Environmental Science"=>{"Environmental Science"=>1}}, "reader_count_by_country"=>{"Canada"=>1, "United States"=>4}, "group_count"=>6}

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• http://doi.org/10.1377/hlthaff.2015.1637
• http://doi.org/10.1377/hlthaff.2015.1367
• http://doi.org/10.1111/joca.12266
• http://doi.org/10.1073/pnas.1413570112
• http://doi.org/10.2139/ssrn.2727301
• http://doi.org/10.1177/2381468316679998
• http://doi.org/10.2139/ssrn.2579733
• http://doi.org/10.1377/hlthaff.2016.0993
• http://doi.org/10.1177/2381468317716441
• http://doi.org/10.1017/bpp.2018.43
• http://doi.org/10.1017/bpp.2018.1
• http://doi.org/10.1017/bpp.2016.14
• http://doi.org/10.1056/NEJMp1315956
• http://doi.org/10.1056/NEJMp1414771
• http://doi.org/10.1177/1077558717718625
• http://doi.org/10.1377/hlthaff.2018.05021
• http://doi.org/10.1016/j.jhealeco.2017.09.008
• http://doi.org/10.1093/qje/qjx011
• http://doi.org/10.2139/ssrn.2485930
• http://doi.org/10.1177/1355819616664374
• http://doi.org/10.2139/ssrn.2339604
• http://doi.org/10.1016/j.obhdp.2019.02.002
• http://doi.org/10.1016/j.jhealeco.2019.05.004
• http://doi.org/10.1177/0011392115590092
• http://doi.org/10.1177/1077558716669210
• http://doi.org/10.1371/journal.pone.0151095
• http://doi.org/10.1287/mksc.2016.1021
• http://doi.org/10.1007/s11606-018-4483-x

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• 3685847
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• 4513642
• 4814125

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• {"id"=>"413440551535398912", "text"=>"Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture http://t.co/pFSaAU04EM", "created_at"=>"2013-12-18T22:48:03Z", "user"=>"PLOSONE", "user_name"=>"PLOS ONE", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2429958559/mzjl6as5u2m09r2erof6_normal.jpeg"}
• {"id"=>"413442929009917952", "text"=>"La incertidumbre y la asimetría de la información frente al riesgo y a la enfermedad http://t.co/en6YMbfzBj", "created_at"=>"2013-12-18T22:57:30Z", "user"=>"bmassutis", "user_name"=>"Bartomeu Massuti", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000815179180/824afb92a29dfe3e0ea3bfc1ec72d3d2_normal.jpeg"}
• {"id"=>"413461344067665921", "text"=>"RT @PLOSONE: Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture http://t.co/pFSaAU04EM", "created_at"=>"2013-12-19T00:10:40Z", "user"=>"RegReader", "user_name"=>"Reg Reader", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2821548353/0820870c1c659a8d99a66aaf4479eede_normal.jpeg"}
• {"id"=>"413482751468122113", "text"=>"Can consumers make Affordable Care affordable? Experiments on the quality of decisions about health care coverage http://t.co/FLWSR9j947", "created_at"=>"2013-12-19T01:35:44Z", "user"=>"GVBodenhausen", "user_name"=>"Galen Bodenhausen", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000866422285/ncvCSADI_normal.jpeg"}
• {"id"=>"413493990122483712", "text"=>"社会保障の危機が叫ばれている国の役人が読まなければならない論文。Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture http://t.co/heVhzyYAZt", "created_at"=>"2013-12-19T02:20:24Z", "user"=>"uranus_2", "user_name"=>"マーキュリー２世", "user_profile_image"=>"http://abs.twimg.com/sticky/default_profile_images/default_profile_5_normal.png"}
• {"id"=>"413807075387392001", "text"=>"Can Consumers Make #AffordableCare Affordable? The Value of Choice Architecture\nhttp://t.co/pBtQ8reqyN", "created_at"=>"2013-12-19T23:04:29Z", "user"=>"birgeleanna", "user_name"=>"Leanna Birge", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000750473868/a7f5a857735a3ea62f7a9fd6ea686242_normal.jpeg"}
• {"id"=>"414066580797267968", "text"=>"PLOS ONE: Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture http://t.co/VZUnJXFyku #Bioethics", "created_at"=>"2013-12-20T16:15:40Z", "user"=>"bermaninstitute", "user_name"=>"Berman Institute ", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3672117883/27beaee675b22324498ce3c192144a77_normal.png"}
• {"id"=>"414067842762280960", "text"=>"RT @bermaninstitute: PLOS ONE: Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture http://t.co/VZUnJXFyku #Bioe…", "created_at"=>"2013-12-20T16:20:41Z", "user"=>"PLOSONE", "user_name"=>"PLOS ONE", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2429958559/mzjl6as5u2m09r2erof6_normal.jpeg"}
• {"id"=>"414069752294694912", "text"=>"#Science: Can Consumers Make Affordable Care Affordable? The Value of #Choice Architecture http://t.co/rLhGEXt3of c/o @PLOS #CdnPoli #Design", "created_at"=>"2013-12-20T16:28:16Z", "user"=>"deepgreendesign", "user_name"=>"Graham Chivers", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1306613848/deepgreendesign1_normal.jpg"}
• {"id"=>"418109908182388736", "text"=>"#Healthinsurance shoppers make a much better plan choices with decision support tools & calculators http://t.co/ipUWuUQwLO #HIX #consumers", "created_at"=>"2013-12-31T20:02:24Z", "user"=>"brycewatch", "user_name"=>" Bryce Williams", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000408268646/0504df904b49b2c5750ba4f947452e28_normal.jpeg"}
• {"id"=>"418113530689515520", "text"=>"RT @brycewatch: #Healthinsurance shoppers make a much better plan choices with decision support tools & calculators http://t.co/ipUWuUQwLO …", "created_at"=>"2013-12-31T20:16:48Z", "user"=>"SeanMMcGuire", "user_name"=>"Sean McGuire", "user_profile_image"=>"http://pbs.twimg.com/profile_images/412805980020150272/KyhXaDA1_normal.jpeg"}
• {"id"=>"418114171642073088", "text"=>"#Healthinsurance shoppers make much better plan choices with decision support tools & calculators http://t.co/ipUWuUQwLO #HIX #consumers", "created_at"=>"2013-12-31T20:19:21Z", "user"=>"brycewatch", "user_name"=>" Bryce Williams", "user_profile_image"=>"http://pbs.twimg.com/profile_images/378800000408268646/0504df904b49b2c5750ba4f947452e28_normal.jpeg"}
• {"id"=>"418130300917387264", "text"=>"RT @brycewatch: #Healthinsurance shoppers make better plan choices with decision support tools & calculators http://t.co/T7SAA6EwDJ #HIX", "created_at"=>"2013-12-31T21:23:26Z", "user"=>"ShimCode", "user_name"=>"Steve Sisko", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1531682665/Twit-1__Small__reasonably_small_normal.jpg"}
• {"id"=>"418133261706342400", "text"=>"The process of selecting cost-effective health #insurance must address 3 things. http://t.co/azTTCsvrpR", "created_at"=>"2013-12-31T21:35:12Z", "user"=>"ShimCode", "user_name"=>"Steve Sisko", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1531682665/Twit-1__Small__reasonably_small_normal.jpg"}
• {"id"=>"419333718264672256", "text"=>"#PLOSONE: Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture http://t.co/kyy58y1GZJ", "created_at"=>"2014-01-04T05:05:23Z", "user"=>"MCGbenefits", "user_name"=>"news", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3406448487/b3318500ef6cbc4af97784c020ed975b_normal.jpeg"}
• {"id"=>"425766364951740416", "text"=>"Can consumers make affordable care affordable? http://t.co/jcuJ9wJ1w5 @galentreuer @polos @bernardhealth", "created_at"=>"2014-01-21T23:06:26Z", "user"=>"rmccost", "user_name"=>"Ryan McCostlin", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1897018141/Ryan_2_normal.jpg"}
• {"id"=>"425845546088022016", "text"=>"RT @rmccost: Can consumers make affordable care affordable? http://t.co/jcuJ9wJ1w5 @galentreuer @polos @bernardhealth", "created_at"=>"2014-01-22T04:21:04Z", "user"=>"BernardHealth", "user_name"=>"Bernard Health", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1162839276/Bernard_Health_Dog_Logo_-_Black_tail__smaller__normal.jpg"}
• {"id"=>"426139290331262976", "text"=>"RT @rmccost: Can consumers make affordable care affordable? http://t.co/jcuJ9wJ1w5 @galentreuer @polos @bernardhealth", "created_at"=>"2014-01-22T23:48:18Z", "user"=>"mkleymeyer", "user_name"=>"Matt Kleymeyer ", "user_profile_image"=>"http://pbs.twimg.com/profile_images/860347610/untitled_normal.JPG"}
• {"id"=>"540573312410476544", "text"=>".@afrakt you might be interested in this if you have not seen it. http://t.co/bWZTZrvBO6", "created_at"=>"2014-12-04T18:28:15Z", "user"=>"JonWalkerDC", "user_name"=>"Jon Walker", "user_profile_image"=>"http://pbs.twimg.com/profile_images/484407341417107456/UORi1E8u_normal.jpeg"}
• {"id"=>"540575095555895297", "text"=>"Even 27 percent of trained MBA students when given simplied insurance shopping test choose the wrong plan http://t.co/bWZTZrvBO6", "created_at"=>"2014-12-04T18:35:20Z", "user"=>"JonWalkerDC", "user_name"=>"Jon Walker", "user_profile_image"=>"http://pbs.twimg.com/profile_images/484407341417107456/UORi1E8u_normal.jpeg"}
• {"id"=>"540579703376334848", "text"=>"On the role of \"choice architecture\" in plan choice. MT @JonWalkerDC: http://t.co/CXf9uUia33 cc @timothyjlayton", "created_at"=>"2014-12-04T18:53:39Z", "user"=>"afrakt", "user_name"=>"Austin Frakt", "user_profile_image"=>"http://pbs.twimg.com/profile_images/457874753177399296/0_3cjNRS_normal.jpeg"}
• {"id"=>"540580709975326720", "text"=>"RT @afrakt: On the role of \"choice architecture\" in plan choice. MT @JonWalkerDC: http://t.co/CXf9uUia33 cc @timothyjlayton", "created_at"=>"2014-12-04T18:57:39Z", "user"=>"BillNigh", "user_name"=>"Bill Nigh", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1834936719/LochNessCloseUp2_normal.PNG"}
• {"id"=>"540584713023668225", "text"=>"RT @afrakt: On the role of \"choice architecture\" in plan choice. MT @JonWalkerDC: http://t.co/CXf9uUia33 cc @timothyjlayton", "created_at"=>"2014-12-04T19:13:33Z", "user"=>"weinerja", "user_name"=>"Janet Weiner", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3703090737/615e54bc8bc5ad73c3bc60107f3e38cb_normal.jpeg"}
• {"id"=>"540650361506127872", "text"=>"RT @afrakt: On the role of \"choice architecture\" in plan choice. MT @JonWalkerDC: http://t.co/CXf9uUia33 cc @timothyjlayton", "created_at"=>"2014-12-04T23:34:25Z", "user"=>"allisora", "user_name"=>"Andy Allison", "user_profile_image"=>"http://pbs.twimg.com/profile_images/504328685621895168/zw_aUTLb_normal.jpeg"}
• {"id"=>"553629597569253376", "text"=>"#PLOSONE: Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture. Dec 2013 http://t.co/9lA7cfbKjv", "created_at"=>"2015-01-09T19:09:16Z", "user"=>"wilte", "user_name"=>"Wilte Zijlstra", "user_profile_image"=>"http://pbs.twimg.com/profile_images/1398369998/Wilte_normal.jpg"}
• {"id"=>"661255601532485632", "text"=>"Can consumers make affordable care affordable? https://t.co/zFNSJjrIgd", "created_at"=>"2015-11-02T18:56:35Z", "user"=>"cmio", "user_name"=>"Adrian Rawlinson MD", "user_profile_image"=>"http://pbs.twimg.com/profile_images/600531034212413440/s837BS55_normal.jpg"}
• {"id"=>"661255832395386880", "text"=>"Can consumers make affordable care affordable? https://t.co/0f3szQzsWx", "created_at"=>"2015-11-02T18:57:30Z", "user"=>"ObeoHealth", "user_name"=>"Obeo Health", "user_profile_image"=>"http://pbs.twimg.com/profile_images/510482563660394496/ODR3hGcE_normal.png"}
• {"id"=>"661269945788010496", "text"=>"RT @ObeoHealth: Can consumers make affordable care affordable? https://t.co/0f3szQzsWx", "created_at"=>"2015-11-02T19:53:35Z", "user"=>"VivorHQ", "user_name"=>"Vivor", "user_profile_image"=>"http://pbs.twimg.com/profile_images/527173469885042688/6cC0fULd_normal.png"}

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Figshare

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• {"files"=>["https://ndownloader.figshare.com/files/1321569"], "description"=>"<p>The top half of each bar, in blue, represents the proportion of correct choices, and the bottom half, below the zero line in red, plots the average dollar error, across respondents. A dashed line for each condition represents the performance of a random chooser, and the error bars represent 95% confidence intervals. Darker shades denote the provision of calculators. Panel (A) represents the results of Experiments 1–4 collapsing across other manipulations (see SM). Panel (B) represents the results of a sample of highly educated MBA students (Experiment 5), and of individuals from the target population, when given different choice architecture interventions. For (b) the random response threshold ($1264) exceeds the lower limit of the graph.</p>", "links"=>[], "tags"=>["choices"], "article_id"=>881485, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Eric J. Johnson", "Ran Hassin", "Tom Baker", "Allison T. Bajger", "Galen Treuer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0081521.g002", "stats"=>{"downloads"=>1, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_percentage_of_choices_of_the_most_cost_effective_option_and_respondents_average_error_/881485", "title"=>"The percentage of choices of the most cost effective option and respondents' average error.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-12-18 03:42:25"}
• {"files"=>["https://ndownloader.figshare.com/files/1321566"], "description"=>"<p>Respondents saw either 8 (pictured) or 4 options.</p>", "links"=>[], "tags"=>[], "article_id"=>881482, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Eric J. Johnson", "Ran Hassin", "Tom Baker", "Allison T. Bajger", "Galen Treuer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0081521.g001", "stats"=>{"downloads"=>2, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_A_decision_display_used_in_Experiment_4_/881482", "title"=>"A decision display used in Experiment 4.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-12-18 03:42:25"}
• {"files"=>["https://ndownloader.figshare.com/files/1321571"], "description"=>"<p>The decline in odds of being chosen for each increase in $100 in annual cost for the three cost components in experiments.</p>", "links"=>[], "tags"=>["calculator"], "article_id"=>881487, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Eric J. Johnson", "Ran Hassin", "Tom Baker", "Allison T. Bajger", "Galen Treuer"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0081521.g003", "stats"=>{"downloads"=>4, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Premiums_deductibles_and_co_payments_both_without_calculator_blue_and_with_calculator_red_/881487", "title"=>"Premiums, deductibles, and co-payments, both without calculator (blue) and with calculator (red).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-12-18 03:42:25"}

PMC Usage Stats | Further Information

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• {"unique-ip"=>"3", "full-text"=>"2", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"8"}
• {"unique-ip"=>"8", "full-text"=>"5", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"9"}
• {"unique-ip"=>"10", "full-text"=>"9", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"10"}

Relative Metric

{"start_date"=>"2013-01-01T00:00:00Z", "end_date"=>"2013-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences", "average_usage"=>[269, 466, 588, 697, 800, 896, 988, 1076, 1165, 1254, 1340, 1417]}, {"subject_area"=>"/Biology and life sciences/Behavior", "average_usage"=>[306, 490, 611, 718, 817, 916, 999, 1091, 1185, 1258, 1341, 1412, 1476]}, {"subject_area"=>"/Biology and life sciences/Neuroscience", "average_usage"=>[261, 444, 554, 655, 748, 834, 923, 1004, 1089, 1170, 1244, 1315, 1380]}, {"subject_area"=>"/Engineering and technology/Management engineering", "average_usage"=>[221, 395, 464, 531, 614, 708, 792, 887, 945, 1051, 1131, 1209, 1251]}, {"subject_area"=>"/Social sciences/Economics", "average_usage"=>[283, 468, 592, 699, 799, 907, 980, 1079, 1187, 1282, 1376, 1479, 1547]}]}

F1000Prime