Consumer Driven Health Plans:
Early Findings from the Field
and Future Directions
Stephen T. Parente, Roger Feldman, Jon B. Christianson
University of Minnesota
March, 2004
Funded by the Robert Wood Johnson Foundation Health Care Organization
and Financing Initiative
For more information: sparente@csom.umn.edu
Presentation Objectives
• Describe the CDHP business model.
• Illustrate the mechanics of a CDHP using
Definity Health as an example.
• Provide an Overview of our RWJ evaluation of
Definity.
• Present current analysis results.
• Opportunities and conundrums of CDHPs.
Issues Driving CDHP Creation
Patients
 Dissatisfaction with provider access
 Patient incentives are to consume
 Limited choices of benefits and providers
 Combative relationship with managed care companies
Providers
 Loss of autonomy
 Erosion of physician/patient relationship
 Misalignment of physician reimbursement and incentives
Employers
 Plan costs are increasing
 Employees are not happy
 Increase of employer administration burdens
CDHP Business Enablers
–
‘Ready to Lease’ Components of Health Insurance:
•
•
•
•
•
–
Electronic claims processing
National panel of physicians
National pharmaceutical benefits management firms
Consumer-friendly health data web portals
Disease management vendors
Internet
• Transaction medium for claims processing
• 2-way communication with members
–
ERISA-exemption
• Lack of state oversight
• Half the US commercial health insurance market is self-insured.
Early CDHPs in Operation
– Definity
• Concept developed in 1998, Funded in April, 2000
• Minnesota based
• Clear first mover & dot-bomb survivor
– Lumenos
• Started in 2000
• Based in Virgina
• Havard B-School inspired (Regina Herzlinger)
– Destinty
• Operating as Medical Savings Account model
• In operation for 10 years in South Africa
Definity Health Component Details
Health Tools
and Resources
$$
Health Coverage
• Preventive care covered 100%
• Annual deductible
Definity
• Expenses beyond the PCA
Health
Care
• Nationwide provider access
Advantage
• No referrals required
Health Tools and Resources
• Care management program
• Extensive easy-to-use
information and services
1
2
Annual
Deductible
PCA
Employer selects which expense apply toward the Health Coverage annual deductible.
Paid out of employer’s general assets.
Preventive Care 100%
Health
Coverage
Annual Deductible
Personal Care Account (PCA)
• Employer allocates PCA1
• Member directs PCA
• Section 213(d) “scope”
• Roll over at year-end
• Apply toward deductible2
Web- and
PhoneBased
Tools
New RWJ-Funded Research
Key Research Questions
1.
2.
Is there an ‘adverse selection’ problem? Traditionally,
adverse selection is defined as the situation when
healthy individuals choose Definity leaving the sick in
a traditional plan that will soon implode its premiums
because of disproportionate share of sick individuals
in the insurance pool.
What is the impact on cost and utilization? Definity
has been chosen as a response to rising premium
prices in an attempt to make the consumer ‘drive the
market’ be examining price variations and
constraining their personal consumption, if possible.
Research Design
– 2 Year study (11/1/2002 - 10/31/2004)
– Six employers examined:
•
•
•
•
•
•
University of Minnesota, MN
Medtronic, National
Ridgeview Medical Center, MN
Hannaford Bros, New England
Welch-Allyn, Upstate NY (tentative)
Raytheon (New England or South Atlantic firm)
– Data collected
• Claims data of all utilization for all health plan choices, pre (2001) and
post (2002-2003) Definity.
• Employer info on flexible spending accounts and employee income
• Survey information on Definity choices in 2002 & 2003 from U of M.
Early Results #1:
Employee Choice of a Consumer
Driven Health Plan in a Multi-Plan,
Multi-Product Setting
Conceptual Model to Address
Selection Question
We use a choice model based on utility maximization, where utility
is considered to be a function of personal attributes such as health
status, health plan attributes such as price, and the interaction of
price and health status, formally stated as:
Uij = f(Zj,Yi,Xij), where,
• i is the decision-making employee choosing among,
• j health plan alternative choices,
• Yi = employee personal attributes,
• Zj = health plan alternative attributes and
• Xij = interactions between alternative-specific and personal
attributes, Xij.
Follows methods used by Harris, Schultz and Feldman (2002).
Multivariate Analysis of Plan Choice
– Focus on the University of Minnesota 2002 survey
– Combine survey data with HR information including:
•
•
•
•
•
After tax income
Contract type
Age and Gender
Location
Medical premium choice set
– Run Conditional Logistic Regression Model to predict
the effects of premium price, employee characteristics
and health plan feature preferences for early adopters
of Definity compared to other health plans.
Health Plan Choices
1.
2.
3.
4.
Health Partners: Staff model HMO with direct capitation
contracting at a limited number of group practices.
Patient Choice: A ‘Tiered-direct contracting’ descendent of
Minnesota’s Buyers Health Care Action Group health benefit
design experiment.
Definity Health: Consumer-driven Health Plan
Preferred One: Preferred Provider Organization
UPlan Options/Enrollment (2002)
HealthPartners Classic
Patient Choice Cost Group I
Patient Choice Cost Group II
Patient Choice Cost Group III
PreferredOne National
Definity Health Option 1
Definity Health Option 2
Total
HealthPartners Classic
Patient Choice Cost Group I
Patient Choice Cost Group II
Patient Choice Cost Group III
PreferredOne National
Definity Health Option 1
Definity Health Option 2
Total
Single & Family Total
Total
Cost
$137.84
$137.84
$147.15
$157.90
$189.61
$150.52
$150.48
Total Cost
$344.59
$344.59
$363.15
$389.65
$467.83
$375.55
$375.47
Employee-only coverage
Less UM Employee
contribution contribution Enrollment
$137.84
$0.00
5,027
$137.84
$0.00
$137.84
$9.31
2,091
$137.84
$20.06
$137.84
$51.77
731
$137.84
$12.68
349
$137.84
$12.64
8,198
Family coverage
Less UM
Employee
contribution contribution
$323.92
$20.67
$323.92
$20.67
$323.92
$39.23
$323.92
$65.73
$323.92
$143.91
$323.92
$51.63
$323.92
$51.55
Enrollment
3,967
2,808
997
346
8,118
16,316
Early UM Definity Experience
Year 2002
46%
49%
54%
51%
Option 1
Option 2
Female
Male
49%
49%
51%
51%
Family
Single
Employee
Dependents
Definity Age/Gender Distribution
2002 University of Minnesota
70
60
50
40
Definity Male
Definity Total
Other Plans
30
20
10
0
<25
25-34
35-54
55-64
>65
All Respondents
Satisfaction with Plan
Overall
By Whether Respondent or
Dependent Has Chronic Condition
Yes
No
How would you rate your overall
experience with your health plan in 2002?
(1=worst possible, 10=best possible)
Definity
Other Plans
For Definity respondents, would you
recommend Definity to a friend, family
member or colleague? (%)
Yes
No
Don't know/refused
7.47
7.55
7.41
7.64
7.50
7.49
85.0
12.4
2.6
87.4
9.3
3.3
83.6
14.1
2.2
Health Plan Features Most Preferred
0
20
Percent agreement
40
60
My doctors in health plan
76.44
50
No referral authorizations
Has preventive care
46.4
National provider panel
36.7
29.8
PCA balance rolls over
Small out-of-pocket $$
Small paycheck deduction
No copayments
Online tools
80
16
15
12
6.93
Other Health Plans
Definity
100
Results: Premium Sensitivity
• Employees are sensitive to out-of-pocket
premiums, and surprisingly, employees with
chronic conditions are more premium-sensitive
• If Definity raised its premium by 1% it would lose
4.6 % of healthy single enrollees and 5.4% of
healthy families
• 1% premium boost would cause 6.9% of singles
and 10.7% of families with chronic condition to
leave Definity
• The results depend on 100% of the premium hike
being passed along to the employee (i.e, defined
contribution), as is the case for the UM
Results: Health Status and Other
Employee Characteristics
• Employees and families with chronic conditions prefer
the PPO, but otherwise, there is no evidence of adverse
selection
• Having a chronic condition is associated with a 3.2% increase in
the probability of choosing PreferredOne vs. HealthPartners
• Note that PreferredOne had the highest premiums ($189.51 for
single coverage and $448.40 for family coverage per pay period),
suggesting that the plan is experiencing adverse selection
• Higher income employees chose Definity or Choice
Plus, suggesting these plans may evolve as favorites of
the ‘well-to-do’
• Older employees chose PreferredOne or Choice Plus
Early Results #2:
Consumer-Driven Health Plans:
Early Evidence about Utilization,
Spending and Cost
Study Setting
• Health plan choices by employees:
– HMO, 2000-2002
– PPO, 2000-2002
– CDHP, 2001-2002
• Variation in cost sharing by contract
• Take-up of CDHP approximately 15%.
• General caveat: Each of the six employers’ experience
can be quite different due to:
–
–
–
–
Alternatives offered
Plan design
Communications with employees
Sponsor’s objectives for the plan
Presentation of Results
•
Results are limited to two groups of employees who worked
for their firm continuously for three years (2000-2002) where:
1.
•
•
Employee chose the CDHP in 2001 and 2002.
2. Employee chose another health plan in 2001 and 2002.
This limitation removed 40% to 50% of all employees from the
analysis.
Why make this limitation? We want to see both adoption and
maturing impact of CDHP while controlling for prior
spending.
–
–
–
2000: Pre-CDHP experience controls for prior spending
2001: CDHP adoption year
2002: CDHP ‘maturation’ year
Statistical Approach
• Used difference-in-difference approach
• Generate unadjusted and regression-adjusted
comparisons.
• Regression adjustment based on two-part model
• Regressors included: age, gender, baseline illness
burden (ADGs), contemporaneous health shock,
number of dependents, FSA election and income.
• Subsequent tests for regression to the mean found the
problem to be present, but not to a degree that would
influence our results by the last year of our findings.
Baseline Demographics
Demographic Variable of Study Population Cohorts in 2000
(N=531)
CDHP
(N=1551)
HMO
(N=1544)
PPO
Sample
Mean
Sample
Mean
Sample
Mean
Employe age (in years)
40.9
39.5
41.6
Percent male
62%
57%
51%
Case-mix index of entire employee's contract
6.493
6.831
7.136
Case-mix index of each person covered under the employee's contract
2.691
2.961
3.221
<25th percentile or below of employer
12%
28%
27%
Between 25th and 75th pecentile of employer
52%
53%
47%
>75th percentile of employer
36%
20%
27%
Income Distribution
Employee's health insurance premium contribution
Employee's healthcare flexible spending account contribution
$ 4,228.56
$ 407.84
$ 3,524.84
$ 203.52
$ 4,395.14
$ 236.42
Estimated number of covered lives including the employee
2.58
2.60
2.49
Reported number of dependents excluding employee
1.81
1.82
1.68
Case-mix Differences based on a
Weighted ADG Index
Health Plan Cohorts
Year 2000
Year 2001
Year 2002
Sample
Mean
Sample
Mean
Sample
Mean
CDHP Cohort N=531
Case-mix index of entire employee's contract
6.49
7.45
7.94
Case-mix index of each person covered under the employee's contract
2.69
3.14
3.38
Case-mix index of entire employee's contract
6.83
7.47
7.29
Case-mix index of each person covered under the employee's contract
2.96
3.20
3.09
Case-mix index of entire employee's contract
7.14
7.84
8.16
Case-mix index of each person covered under the employee's contract
3.22
3.48
3.64
HMO Cohort N=1,551
PPO Cohort N=1,554
CDHP, HMO versus PPO
CDHP
HMO
PPO
2000
$ 116.56 $
$ 144.99 $
$ 138.82 $
2001
156.13 $
157.97 $
170.53 $
PMPM Differences for Continuously enrolled sample
2002
238.84
169.44
242.97
What was the ADJUSTED impact
on provider and patient payment?
2000
Mean
2001
Mean
2002
Mean
CDHP Cohort N=531
Total Expenditure
Employer Expenditure
Employee Expenditure
$ 4,396.22
$ 4,005.28
$ 416.51
$ 6,154.36
$ 5,903.61
$ 634.38
$ 8,149.26
$ 7,807.39
$ 792.01
HMO Cohort N=1,551
Total Expenditure
Employer Expenditure
Employee Expenditure
$ 5,284.53
$ 4,895.75
$ 394.70
$ 6,773.62
$ 6,227.81
$ 549.32
$ 7,197.50
$ 6,428.83
$ 702.49
PPO Cohort N=1,554
Total Expenditure
Employer Expenditure
Employee Expenditure
$ 5,228.42
$ 4,688.28
$ 511.84
$ 7,050.59
$ 6,349.99
$ 657.16
$ 8,377.78
$ 7,330.94
$ 881.47
Health Plan Cohorts
NOTE: These are results from a restricted continuously enrolled sample of 50% to 60% of the total employee population and are not a reflection of the
plans’ full PMPM expenditures. Also note: 1) Patient expenditures from the Personal Care Account (PCA) are included in the employer payment
category. 2) Consumer payment reflects deductibles, copayments, and coinsurance expenses.
What was the ADJUSTED impact on provider &
patient payment by different services?
Health Plan Cohorts
Year 2000
Year 2001
MeanDeviationMean
Year 2002
Mean
CDHP Cohort N=531
Hospital Expenditure
Physician Expenditure
Pharmacy Expenditure
$
$
$
1,369.97
2,093.70
935.29
$ 1,999.25
$ 2,935.84
$ 1,103.72
$ 3,468.53
$ 3,510.83
$ 1,341.78
HMO Cohort N=1,551
Hospital Expenditure
Physician Expenditure
Pharmacy Expenditure
$
$
$
1,842.80
2,381.08
1,107.64
$ 1,796.37
$ 2,959.90
$ 1,498.54
$ 1,956.83
$ 3,088.22
$ 1,640.25
PPO Cohort N=1,554
Hospital Expenditure
Physician Expenditure
Pharmacy Expenditure
$
$
$
1,779.06
2,245.22
1,007.95
$ 2,049.76
$ 2,834.32
$ 1,484.91
$ 2,367.17
$ 3,294.47
$ 1,789.26
NOTE: These are results from a restricted continuously enrolled sample of 50% to 60% of the total employee
population and are not a reflection of the plans’ full PMPM expenditures.
Was ADJUSTED service use
different for CDHPs?
Health Plan Cohorts
2000
Mean
2001
Mean
2002
Mean
CDHP Cohort N=531
Physician Visits
Hospital Admission Rate
Prescriptions Filled
5.74
0.05
18.89
7.49
0.10
22.23
7.15
0.16
22.23
HMO Cohort N=1,551
Physician Visits
Hospital Admission Rate
Prescriptions Filled
6.75
0.07
22.23
7.56
0.06
22.59
7.29
0.09
30.89
PPO Cohort N=1,554
Physician Visits
Hospital Admission Rate
Prescriptions Filled
5.78
0.07
20.63
6.54
0.07
23.79
6.95
0.11
24.50
NOTE: These are results from a restricted continuously enrolled sample of 50% to 60% of the total employee
population and are not a reflection of the plans’ full admissions and prescription drug experience.
Distribution of CDHP Population by
PCA Usage Levels
PCA MAP
Under PCA Limit
Ended Within Gap
Above Deductible
Continuously enrolled population
2001
40%
13%
47%
2002
28%
15%
57%
Conclusions
• The most important factor affecting choice is income.
• The consumer drive health plan was not
disproportionately chosen by the young and the healthy
(for the U of MN population).
• For the non-U of MN pop, in adjusted dollars, the
patterns remains, despite the likely event that the
CDHP experienced favorable expenditure selection.
• Year 3 of CDHP experience will reveal if they can
stem high cost growth trajectory from years 1 & 2.
Critical Caveat:
Benefit Design will Drive Expenditure Results
‘Draconian’ benefit design for family contract:
•
$1,0000 PCA, $4,000 Deductible, 20% co-insurance after deductible
Current industry standard design for family contract:
•
$2,000 PCA, $4,000 Deductible, 10% to 15% co-insurance after
deductible
Generous benefit design for family contract:
•
$2,000 PCA, $3,000 Deductible, 0% co-insurance after deductible
Policy Opportunities
What is the Upside to CDHPs?
• Innovative means to bring consumer choice into the
medical marketplace as well as consumer awareness of
the trade-offs of liberal medical insurance coverage
policies.
• Creates infrastructure for personal, portable health
care coverage.
• Hybrid variants could be crafted to serve low income,
part time workers and possibly the uninsured through
tax credits and vouchers.
Policy Conundrums
What is the Downside to CDHPs?
• What if CDHPs accelerate the consumer’s
burden of health care spending ‘too’ quickly?
• Not much incentives for managed care’s proven
assets (e.g., disease management) to play a role.
Next Steps within the
RWJ Grant Period
2nd Year U of M Survey
Examination of switching behavior
Multi-employer/multi-year results
Examine the effect of online tools on medical
care demand
• More detailed examination of service use
differences from claims data
•
•
•
•
Next Steps in a (soon to be) Proposed
RWJ Grant Extending the Analysis
• Involve 12 employers
– 6 original employers in study
– 6 new employers using non-Definity CDHPs
• Three year continuation grant
• Develop five year cohorts for six original employers to
see long terms effects on plan selection and the
resulting cost and utilization impact.
• Develop optimal choice model of plan selection for a
consumer.
• Empirically test optimal choice to examine rationality
of consumers as the market evolves.
CDHP’s Legislative Cousins:
Health Savings Accounts
Introduced in the 2003 Medicare Reform Law
What it enables:
•
•
•
Any U.S. citizen can create a ‘qualified’ HSA
account.
Must have ‘catastrophic health insurance’ with
minimum deductible of $2,000. Max is $10,000 for
a family contract.
Individuals or employers can make annual pre-tax
contribution to an HSA, separate from the
insurance policy, of 100% of the deductible (max
of $5,150).
Compare & Contrast:
The CDHP Model versus….
Health Tools
and Resources
$$
Health Coverage
• Preventive care covered 100%
• Annual deductible
Definity
• Expenses beyond the PCA
Health
Care
• Nationwide provider access
Advantage
• No referrals required
Health Tools and Resources
• Care management program
• Extensive easy-to-use
information and services
1
2
Annual
Deductible
PCA
Employer selects which expense apply toward the Health Coverage annual deductible.
Paid out of employer’s general assets.
Preventive Care 100%
Health
Coverage
Annual Deductible
Personal Care Account (PCA)
• Employer allocates PCA1
• Member directs PCA
• Section 213(d) “scope”
• Roll over at year-end
• Apply toward deductible2
Web- and
PhoneBased
Tools
…The HSA Model
Annual Deductible
Health Coverage
• Purchased by ‘Qualified’ Plans
• Annual deductible
• Expenses beyond the HSA
• No managed care provisions
• Nationwide provider access
• No referrals required
Health
Coverage
Annual
Deductible
HSA
Preventive Care 100%
Health Care Account (HSA)
• Consumer/Employer allocates HSA
• Consumer directs HSA
• Owned by consumer and portable
• Roll over at year-end
$$
• Many deposited pre-tax
• Consumer can withdrawal with penalty
• Can apply toward deductible
Why Would Anyone Want such a Wacky Thing?
Compare & Contrast
Old Way for Family to Buy
Coverage:
Buy family policy from BCBS
Policy cost: $8,460
Plan has $500 deductible
Deductible applied per person
Deductible capped at $1,000
Cost if healthy: $8,460
Cost if 1 person sick: $8,960
Cost if 2+ people sick: $9,460
The New HSA Way:
 Buy ‘qualified’ plan from
BCBS
 Qualified plans costs: $3,936
 Plan has $2,500 deductible
 Deductible applied per person
 Deductible capped at $5,000
 Cost of healthy: $3,936
 Cost if 1 person sick: $6,436
 Cost if 2+ people sick: $8,936
HSA Policy Questions we can answer
• What type of person chooses the plans?
• If they save money, how?
• What would be the cost of filling the uninsured
gap with this type of plan?
What unique data do we have?
• For all CDHP-offered employees, a combination of:
–
–
–
–
–
Plan choice
Benefit design
Income and other demographics
FSA election
Claims history (medical, hospital, pharmacy)
• For CDHP enrollees:
– Use of Internet tools
– Use of preventive service benefit
– Behavior at ‘key’ points of inflection
What We Want to Do if Someone
Pays the Tab
• Combine our data with MEPS to cost out HSA
plan for different segments of the population
through micro-simulation.
– Focus on low-income because we could price a
voucher/tax credit.
– We know how much low-income people would
spend because they are present in our data.
– We know how preventive care in HSA would work
with actual data for this population too.
Could We Estimate a Choice Model
to Look at Possible Take-Up?
• What we know:
– Choices of individuals in firms with multiple health
plans
– Their consumption given their choices
• What we don’t know:
– Probability of uninsured choosing an HSA
– If employers will offer HSAs as a choice with other
plans or as a replacement
– Individual insurance market take-up rate
Econometric Issues
•
How to group health plan choices?
•
Ideally, estimate separate choice models for:
1. Single employees with no dependents
2. Families who have no other source of health insurance
3. Families who have multiple choices of health insurance
•
•
•
Practically, we can’t identify (2) and (3), so we combine single and
family contracts into one choice model through the use of planinteracted dummy variables (Feldman & Schultz, 2001).
Considered a nested logit, but the Definity next, if weighted,
was not large enough.
Correction for oversampling Definity and undersampling the
other plans. Lerman-Manski correction was used obtain
appropriate standard errors.
Impact of price, employee characteristics and health
plan feature preferences on health plan choice
Variable
Description
Coefficient
Standard
Deviation
T-Statistic
Marginal
Effect
Medical Insurance Tax-Adjusted Premium
ADJPREM
Employee Medical Insurance Premium-Adjsuted
-0.002
0.0007
-2.265
CHR_PREM
Premium Price & Chronic Interaction
-0.001
0.0001
-7.878
FAM_PREM
Premium Price & Family Contract Interaction
0.001
0.0007
1.749
Plan Choices Intercepts (The HMO Health Partners is the reference category)
DF_INT
CDP - Definity Intercept
-2.572
0.887
-2.899
PC_INT
PTC - Patient Choice Intercept
-4.061
0.348
-11.668
P1_INT
PPO - Preferred One Intercept
-7.003
0.859
-8.151
0.409
0.271
1.507
5.911
Employee Chararacteristics
DF_CHR
CDP
CP_CHR
PTC
-0.109
0.117
-0.936
-1.819
P1_CHR
PPO
1.818
0.219
8.301
11.792
DF_FAM
CDP
-0.418
0.319
-1.31
-6.038
CP_FAM
PTC
0.368
0.114
3.233
6.126
P1_FAM
PPO
0.083
0.649
0.129
0.541
DF_INC
CDP
0.013
0.005
2.404
0.187
CP_INC
PTC
0.007
0.003
2.524
0.109
P1_INC
PPO
-0.004
0.003
-1.664
-0.029
DF_FEM
CDP
-0.013
0.251
-0.05
-0.181
CP_FEM
PTC
-0.324
0.114
-2.856
-5.396
P1_FEM
PPO
-0.203
0.119
-1.7
-0.608
DF_AGE
CDP
0.008
0.012
0.621
0.111
CP_AGE
P1_AGE
PTC
0.030
0.006
PPO
0.036
0.006
5.279
6.574
0.503
0.235
Chronic Patient or Family Member
Family Contract=1, Single=0
After tax income (in thousands)
Gender, Female=1, Male=0
Employee Age
Continued: Impact of employee characteristics and
health plan feature preferences on health plan choice
Variable
Description
Coefficient
Standard
Deviation
T-Statistic
Marginal
Effect
Employee Chararacteristics
DF_KND
CDP
-0.132
0.248
-0.534
CP_KND
PTC
0.282
0.119
2.374
4.689
P1_KND
PPO
-0.636
0.116
-5.48
-4.123
0.811
0.322
2.515
11.723
Employee Benefit Knowledge
-1.912
Employee Health Plan Feature Preferences
DF_NPL
CDP
CP_NPL
PTC
0.132
0.147
0.9
2.203
P1_NPL
PPO
0.687
0.146
4.699
4.456
DF_PRV
CDP
0.406
0.310
1.311
5.869
CP_PRV
PTC
0.204
0.127
1.608
3.397
P1_PRV
PPO
0.037
0.138
0.266
0.238
DF_MDR
CP_MDR
P1_MDR
DF_NRF
CP_NRF
P1_NRF
DF_NCP
CP_NCP
P1_NCP
DF_ROL
CP_ROL
P1_ROL
DF_ONL
CP_ONL
P1_ONL
CDP
0.822
0.324
PTC
1.777
0.140
PPO
5.396
0.398
2.539
12.727
13.561
2.58
2.430
7.828
-0.185
2.567
-1.443
0.585
-0.671
-7.068
1.696
5.587
-4.446
11.889
29.558
35.002
11.535
5.013
6.219
-0.978
6.206
-1.351
2.785
-1.522
-7.292
12.776
20.193
-18.143
Number of observations
Log-L for Choice model
Adjusted R-square
CDP
National Provider Panel
Preventive Services Covered
My Doctor is in the Panel
No Referrals or Pre-Authorization
PTC
PPO
0.80
0.31
0.301
0.124
0.96
0.122
-0.07
0.365
PTC
0.373
0.145
PPO
-0.208
0.144
0.193
0.329
PTC
-0.092
0.136
PPO
-1.124
0.159
0.884
0.521
PTC
1.214
0.217
PPO
-2.797
0.629
CDP
CDP
CDP
915
-897.19
0.30
Health Plan has No Copayments
Personal Care Account Rolls Over
Use of On-line Tools