Understanding Health Insurance Choice and Provider Markets

“I’m very interested in how people make decisions among different types of health insurance plans, what factors drive their decisions, and what are the implications of those choices.”

Kate Bundorf, associate professor of health research and policy at the Stanford University School of Medicine, has long been driven to help people get health insurance and to understand their options when selecting coverage. Over the years, her research has advanced professional knowledge in health care financing and delivery, health insurance choices, and employer-sponsored health insurance as well as their effect on access, cost, and quality of care.

Recently, Dr. Bundorf has examined how physician consolidation and hospital-physician integration influence the price and quantity of health care services. This research highlights a significant unintended consequence of policies aimed at promoting greater integration among providers—namely, providers charge higher prices when they have greater market power.

Another recent project arose from her desire to help people select appropriate coverage. Dr. Bundorf wanted to determine the types of challenges Medicare beneficiaries face when choosing a Part D prescription drug plan. To ease the confusion these beneficiaries sometimes encounter when trying to choose among several different plans, Dr. Bundorf and her team designed an online decision tool to help older adults understand and choose Medicare Part D prescription drug coverage. The goal is to roll out the tool as part of a randomized, controlled trial during the 2016 Medicare Open Enrollment period.

In preliminary work, Dr. Bundorf has found that people tend to fall into one of two groups: (1) those who want guidance and "expert" recommendations or (2) those who want to examine and understand the details of each available choice. The trial will test the effectiveness of providing expert recommendations.

This project stemmed from an AHRQ Career Development (K) Award Dr. Bundorf received in 2001. The AHRQ award allowed her to work in a hypothetical context to discover barriers to decisionmaking, which led to her focus on helping Medicare Part D beneficiaries choose the best coverage for their individual circumstances.

In addition to her position at Stanford, Dr. Bundorf is also a faculty research fellow at the National Bureau of Economic Research. In 2015, she was appointed to the U.S. Congressional Budget Office Panel of Health Advisors. She was also a Fulbright Lecturer at Fudan School of Public Health in Shanghai, China, during 2009 and 2010. Her research on health insurance and health policy has been published in leading health policy and economic journals.

Interview Transcript

Principal Investigator:  M. Kate Bundorf, Ph.D., M.B.A., M.P.H., Associate Professor of Health Research and Policy
Institution: Stanford University School of Medicine
Grantee Since: 2001
Type of Grant: Multiple

Consistent with its mission, AHRQ provides a broad range of extramural research grants and contracts, research training, conference grants, and intramural research activities. AHRQ is committed to fostering the next generation of health services researchers who can focus on some of the most important challenges facing our Nation's health care system.

To learn more about AHRQ's Research Education and Training Programs, please visit: http://www.ahrq.gov/training.

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Page last reviewed August 2016
Page originally created February 2016
Internet Citation: Understanding Health Insurance Choice and Provider Markets . Content last reviewed August 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/funding/grantee-profiles/grtprofile-bundorf.html