Enrollment in Medicare Advantage Plans in Miami-Dade County: Evidence of Status Quo Bias? by Anna D. Sinaiko, Christopher C. Afendulis and Richard G. Frank (National Bureau of Economic Research)
Evidence from behavioral economics reveals that decision-making in health care settings can be affected by circumstances and choice architecture. This paper conducts an analysis of choice of private Medicare plans (Medicare Advantage plans) in Miami-Dade County. We provide a detailed description of the choice of MA plans available in Miami over much of the program’s history and the composition of Medicare beneficiaries in Miami over the 2000s. Our analysis suggests that first becoming eligible for Medicare is the key transition point for MA, and that there is significant status quo bias in the MA market. This consumer behavior has important implications for policy that regulates the MA market.
Making Nutritional Information Digestible: Effects of a Receipt-Based Intervention on Restaurant Purchases by Kelly Bedard and Peter J. Kuhn
We study the effects of receipts that include personalized ordering suggestions designed to reduce fat and calorie consumption on purchasing behavior at a restaurant chain. We find that customers, in the aggregate, made most of the item substitutions that were encouraged by the messages, such as substituting ham for sausage in a breakfast sandwich, or substituting frozen yogurt for ice cream, though effects on overall calories and fat consumed were small. The results illustrate the potential of emerging information technologies, which allow retailers to tailor product marketing to individual consumers, to contribute in meaningful new ways to the battle against obesity.
Reducing Moral Hazard in Employment Relationships: Experimental Evidence on Managerial Control and Performance Pay by C. Kirabo Jackson and Henry S. Schneider (National Bureau of Economic Research)
Moral hazard is endemic to employment relationships and firms often use performance pay and managerial control to address this problem. While performance pay has received much empirical attention, managerial control has not. We analyze data from a managerial-control field experiment in which an auto-repair firm provided detailed checklists to mechanics and monitored their use. Revenue was 20 percent higher under the experiment. We compare this effect to that of quasi-experimental increases in mechanic commission rates. The managerial-control effect is equivalent to that of a 10 percent commission increase. We find evidence of complementarities between the two, suggesting benefits from an all-of-the-above approach. We also find evidence of incentive gaming under performance pay.
Coronary Artery Bypass Graft Surgery vs Percutaneous Interventions in Coronary Revascularization: A Systematic Review by Saswata Deb and others (JAMA)
Ischemic heart disease is the leading cause of death globally. Coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI) are the revascularization options for ischemic heart disease. However, the choice of the most appropriate revascularization modality is controversial in some patient subgroups. […] Thirteen RCTs and 5 meta-analyses were included. […] Both CABG surgery and PCI are reasonable options for patients with advanced CAD. Patients with diabetes generally have better outcomes with CABG surgery than PCI. In cases of ULMD, multivessel CAD, or LVD, CABG surgery should be favored in patients with complex coronary lesions and anatomy and PCI in less complicated coronary disease or deemed a high surgical risk. A heart-team approach should evaluate coronary disease complexity, patient comorbidities, patient preferences, and local expertise.
Subgroup Analyses in Trial Reports Comparing Percutaneous Coronary Intervention With Coronary Artery Bypass Surgery by Stuart J. Head and others (JAMA)
Subgroup analyses within randomized clinical trials (RCTs) may not be valid, although they may identify important treatment heterogeneity. Reviews of subgroup analyses in primary reports of RCTs have found low credibility due to methodological or reporting issues.2 Subgroup analyses may also be presented in separate reports of extended follow-up beyond the primary end point or specific subgroups of patients.