Effect of Email Nudges on Plan Switching and Healthcare Utilization Among Unemployment Insurance Recipients

NCT ID: NCT05891418

Last Updated: 2023-06-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

42470 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-25

Study Completion Date

2021-12-31

Brief Summary

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In March 2021, President Biden signed into law the American Rescue Plan Act of 2021 (ARP), a landmark federal economic relief and stimulus package designed to provide support to Americans hit by the economic recession brought about by the COVID-19 global pandemic. The law provides increased federal premium tax credits (PTC), and ensures that consumers will pay no more than 8.5 percent of household income on health insurance premiums in 2021 and 2022, if enrolled through an Affordable Care Act marketplace like Covered California.

The ARP also provides additional PTC and cost-sharing reduction (CSR) benefits to eligible marketplace enrollees who report receiving unemployment insurance benefits (UIB) for at least one week in 2021. Under the law, for 2021 only, Covered California consumers will have their household income level treated as if it were at 138.1 percent of the federal poverty level (FPL), regardless of their projected annual income, which will make them eligible for a Silver 94 plan, and which offers the greatest value on cost-sharing benefits.

But in order to access those cost-sharing benefits, households must be in silver tier plans, but over 40,000 were not. This project's goal is to assess the effects of an informational email on plan switching into Cost Sharing Reduction Silver plans and downstream healthcare utilization.

The project's research design is a randomized intervention among approximately 42,500 enrolled households with an email address in non-silver tier plans. The investigators randomly assigned to either two informational emails or to a no email control group. The investigators then collected administrative data to examine plan switching behavior and healthcare utilization among households in the study.

Detailed Description

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Conditions

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Health Behavior

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Participants

Study Groups

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Control Group with a standard eligibility notice

Control group was assigned to receive no email outreach in June and July beyond an eligibility redetermination notice.

Group Type EXPERIMENTAL

Standard notice of eligibility determination

Intervention Type BEHAVIORAL

No extra outreach during intervention period.

Treatment group with a standard eligibility notice and assigned two email nudges

Assigned to receive an eligibility redetermination notice along with two informational emails about the benefits of Cost-Sharing Reduction Silver plans.

Group Type EXPERIMENTAL

Two informational emails with plan information

Intervention Type BEHAVIORAL

Informational emails about the benefits of Cost-Sharing Reduction Silver plans.

Interventions

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Two informational emails with plan information

Informational emails about the benefits of Cost-Sharing Reduction Silver plans.

Intervention Type BEHAVIORAL

Standard notice of eligibility determination

No extra outreach during intervention period.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Has email address, in a non-silver plan and reported unemployment insurance in 2021

Exclusion Criteria

* In a silver plan, no email address
Minimum Eligible Age

0 Years

Maximum Eligible Age

74 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Office of Evaluation Sciences

FED

Sponsor Role lead

Responsible Party

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Andrew Feher

Research Scientist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Andrew Feher, PhD

Role: PRINCIPAL_INVESTIGATOR

Covered California

Locations

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Covered California

Sacramento, California, United States

Site Status

Countries

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United States

References

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Lovchikova M, Feher A, Lian L. Health Plan Switching and Health Care Utilization: A Randomized Clinical Trial. JAMA Health Forum. 2024 Mar 1;5(3):e240324. doi: 10.1001/jamahealthforum.2024.0324.

Reference Type DERIVED
PMID: 38551588 (View on PubMed)

Provided Documents

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Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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022023

Identifier Type: -

Identifier Source: org_study_id

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