Une \u00e9tude conduite dans le cadre d\u2019un syst\u00e8me d\u2019assurance maladie \u00e0 base d\u2019emploi a \u00e9valu\u00e9, aux \u00c9tats-Unis, l\u2019impact d\u2019une information cibl\u00e9e sur les co\u00fbts des cliniques de soins primaires (Primary Care Clinics, PCCs) sur les choix des assur\u00e9s lors de la p\u00e9riode d\u2019adh\u00e9sion annuelle (\u201copen enrollment\u201d) pour l\u2019ann\u00e9e 2020. Le dispositif concernait un r\u00e9gime avec hi\u00e9rarchisation des PCC en plusieurs niveaux (\u201ctiers\u201d) fond\u00e9s sur le co\u00fbt total des soins, chaque niveau \u00e9tant associ\u00e9 \u00e0 un niveau de reste \u00e0 charge diff\u00e9rent.<\/p>\n
Les assur\u00e9s ont \u00e9t\u00e9 r\u00e9partis de fa\u00e7on al\u00e9atoire par code postal de r\u00e9sidence : 100 codes postaux ont \u00e9t\u00e9 affect\u00e9s au groupe \u201ctraitement\u201d et 100 au groupe \u201ccontr\u00f4le\u201d. Les membres du groupe \u201ctraitement\u201d ont re\u00e7u, pendant la p\u00e9riode d\u2019adh\u00e9sion, des courriels leur fournissant des informations renforc\u00e9es sur le niveau de co\u00fbt (tier) des PCC les plus fr\u00e9quemment utilis\u00e9s dans leur zone de r\u00e9sidence. Le groupe \u201ccontr\u00f4le\u201d n\u2019a pas re\u00e7u cette information suppl\u00e9mentaire. Des analyses de r\u00e9gression ont \u00e9t\u00e9 men\u00e9es pour mesurer l\u2019effet marginal de cette intervention cibl\u00e9e sur le choix de PCC.<\/p>\n
Les r\u00e9sultats montrent que l\u2019envoi d\u2019informations d\u00e9taill\u00e9es sur le niveau de co\u00fbt des PCC locaux n\u2019a eu qu\u2019un effet marginal et limit\u00e9 sur les choix des assur\u00e9s. Avant m\u00eame l\u2019intervention, pr\u00e8s de 85 % des consommateurs s\u00e9lectionnaient d\u00e9j\u00e0 des PCC appartenant aux deux niveaux avec le plus faible reste \u00e0 charge. Ce r\u00e9sultat sugg\u00e8re que le simple m\u00e9canisme de hi\u00e9rarchisation des co\u00fbts dans le contrat d\u2019assurance avait d\u00e9j\u00e0, en grande partie, corrig\u00e9 les probl\u00e8mes d\u2019asym\u00e9trie d\u2019information et de signal-prix pr\u00e9sents dans d\u2019autres mod\u00e8les de couverture.<\/p>\n
Les auteurs concluent que les interventions purement informationnelles, m\u00eame cibl\u00e9es et personnalis\u00e9es, sont insuffisantes pour r\u00e9duire sensiblement l\u2019inertie des assur\u00e9s dans le choix de leur structure de soins primaires, soit parce que cette inertie est difficile \u00e0 surmonter, soit parce que les assur\u00e9s disposaient d\u00e9j\u00e0 d\u2019un niveau d\u2019information jug\u00e9 suffisant via le dispositif de hi\u00e9rarchisation des co\u00fbts. Cette exp\u00e9rience apporte un \u00e9l\u00e9ment de comparaison utile pour les politiques publiques qui envisagent de s\u2019appuyer sur la diffusion d\u2019informations sur les co\u00fbts pour orienter les choix des assur\u00e9s, en soulignant l\u2019importance de la conception globale du contrat (notamment les m\u00e9canismes de tiers et de reste \u00e0 charge) par rapport aux seules actions d\u2019information.(contenu r\u00e9sum\u00e9 en fran\u00e7ais par l’IA)\u00a0Lire la Suite<\/a><\/p>","protected":false},"excerpt":{"rendered":" Une \u00e9tude conduite dans le cadre d\u2019un syst\u00e8me d\u2019assurance maladie \u00e0 base d\u2019emploi a \u00e9valu\u00e9, aux \u00c9tats-Unis, l\u2019impact d\u2019une information cibl\u00e9e sur les co\u00fbts des cliniques de soins primaires (Primary 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