The HCFO program ended in December 2016.
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Anna D. Sinaiko, Ph.D.
Anna D. Sinaiko, Ph.D., is a research scientist in the Department of Health Policy and Management at the Harvard School of Public Health. Dr. Sinaiko received her Ph.D. in health policy with a concentration in economics from Harvard University in 2010. Her research focuses on consumer decision-making and how information and financial incentives alter consumer behavior in health care settings. Specific empirical projects include an examination of consumer response to tiered physician networks, of consumer experience in the Massachusetts health insurance exchange, and of consumer choice of private Medicare plans.
Since December 2013, Dr. Sinaiko has been the principal investigator on a project funded as part of a Robert Wood Johnson Foundation’s solicitation, “Understanding the Use and Impact of Price Data in Health Care.” Dr. Sinaiko and her research team are examining the impact of price transparency tools on consumer behavior. The researchers will evaluate the effects of the Aetna Member Payment Estimator (MPE), a web-based transparency tool that provides personalized, real-time, service-level estimates of consumer out-of-pocket and total costs for over 500 common, non-emergent services to Aetna enrollees. The researchers will use enrollment, eligibility, and other MPE data, as well as data from the Area Resource File to (1) analyze the characteristics of members who used and did not use the MPE; (2) analyze the impact of the MPE on provider choice, out-of pocket spending and total spending; and (3) identify patient, plan and health care service characteristics associated with greater use of the MPE. The goal of this project is to inform ongoing and future price transparency policies, including the use of consumer information tools.
Dr. Sinaiko also worked with Meredith Rosenthal, Ph.D., Harvard School of Public Health, on a HCFO-funded study examining the impact of tiered physician networks on consumer behavior. The study, conducted from July 2010 through December 2011, focused on tiered physician networks introduced in six health plans offered to beneficiaries of the Massachusetts Group Insurance Commission (GIC). The researchers explored (1) whether tier status of a regular physician is associated with choice of plan; (2) whether tier status affects the probability that a patient will visit a physician for the first time; (3) whether tier status affects the probability that a patient will continue seeking care with a physician seen prior to tiering; and (4) the patient, plan, and physician characteristics associated with greater responsiveness on aims 1-3. The objective of this project was to assist employers in assessing the impact of tiered physician networks on consumer behavior and to assess the value of this benefit design feature. The researchers observed that patients had considerable loyalty to their physicians, and there was no impact of a physician’s tier-ranking on patient decisions to switch away from a physician they had seen previously. However, tiering did affect patient selection of physicians when they were visiting a doctor for the first time; Sinaiko and Rosenthal report that the physicians in the least-preferred tier (those with the worst rankings) had a significantly smaller market share of new patients than did their top and average tiered colleagues. Information on the HCFO-funded study with Meredith Rosenthal is available here.