The long-term goal of the candidate's research agenda is to determine how choice among competing health plans within group purchasing arrangements can most effectively be designed to provide access to and deliver high quality, high-value health care to consumers. In this research career award application, the candidate identifies short-term (5-year) career development and research objectives leading toward that goal and describes an integrated career development and research plan that will enable her to achieve these objectives. Career development activities include formal training in three new methodological areas, formal career development mentoring, and research collaborations with senior investigators. The research agenda has the following three specific aims: 1) to analyze how individuals choose among alternative health plans, focusing on how characteristics of managed care plans influence the choices of different types of consumers; 2) to examine the effects of group purchasing strategies relying on choice among competing plans on cost and access to health insurance for consumers and purchasers, and to determine how the mix of individuals within a purchasing group affects these outcomes; and 3) to determine how differences between public and private purchasers in their objectives and the composition of their covered populations affect the feasibility and optimal design of group health insurance purchasing arrangements. To analyze individual choice among health plans, the candidate will conduct econometric studies of individual choice behavior, focusing on the elderly and near-elderly. She will also use an alternative, complementary methodology, contingent valuation, to determine the value individuals place on health plan characteristics. The applicant will explore the implications of group purchasing strategies by developing a simulation model of health insurance purchasing groups and estimating empirical models of the determinants of employer purchasing strategies.
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