Presenting Quality Data to Vulnerable Groups: Charts, Summaries or Behavioral Economic Nudges?

Elbel B, Gillespie C, Raven MC.
Elbel B, Schlesinger M. Responsive Consumerism: Empowerment in Markets for Health Plans. The Milbank Quarterly. 2009; 87(3): 633-682.


Despite the increased focus on health care consumers' active choice, not enough is known about how to best facilitate the choice process. We sought to assess methods of improving this process for vulnerable consumers in the United States by testing alternatives that emphasize insights from behavioral economics, or 'nudges'.


We performed a hypothetical choice experiment where subjects were randomized to one of five experimental conditions and asked to choose a health center (location where they would receive all their care). The conditions presented the same information about health centers in different ways, including graphically as a chart, via written summary and using behavioral economics, 'nudging' consumers toward particular choices. We hypothesized that these 'nudges' might help simplify the choice process. Our primary outcomes focused on the health center chosen and whether consumers were willing to accept 'nudges'.


We found that consumer choice was influenced by the method of presentation and the majority of consumers accepted the health center they were 'nudged' towards.


Consumers were accepting of choices grounded in insights from behavioral economics and further consideration should be given to their role in patient choice.

Wagner Faculty