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Moving to personalized medicine requires personalized health plans

Powell, Adam and Dolan, Paul (2022) Moving to personalized medicine requires personalized health plans. Journal of Participatory Medicine, 14 (1). ISSN 2152-7202

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Identification Number: 10.2196/35798


When individuals, families, and employers select health plans in the United States, they are typically only shown the financial structure of the plans and their provider networks. This variation in financial structure can lead patients to have health plans aligned with their financial needs, but not with their underlying nonfinancial preferences. Compounding the challenge is the fact that managed care organizations have historically used a combination of population-level budget impact models, cost-effectiveness analyses, medical necessity criteria, and current medical consensus to make coverage decisions. This approach to creating and presenting health plan options does not consider heterogeneity in patient and family preferences and values, as it treats populations as uniform. Similarly, it does not consider that there are some situations in which patients are price-insensitive. We seek to highlight the challenges posed by presenting health plans to patients in strictly financial terms, and to call for more consideration of nonfinancial patient preferences in the health plan design and selection process.

Item Type: Article
Official URL:
Additional Information: © 2022 The Authors
Divisions: Psychological and Behavioural Science
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 01 Sep 2022 17:24
Last Modified: 17 Nov 2023 17:48

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