What’s Your Doctor Worth to You?

Should I switch plans to keep my doctor?

Every open enrollment season, many employees face a deceptively simple question: should I choose the plan that looks better on paper, or the one that lets me keep my doctor? Employer-provided health insurance covers more than half the U.S. population, so this is not a niche problem. It is a recurring decision for millions of people.

Health insurance plans spend substantial time designing high-value options for employers and member segments. But designing for a population is one challenge; understanding the value an individual member places on keeping a trusted doctor is another. A plan can look better on premium, benefits and network breadth, but if a member’s current doctor is not included, the value equation changes.

In Doctor Switching Costs, published in the Journal of Public Economics, Gordon B. Dahl from the University of California San Diego and Silke J. Forbes from Tufts University use a quasi-random health insurance experiment in the University of California system to estimate how much employees value keeping their current doctors.

The setting was unusually clean. The University of California created a new version of its existing Health Net plan, called Health Net Blue & Gold. The two plans differed in premiums and doctor networks, while other financial characteristics, covered treatments, and plan administration stayed the same.

The key nuance is that not everyone faced the same trade-off.

Consider this example:

Suppose that two employees are both in the more expensive Health Net plan. One employee’s doctor is already in the cheaper Health Net Blue & Gold plan, so switching would save money without requiring a doctor change. If that employee does not switch, it suggests inattention, confusion or inertia.

Another employee’s doctor is not in the cheaper plan, so switching would save money but require changing doctors. If that employee stays in the more expensive plan, it suggests something more specific: a willingness to pay more to keep the current doctor. Comparing these two situations allowed the researchers to separate general plan-choice inattention from the value people placed on keeping their doctor.

The results are striking.

• Forty-six percent of employees were willing to pay higher premiums to keep their doctors, with the price of keeping a doctor ranging from about $600 to $1,900 per year.
• At the same time, 21% of employees whose doctors were already in the cheaper plan still stayed in the more expensive default plan in the first year, even though switching would have saved them up to $1,900 annually without requiring a doctor change. That is, about a fifth of people are not paying enough attention or not understanding the plan.

The study also shows that member segments differ. Older and sicker employees pay more attention and also have stronger attachment to their doctors. That means the practical challenge varies by audience: some members may need simpler decision support and stronger reminders, while others may place real economic value on provider continuity.

For health plans, the lesson is that provider networks are not just operational infrastructure. They are part of the members’ value proposition. Open-enrollment messaging, network strategy, plan design and decision support all need to reflect that members may value keeping a trusted doctor as much as – or sometimes more than – other plan features.