Capturing and harvesting in Medicare Advantage plan design.

Consumers in health insurance markets have inertia stemming from the desire to maintain relationships with providers and other frictions involved in switching plans. In other markets that feature inertia, suppliers respond with pricing strategies that vary by market share: lowering markups to capture consumers when market shares are low and raising markups to harvest profits once market share has been established. I tested for this behavior in the Medicare Advantage (MA) market by examining how MA plan sponsors changed the financial terms of their plans in response to changes in market share from 2007 to 2021 using a first-difference model with fixed effects. I found evidence that plans increase premiums, copays, and out-of-pocket limits when market shares increase. The results imply that for every 1% increase in market share, plan sponsors subsequently increase out-of-pocket costs by 1% in the following year.

Costs of being a diet generalist for the protist predator Dictyostelium discoideum.

Consumers range from specialists that feed on few resources to generalists that feed on many. Generalism has the clear advantage of having more resources to exploit, but the costs that limit generalism are less clear. We explore two understudied costs of generalism in a generalist amoeba predator, Dictyostelium discoideum, feeding on naturally co-occurring bacterial prey. Both involve costs of combining prey that are suitable on their own. First, amoebas exhibit a reduction in growth rate when they switched to one species of prey bacteria from another compared to controls that experience only the second prey. The effect was consistent across all six tested species of bacteria. These switching costs typically disappear within a day, indicating adjustment to new prey bacteria. This suggests that these costs are physiological. Second, amoebas usually grow more slowly on mixtures of prey bacteria compared to the expectation based on their growth on single prey. There were clear mixing costs in three of the six tested prey mixtures, and none showed significant mixing benefits. These results support the idea that, although amoebas can consume a variety of prey, they must use partially different methods and thus must pay costs to handle multiple prey, either sequentially or simultaneously.

The effect of inhibitory control and language proficiency on intra-sentential switching costs in reading comprehension.

Based on the inhibition account and activation account, inhibitory control and language proficiency play big roles on language control mechanisms underlying language switching respectively. But it is still debatable whether inhibitory control and language proficiency play roles in sentential context during bilingual language comprehension, and how and when they work if they both do. The present study examined the specific roles of language proficiency and inhibitory control on modulating intra-sentential switching costs in Chinese-English bilinguals using self-paced reading task. Results indicated that language proficiency and switching direction modulated intra-sentential switching costs significantly. Switching costs were larger when switching into L1 than into L2 for the first two code-switched words due to inhibitory effect, but more costly switching into L2 than into L1 since the third code-switched words owing to the effect of relative language proficiency. During bilingual language processing, inhibition and activation of languages shaped a dynamic interplay of complementary language control processes. Specifically, inhibitory control and language proficiency work as a dynamic continuum in language switching at sentence level. Switching into L1 requires the release of inhibition to L1, but switching into L2 asks the activation and access of L2. The interaction effects of language proficiency and inhibitory control influenced the exertion and components of inhibition. This study reconciled the independent roles of language proficiency and inhibitory control on language switching and constructed a new continuum based on language proficiency.

Language-switching and retrieval-based learning: an unfavorable combination.

Language-switching costs arise when learners encode information in one language and subsequently recall that information in a different language. The assumed cognitive mechanism behind these costs is the principle of encoding specificity that implies language-dependent representations of information. The aim of our study was to test this mechanism and to gain insights into the impact of language-switching on subsequent learning. To this end, we used retrieval-based learning as a carrier-paradigm. In a 2×3-design, 117 participants learned mathematical concepts with a practice-test or a restudy opportunity (within-subjects factor). In addition, the sample was divided into three groups regarding language-switching (between-subjects factor): one group without switching, one switched for the final tests, and one switched between initial learning and subsequent learning. Results show the expected main effects: participants performed better for the items learned via retrieval-based learning (testing-effect) and worse in conditions with language-switching (language-switching-costs). Most importantly, we were able to find an interaction between learning condition and language-switching: retrieval-based learning suffers particularly from language-switching. Additionally, our results indicate that language switching before subsequent learning seems to be particularly detrimental. These results provide both validation for encoding specificity as mechanism underlying language-switching costs and new information on the impact of the time of language-switching that can be considered in educational designs such as "Content and Language Integrated Learning."

Investigating the modulation of stimulus types on language switching costs: Do semantic and repetition priming effect matter?

Introduction: In the present study, I investigated the influence of stimulus types on bilingual control in the language switching process. The commonly employed stimuli in language switching studies - Arabic digits and objects - were compared to further investigate the way in which inhibitory control could be modulated by semantic and repetition priming effects. The digit stimuli have two unique characteristics in the language switching paradigm, for example, they are present repeatedly and are semantically related to each other, compared with pictural stimuli. Thus, these unique characteristics might influence the operation of inhibitory control in bilingual language production, modulating the size and asymmetry of switching costs. Methods: Two picture control sets were set up to match those characteristics: (1) a semantic control set, in which picture stimuli belong to the same category group, such as, animals, occupations or transportation and specific semantic categories were presented in a blocked condition; and (2) a repeated control set, in which nine different picture stimuli were repeatedly presented like the Arabic digits from 1 to 9. Results: When comparing the digit condition and the standard picture condition, analyses of naming latencies and accuracy rates revealed that switching costs were reliably smaller for digit naming than for picture naming and the L1 elicited more switching costs for picture naming than for digit naming. On the other hand, when comparing the digit condition and the two picture control sets, it was found that the magnitude of switching costs became identical and the asymmetry in switching costs became much smaller between the two languages.

Investigating the modulation of active preparation and passive dissipation on inhibitory control processes in the language switching paradigm.

Introduction: Previous language-switching studies have received scholastic attention and the observed switching cost patterns have provided empirical evidence for bilingual language control. However, results are inconsistent as the size of and (a)symmetry in switching costs differ across studies. In addition, there are various methodological differences that go beyond stimulus differences, such as the language proficiency of the participants (the participant-level factor) and the preparation time (a task-related level factor), which might be responsible for these inconsistent results. Methods: With a focus on task-related factors, the present study was designed to examine whether and how preparation time modulates the size and (a)symmetry in switching costs by using the language-switching paradigm with cue-to-stimulus and response-to-cue intervals manipulated. Results: Replicating previous literature on language switching and task switching, a clear preparation effect was observed in all trials (stay and switch trials) for both L1 and L2. The switching costs were modulated by the cue-to-stimulus intervals, and specifically, switching costs decreased when the preparation time increased. Another intriguing finding was that even when participants were offered enough time to fully prepare for selecting the target language at the cue window, the switching costs were not completely eliminated. In terms of the passive preparation at the response-to-cue interval, switching costs could be modulated by the response-to-cue interval - the time for passive dissipation of inhibitory control applied in previous trials. The size of switching costs was clearly modulated by manipulating response-to-cue intervals and switching costs decreased as the waiting time after a naming response increased. Discussion: This study provides empirical evidence for the modulation of preparation effects on switching costs and inhibitory control mechanisms in bilingual language production.

Modality Switching in Landmark-Based Wayfinding.

This study investigates switching costs in landmark-based wayfinding using olfactory and visual landmark information. It has already been demonstrated that there seem to be no switching costs, in terms of correct route decisions, when switching between acoustically and visually presented landmarks. Olfaction, on the other hand, is not extensively focused on in landmark-based wayfinding thus far, especially with respect to modality switching. The goal of this work is to empirically test and compare visual and olfactory landmark information with regard to their suitability for wayfinding including a modality switch. To investigate this, an experiment within a virtual environment was conducted in which participants were walked along a virtual route of 12 intersections. At each intersection, landmark information together with directional information was presented, which was to be memorized and recalled in the following phase, either in the same or in the other modality (i.e., visual or olfactory). The results of the study show that, in contrast to the no-switching costs between auditory and visual landmarks in previous studies, switching costs occur when switching modality from visual to olfactory and vice versa. This is indicated by both longer decision times and fewer correct decisions. This means that a modality switch involving olfactory landmark information is possible but could lead to poorer performance. Therefore, olfaction may still be valuable for landmark-based-wayfinding. We argue that the poorer performance in the switching-condition is possibly due to higher cognitive load and the separate initial processing of odors and images in different cognitive systems.

The Influence of Brand Image and Favorability Toward Citizens in a Product's Country of Origin on Product Evaluation: Moderating Effects of Switching Costs.

This study aimed to provide practical implications for South Korean corporations seeking to enter the Chinese market. It explored the influences of brand image and favorability toward citizens in a product's country of origin (FCPCO) on consumers' product evaluation and repurchase intention, in addition to examining the moderating effects of procedural switching costs (economic risk costs, evaluation costs, learning costs, and set-up costs), financial switching costs (benefit loss costs and monetary loss costs), and relational switching costs (personal relationship loss costs and brand relationship loss costs) on the aforementioned influences. Although previous studies have established the relationships between some of the aforementioned variables, further research is required to determine the moderating effects of switching costs in various dimensions. Studies on the relationships of a product's country of origin with product evaluation and repurchase intention have rarely explored FCPCO. Through a questionnaire survey, this study obtained effective data from 302 respondents. Constituted of an exploratory research design, this study adopted PLS-SEM method for empirical analysis. IPMA analysis results indicated that brand image had a stronger influence on product evaluation than FCPCO did and that FCPCO had a stronger influence on repurchase intention than brand image did. Overall, the performance of FCPCO was higher than that of brand image. Moreover, economic risk costs and brand relationship loss costs positively moderated the relationship between brand image and product evaluation; monetary loss costs and brand relationship loss costs negatively moderated the relationship between FCPCO and product evaluation. These study results could help corporations gain competitive edge.

Quality provision in hospital markets with demand inertia: The role of patient expectations.

Switching costs and persistent preferences generate demand inertia and link current and future choices of hospital. Using a model of hospital competition with demand inertia, we investigate the effect of patient expectations on quality. We consider three types of expectations. Myopic patients choose a hospital based on current variables alone, forward-looking but naïve patients consider the future but assume that quality remains constant, and forward-looking and rational patients foresee the evolution of quality. We rank quality provision and show that it is higher under naïve than myopic expectations, while quality under rational expectations may be highest or lowest. This result also holds for patients' health gains, suggesting that rationality may hurt patients. Additionally, policies to reduce switching costs lead to lower quality, possibly unless patients are rational and cost substitutability between output and quality is sufficiently strong. Finally, we show how optimal price regulation depends on expectations and switching costs.

The Impact of Switching Intention of Telelearning in COVID-19 Epidemic's Era: The Perspective of Push-Pull-Mooring Theory.

Under the impact of COVID-19, medical telelearning education is increasingly becoming urgent to resolve the contradiction between the physical isolation of medical students and the need for on-site clinical teaching. In this study, the push-pull-mooring (PPM) theory is integrated into a comprehensive model as a conceptual PPM framework: push factors (information system quality and perceived risk), pull factors [telepresence (TP), trust, etc.], mooring factors (switching costs), and switching intention. The results show that most hypotheses were positive, but perceived risk did not influence user satisfaction significantly, and switching costs did not provide the impact on switching intention. This study provides a comprehensive empirical analysis of key factors influencing the choice of distance education by medical students through the integrated multi-model framework.

Within-language lexical interference can be resolved in a similar way to between-language interference.

This study asks if monolinguals can resolve lexical interference within a language with mechanisms similar to those used by bilinguals to resolve interference across languages. These mechanisms are known as bilingual language control, are assumed to be at least in part top-down, and are typically studied with cued language mixing, a version of which we use here. Balanced (Experiment 1) and nonbalanced Spanish-English bilinguals (Experiment 2) named pictures in each of their languages. English monolinguals from two different American cities (Experiments 3 and 4) named pictures in English only with either basic-level (e.g., shoe) or subordinate names (e.g., sneaker). All experiments were identically structured and began with blocked naming in each language or name type, followed by trial-level switching between the two languages or name types, followed again by blocked naming. We analyzed switching, mixing and (introduced here) post-mixing costs, dominance effects and repetition benefits. In the bilingual experiments, we found some signs of dominant deprioritization, the behavioral hallmark of bilingual language control: larger costs for dominant- than for nondominant-language names. Crucially, in the monolingual experiments, we also found signs of dominant deprioritization: larger costs for basic-level than for subordinate names. Unexpectedly and only in the monolingual experiments, we also found a complete dominance reversal: Basic-level names (which otherwise behaved as dominant) were produced more slowly overall than subordinate names. Taken together, these results are hard to explain with the bottom-up mechanisms typically assumed for monolingual interference resolution. We thus conclude that top-down mechanisms might (sometimes) be involved in lexical interference resolution not only between languages but also within a language.

Age-Related Changes in Attentional Refocusing during Simulated Driving.

We recently reported that refocusing attention between temporal and spatial tasks becomes more difficult with increasing age, which could impair daily activities such as driving (Callaghan et al., 2017). Here, we investigated the extent to which difficulties in refocusing attention extend to naturalistic settings such as simulated driving. A total of 118 participants in five age groups (18-30; 40-49; 50-59; 60-69; 70-91 years) were compared during continuous simulated driving, where they repeatedly switched from braking due to traffic ahead (a spatially focal yet temporally complex task) to reading a motorway road sign (a spatially more distributed task). Sequential-Task (switching) performance was compared to Single-Task performance (road sign only) to calculate age-related switch-costs. Electroencephalography was recorded in 34 participants (17 in the 18-30 and 17 in the 60+ years groups) to explore age-related changes in the neural oscillatory signatures of refocusing attention while driving. We indeed observed age-related impairments in attentional refocusing, evidenced by increased switch-costs in response times and by deficient modulation of theta and alpha frequencies. Our findings highlight virtual reality (VR) and Neuro-VR as important methodologies for future psychological and gerontological research.

Switching costs in competitive health insurance markets: The role of insurers' pricing strategies.

Our article deals with pricing strategies in Swiss health insurance markets and focuses on the relationship between basic and supplementary insurance. We analyzed how firms' pricing strategies (i.e., pricing of basic and supplementary products) can create switching costs in basic health insurance markets, thereby preventing competition in basic insurance from working properly. More specifically, using unique market and survey data, we investigated whether firms use bundling strategies or supplementary products as low-price products to attract and retain basic insurance consumers. To our knowledge, this is the first paper to analyze these pricing strategies in the context of insurance/health insurance. We found no evidence of bundling in the Swiss setting. We did however observe that firms used low-price supplementary products that contributed to lock in consumers. A majority of firms offered at least one of such product at a low price. None offered low-price products in both basic and supplementary markets. Low-price insurance products differed across firms. When buying a low-price supplementary product, consumers always bought their basic contract from the same firm. Furthermore, those who opted for low-price supplementary products were less likely to declare an intention to switch basic insurance firms in the near future. This result was true for all risk category levels.

Do Customers Pay Attention to Motivations and Switching Costs When They Terminate Their Relationships?

Research on some key boundary conditions and outcomes of consumers' relationship termination in the online environment is scare. We examine how four categories (e.g., upkeep, time, benefits, and personal loss) of avoiding relationships affect customers' relationship termination. We also consider both the motivation (hedonic vs. utilitarian) and switching costs when customers evaluate whether to exit from or stay in a relationship. Results show that time plays a significant role in customers' relationship termination, but there appears to be an increase or decrease in customers' relationship termination associated with the role of two moderators. More specifically, upkeep plays a significant role in affecting relationship termination for consumers motivated by hedonic interests (as opposed to those motivated by utilitarian interests). Meanwhile, personal loss plays a role in affecting relationship termination for utilitarian consumers (and not hedonic). Furthermore, we found that high switching costs facilitate a relationship termination if time and personal loss are involved. The findings indicate that the effect of high switching costs on customer loyalty is limited. We also found that when consumers consider time category, they are likely to have a greater intent to terminate a relationship regardless of the level of switching costs.

The modality switching costs of Chinese-English bilinguals in the processing of L1 and L2.

Modality switching cost indicates that people's performance becomes worse when they judge sequential information that is related to different sensory modalities than judging information that is related to the same modality. In this study, we conducted three experiments on proficient and non-proficient bilingual individuals to investigate the modality switching costs in L1 and L2 processing separately. In Experiment 1, materials were L1 and L2 words that were either conceptually related to a visual modality (e.g., light) or related to an auditory modality (e.g., song). The modality switching costs were investigated in a lexical decision task in both L1 and L2. Experiment 2 further explored the modality switching costs while weakening the activation level of the perceptual modality by adding a set of fillers. Experiment 3 used a word-naming task to explore the modality switching effect in language production in L1 and L2. Results of these experiments showed that the modality switching costs appeared in both language comprehension and production in L1 and L2 conditions. The magnitude of the modality switching costs was conditionally modulated by the L2 proficiency level, such as in the L2 condition in Experiment 1 and in both L1 and L2 conditions in Experiment 3. These results suggest that sensorimotor simulation is involved in not only language comprehension but also language production. The sensorimotor simulation that is acquired in L1 can be transferred to L2.

Exploring individual differences in task switching.

Previous research has shown that there are significant task-switching costs even when participants have time to prepare for task switching after cueing. We investigated individual differences in task switching by monitoring errors and response times of individual participants. In Experiment 1A, 58 participants were encouraged to finish the session early by completing 200 consecutive trials without making an error. In case of a mistake, they had to repeat their effort until the experimental session expired. Using this demanding procedure, 16 participants managed to complete early. Among these 16 we identified 9 best performers who showed no significant switch costs. We conducted follow-up Experiment 1B on these best performers by systematically varying cue-stimulus intervals and inter-trial intervals. The results confirmed that these participants had no significant RT and ER switch costs when they had time to prepare the task between cue and target onset. However, significant switch costs emerged when cue and target stimulus were presented simultaneously. In Experiment 1C, using three classical task-switching paradigms, we compared the best performers with 9 controls who had made frequent errors in Experiment 1A. Although the best performers responded faster and made fewer errors, they only showed reduced switch costs in a pre-cued paradigm that had been extensively practiced. In two other paradigms with simultaneous presentation of cue and target stimulus, best performers had switch costs and showed considerable individual differences similar to the controls. We conclude that there are considerable individual differences in task switching and that smaller individual switch costs are mainly related to efficient task preparation. We speculate that efficient task preparation may be linked to better executive control and general intelligence.

Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys.

Relatively little analysis has taken place internationally on the consumer-reported benefits and costs to switching insurer in multi-payer health insurance markets. Ideally, consumers should be willing to switch out of consideration for price and quality and switching should be able to take place without incurring significant switching costs. Costs to switching come in many forms and understanding the nature of these costs is necessary if policy interventions to improve market competition are to be successful. This study utilises data from consumer surveys of the Irish health insurance market collected between 2009 and 2013 (N [Formula: see text] 1703) to examine consumer-reported benefits and costs to switching insurer. Probit regression models are specified to examine the relationship between consumer characteristics and reported switching costs, and switching behaviour, respectively. Overall evidence suggests that switchers in the Irish market mainly did so out of consideration for price. Transaction cost was the most common switching cost identified, reported by just under 1 in 7 non-switchers. Psychological switching costs may also be impacting behaviour. Moreover, high-risk individuals were more likely to experience switching costs and this was reflected in actual switching behaviour. A recent information campaign launched by the market regulator may prove beneficial in reducing perceived transaction costs in the market, however, a more focused campaign aimed at high-risk consumers may be necessary to reduce inequalities. Policy-makers should also consider the impact insurer behaviour may have on decision-making.

On the Reliability of Switching Costs Across Time and Domains.

Bilingual speakers are suggested to use control processes to avoid linguistic interference from the unintended language. It is debated whether these bilingual language control (BLC) processes are an instantiation of the more domain-general executive control (EC) processes. Previous studies inconsistently report correlations between measures of linguistic and non-linguistic control in bilinguals. In the present study, we investigate the extent to which there is cross-talk between these two domains of control for two switch costs, namely the n-1 shift cost and the n-2 repetition cost. Also, we address an important problem, namely the reliability of the measures used to investigate cross-talk. If the reliability of a measure is low, then these measures are ill-suited to test cross-talk between domains through correlations. We asked participants to perform both a linguistic- and non-linguistic switching task at two sessions about a week apart. The results show a dissociation between the two types of switch costs. Regarding test-retest reliability, we found a stronger reliability for the n-1 shift cost compared to the n-2 repetition cost within both domains as measured by correlations across sessions. This suggests the n-1 shift cost is more suitable to explore cross-talk of BLC and EC. Next, we do find cross-talk for the n-1 shift cost as demonstrated by a significant cross-domain correlation. This suggests that there are at least some shared processes in the linguistic and non-linguistic task.

Switching benefits and costs in competitive health insurance markets: A conceptual framework and empirical evidence from the Netherlands.

Competitive health insurance markets will only enhance cost-containment, efficiency, quality, and consumer responsiveness if all consumers feel free to easily switch insurer. Consumers will switch insurer if their perceived switching benefits outweigh their perceived switching costs. We developed a conceptual framework with potential switching benefits and costs in competitive health insurance markets. Moreover, we used a questionnaire among Dutch consumers (1091 respondents) to empirically examine the relevance of the different switching benefits and costs in consumers' decision to (not) switch insurer. Price, insurers' service quality, insurers' contracted provider network, the benefits of supplementary insurance, and welcome gifts are potential switching benefits. Transaction costs, learning costs, 'benefit loss' costs, uncertainty costs, the costs of (not) switching provider, and sunk costs are potential switching costs. In 2013 most Dutch consumers switched insurer because of (1) price and (2) benefits of supplementary insurance. Nearly half of the non-switchers - and particularly unhealthy consumers - mentioned one of the switching costs as their main reason for not switching. Because unhealthy consumers feel not free to easily switch insurer, insurers have reduced incentives to invest in high-quality care for them. Therefore, policymakers should develop strategies to increase consumer choice.

Market frictions: A unified model of search costs and switching costs.

It is well known that search costs and switching costs can create market power by constraining the ability of consumers to change suppliers. While previous research has examined each cost in isolation, this paper demonstrates the benefits of examining the two types of friction in unison. The paper shows how subtle distinctions between the two costs can provide important differences in their effects upon consumer behaviour, competition and welfare. In addition, the paper also illustrates a simple empirical methodology for estimating separate measures of both costs, while demonstrating a potential bias that can arise if only one cost is considered.