Week 0: Introduction

Hello everyone, my name is Kanika Reddy and welcome to my Week 0 Senior Project Blog! I am excited to embark on this personal academic journey while sharing my progress in the field of behavioral economics. In this blog, I will be going over the importance of my research topic, introduce my project/project advisors, and mention some things to look forward to in Week 1. I have also linked my proposal for reference on what my project is about and what I hope to achieve by the end. 

Importance of the Subject: 

As the U.S. became more capitalistic in the 1980s and 1990s, insurance companies followed suit in prioritizing profit maximization while minimizing financial risk. Deductibles and co-payments were introduced to shift a greater share of medical costs onto patients, who increasingly bear responsibility for both care and insurance premiums (Hoffman, 2006; Patel & Rushefsky, 2019). However, evidence demonstrates that these mechanisms do not only deter low-value care but also reduce the use of essential primary and preventive services, particularly among individuals with limited financial resources (Baicker & Goldman, 2011; Kullgren et al., 2010). Patients enrolled in high-deductible health plans frequently anticipate reducing care and act on those expectations, even when experiencing symptoms that warrant medical attention (Reed et al., 2009; Gaffney et al., 2020). As a result, financial barriers operate as an early filter on healthcare access, shaping patient behavior before clinical evaluation occurs (Press & Gerald, 2020).

Moreover, patients facing economic strain often adopt cost-coping behaviors such as delaying appointments, skipping follow-up visits, or altering medication use (e.g., breaking up tablets to extend usage) to reduce expenses (Zullig et al., 2013; Hunter et al., 2016). These strategies are especially common among individuals managing chronic conditions—particularly those with cancer and heart disease—for whom ongoing primary care and medication adherence are essential (Gaffney et al., 2020; Press & Gerald, 2020). Evidence suggests that these behaviors reflect financial constraint rather than lack of medical need, contributing to fragmented care and poorer health outcomes over time (Penfold et al., 2011).

Beyond direct costs, limited understanding of insurance benefits, uncertainty about out-of-pocket expenses, and fear of unexpected bills frequently lead patients to delay or avoid seeking care altogether (Smith et al., 2018; Doherty et al., 2025). Financial stress is influenced by cognitive burden, causing patients to prioritize short-term cost avoidance over long-term health benefits, particularly when navigating complex insurance structures (Tzeel & Brown, 2010). Even when primary care services are technically accessible—such as through government-supported programs—patients may remain wary of economical medical plans due to perceived financial risk (Li et al., 2024). These findings suggest that healthcare utilization is shaped not only by income or plan design but also by how patients interpret and navigate financial uncertainty.

Research Project and Advisors Introduction:

With the assistance of my offsite advisor Mr. Sperrazza, my onsite advisor Dr. Brown, JD and the organization, JASA,  I will analyze how uncertainty, in financial status and insurance well-being, affects how patients act in medical crises and checkups. Specifically, the influence of financial uncertainty and insurance instability on patient decision-making in medical crises and routine checkups will be assessed. I will answering my main research question: 

• How do primary care patients in NYC perceive the affordability and stability of their out-of-pocket medical payments in the current U.S. healthcare environment?

The following subquestions will also be answered: 

• How does financial instability in medical payments affect primary care patients’ decisions to seek or delay care?
• How do income level and insurance type shape primary care patients’ views on current financial instability in healthcare payments?
• How do primary care patients evaluate the predictability of medical costs, including copays, deductibles, and unexpected bills?

My Week 1 Plan:

I will be setting up the data organization and coding framework, on Google Sheets, with categories based on the type of question (e.g. long form, likert scale, etc). Secondly, I will be writing my introduction and literature review for my final product, a research paper. While writing and setting up the project, I will refine the already created research questions based on my mentors’ feedback and ethics parameters set by my research organization. 

Thank you for reading! I am looking forward to sharing my research project with you!