TY - JOUR
T1 - Show Me My Health Plans
T2 - Using a Decision Aid to Improve Decisions in the Federal Health Insurance Marketplace
AU - Politi, Mary C.
AU - Kuzemchak, Marie D.
AU - Lu, Esther
AU - Barker, Abigail R.
AU - Peters, Ellen
AU - Ubel, Peter A.
AU - Kaphingst, Kimberly A.
AU - McBride, Timothy
AU - Kreuter, Matthew W.
AU - Shacham, Enbal
AU - Philpott, Sydney E.
N1 - Publisher Copyright:
© The Author(s) 2016.
PY - 2016
Y1 - 2016
N2 - Introduction: Since the Affordable Care Act was passed, more than 12 million individuals have enrolled in the health insurance marketplace. Without support, many struggle to make an informed plan choice that meets their health and financial needs. Methods: We designed and evaluated a decision aid, Show Me My Health Plans (SMHP), that provides education, preference assessment, and an annual out-of-pocket cost calculator with plan recommendations produced by a tailored, risk-adjusted algorithm incorporating age, gender, and health status. We evaluated whether SMHP compared to HealthCare.gov improved health insurance decision quality and the match between plan choice, needs, and preferences among 328 Missourians enrolling in the marketplace. Results: Participants who used SMHP had higher health insurance knowledge (LS-Mean = 78 vs. 62; P < 0.001), decision self-efficacy (LS-Mean = 83 vs. 75; P < 0.002), confidence in their choice (LS-Mean = 3.5 vs. 2.9; P < 0.001), and improved health insurance literacy (odds ratio = 2.52, P < 0.001) compared to participants using HealthCare.gov. Those using SMHP were 10.3 times more likely to select a silver- or gold-tier plan (P < 0.0001). Discussion: SMHP can improve health insurance decision quality and the odds that consumers select an insurance plan with coverage likely needed to meet their health needs. This study represents a unique context through which to apply principles of decision support to improve health insurance choices.
AB - Introduction: Since the Affordable Care Act was passed, more than 12 million individuals have enrolled in the health insurance marketplace. Without support, many struggle to make an informed plan choice that meets their health and financial needs. Methods: We designed and evaluated a decision aid, Show Me My Health Plans (SMHP), that provides education, preference assessment, and an annual out-of-pocket cost calculator with plan recommendations produced by a tailored, risk-adjusted algorithm incorporating age, gender, and health status. We evaluated whether SMHP compared to HealthCare.gov improved health insurance decision quality and the match between plan choice, needs, and preferences among 328 Missourians enrolling in the marketplace. Results: Participants who used SMHP had higher health insurance knowledge (LS-Mean = 78 vs. 62; P < 0.001), decision self-efficacy (LS-Mean = 83 vs. 75; P < 0.002), confidence in their choice (LS-Mean = 3.5 vs. 2.9; P < 0.001), and improved health insurance literacy (odds ratio = 2.52, P < 0.001) compared to participants using HealthCare.gov. Those using SMHP were 10.3 times more likely to select a silver- or gold-tier plan (P < 0.0001). Discussion: SMHP can improve health insurance decision quality and the odds that consumers select an insurance plan with coverage likely needed to meet their health needs. This study represents a unique context through which to apply principles of decision support to improve health insurance choices.
KW - decision aids
KW - health literacy
KW - public health
KW - shared decision making
KW - vulnerable populations
UR - http://www.scopus.com/inward/record.url?scp=85105652983&partnerID=8YFLogxK
U2 - 10.1177/2381468316679998
DO - 10.1177/2381468316679998
M3 - Article
AN - SCOPUS:85105652983
SN - 2381-4683
VL - 1
JO - MDM Policy and Practice
JF - MDM Policy and Practice
IS - 1
ER -