Show Me My Health Plans: Using a Decision Aid to Improve Decisions in the Federal Health Insurance Marketplace

Mary C. Politi, Marie D. Kuzemchak, Esther Lu, Abigail R. Barker, Ellen Peters, Peter A. Ubel, Kimberly A. Kaphingst, Timothy McBride, Matthew W. Kreuter, Enbal Shacham, Sydney E. Philpott

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


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 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 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.

Original languageEnglish
JournalMDM Policy and Practice
Issue number1
StatePublished - 2016


  • decision aids
  • health literacy
  • public health
  • shared decision making
  • vulnerable populations


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