Smart Choice Health Insurance©

Brown, Virginia; Russell, Mia B.; Ginter, Amanda C.; Braun, Bonnie; Little, Lynn; Pippidis, Maria; McCoy, Teresa

doi:10.1177/1524839915620393

Cited by 23 publications

(14 citation statements)

References 11 publications

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“…As our theoretical framework 21 and literature suggests, for example, health insurance literacy interventions, independent of cost calculators or default options, may increase participants’ knowledge of health insurance terms and costs, and improve their health insurance decisions. 12 , 15 , 21 , 33 , 34 However, whether knowledge and confidence alone is sufficient to improve choice needs empirical testing. A large body of research investigating choices among Medicare enrollees suggests that individuals frequently choose more costly plans than they should, primarily attending to monthly premium costs rather than considering the full complexity of plan features, even when they are knowledgeable and make active insurance choices.…”

Section: Discussionmentioning

confidence: 99%

Show Me My Health Plans

Politi

Kuzemchak

Liu

et al. 2016

MDM Policy & Practice

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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.

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Section: Discussionmentioning

confidence: 99%

Show Me My Health Plans

Politi

Kuzemchak

Liu

et al. 2016

MDM Policy & Practice

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“…Despite this limitation, changes in health reform policies continue to place higher levels of personal responsibility on consumers to independently make informed decisions about their health (Long et al 2014). Without adequate levels of HIL, consumers are unable to understand the financial and health implications of health insurance plans, or how to successfully use their own plan when accessing needed care (Kim, Braun & Williams, 2013; Brown et al, 2016). …”

Section: Policy Implicationsmentioning

confidence: 99%

“…Health insurance literacy (HIL) is defined as a person's ability to seek, obtain, and understand health insurance plans, and once enrolled use their insurance to seek appropriate health care services (Quincy, 2012). Without adequate levels of HIL, consumers are unable to understand the financial and health implications of insurance plans, often leading to delayed care or foregoing needed care (Brown et al, 2016; Kim, Braun & Williams, 2013). …”

mentioning

confidence: 99%

“…Having health care coverage results in timely access to needed health care services that are vital for disease prevention and management (Hadley, 2007; Durham et al, 1998; Wilper et al, 2009a; Wilper et al, 2009b). Despite growing research in the area of HIL after the implementation of the Affordable Care Act (ACA) and subsequent changes in health care reform policies, few studies have been able to establish national sociodemographic trends in HIL (Bartholomae, Russell, Braun, & McCoy, 2016; Brown et al, 2016; Harris-Kojetin et al, 2007; Kullgren et al, 2010; Politi et al, 2014; Sinaiko, Ross-Degnan, Soumerai, Lieu, & Galbraith, 2013; Stein, 2016; Wong et al, 2015). The purpose of this study was to assess sociodemographic disparities in HIL, including knowledge of health insurance terms and costs, as well as confidence in using insurance to access health care in a nationally representative sample.…”

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confidence: 99%

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Significant Disparities Exist in Consumer Health Insurance Literacy: Implications for Health Care Reform

Edward¹,

Wiggins²,

Young³

et al. 2019

HLRP: Health Literacy Research and Practice

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Background: Health insurance literacy (HIL) is defined as a person's ability to seek, obtain, and understand health insurance plans, and once enrolled use their insurance to seek appropriate health care services. Objective: The objectives of this study were to assess sociodemographic disparities in HIL, including knowledge of health insurance terms and costs, and confidence in using insurance to access health care in a nationally representative adult sample. Methods: We conducted a secondary data analysis of the Health Reform Monitoring Survey, which included 15,168 adults age 18 years and older who responded to surveys in the third quarter of 2015 and first quarter of 2016. Rao-Scott chi-square tests and weighted logistic regression were used for analysis. Key Results: The majority of our sample (51%) reported having inadequate HIL as measured by knowledge of basic insurance terms, and close to one-half (48%) had low confidence in using their insurance to access health care. Logistic regression analysis indicated significant disparities in HIL, with multiple groups identified as being at higher risk for having inadequate HIL (as measured by both knowledge and use of health insurance). These included young adults, women, those with Hispanic ethnicity, those who were not U.S. citizens, and those who were currently unmarried. Also identified to be at risk were those who are unemployed, uninsured, and enrolled in public health insurance plans, and those with lower levels of education and income. Most had inadequate knowledge of their annual out-of-pocket costs and insurance plan's deductible amounts. Conclusions: One-half of U.S. adults rate themselves as having inadequate HIL. Sociodemographic disparities in self-reported HIL underscore the need for increased consumer education, as well as efforts to simplify the health care system by promoting value-based care, supporting delivery system reforms, and designing services to be responsive to consumer HIL needs and abilities. [ HLRP: Health Literacy Research and Practice . 2019;3(4):e250–e258.] Plain Language Summary: In a nationally representative sample of 15,168 adults, the majority had low knowledge about basic health insurance terms and had difficulty using health insurance to access needed health care services. These findings indicate that health insurance literacy is a major concern in our community that disproportionately affects some underserved groups more than others, including young adults, groups with low-income, and people who are uninsured.

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“…incorporate direct testing of knowledge around health insurance, self-efficacy and behavioral capability around utilization, along with measures of health literacy and numeracy to develop a comprehensive understanding of HIL as a concept (Brown, Russell, Ginter, et al, 2016). Incorporating knowledge-based measures with behavioral measures, such as the HILM (Paez et al, 2014) would strengthen the evidence on the concept of HIL.…”

Section: Discussionmentioning

confidence: 99%