EFFECTIVE COMMUNICATION TO IMPROVE DECISION MAKING ABOUT HEALTH CARE PLANS

Monday, October 21, 2013
Key Ballroom Foyer (Hilton Baltimore)
Poster Board # P2-35
Decision Psychology and Shared Decision Making (DEC)

Mary Politi, PhD1, Kimberly Kaphingst, ScD2, Matthew Kreuter, PhD, MPH3, Enbal Shacham, PhD, MPE4 and Timothy McBride, PhD3, (1)Washington University School of Medicine, St. Louis, MO, (2)Washington University in St. Louis School of Medicine, St Louis, MO, (3)Washington University in St. Louis, St Louis, MO, (4)St. Louis University College for Public Health and Social Justice, St Louis, MO
Purpose: As a result of the passage of the Affordable Care Act (ACA), by 2014, 52 million Americans without health insurance will be eligible for insurance through an exchange system that allows them to choose from multiple plans. Understanding information, making comparisons across plans, and choosing a plan that best suits one’s financial and health needs will be essential. 

Methods: We examined 51 uninsured adults’ health insurance knowledge and preferences through semi-structured interviews.

Results: Participants were between the ages of 18 and 65 without current health insurance. 71% of participants had an income of less than $15,000 per year. 69% identified as African-American, 28% identified as non-Hispanic White, and 4% identified as Hispanic. 47% had inadequate (<7th grade reading level) or marginal (7th – 8th grade reading level) health literacy as measured by the REALM-SF. Several themes emerged from this data. Many uninsured individuals had little or no past experience with important details about health insurance. They often confused the meaning of similar terms (such as coinsurance vs. copayment, urgent vs. emergency care). Individuals drew from the context of passages we presented to better understand the terms. They also used familiar non-health contexts to assist in understanding the terms (e.g. car insurance was used to understand deductibles). After we explained the terms to participants, most (96%) reported that a health insurance premium would be very important to their choice of plans, followed by specific covered benefits (92%) and being responsible for fixed or known costs vs. a percentage of health care costs (82%).  The amount of paperwork and having a choice of doctors or hospitals were less important factors when thinking about choosing a health insurance plan.

Conclusions: Our study was one of the first to examine uninsured individuals’ health insurance knowledge and preferences. Uninsured individuals have different information needs and preferences than those studied in previous research. Clear information that explains differences across the exchange plans will be important when the ACA is implemented. Narratives and contexts familiar to individuals may help improve understanding. Tailoring information by emphasizing details that are important to individuals may also facilitate decision. We developed and are currently testing decision support strategies to facilitate decision-making about the ACA exchange plans (25 enrolled; 280 planned by this fall).