As a result of the passage of the Patient Protection and Affordable Care Act, by 2014, 52 million Americans without health insurance will be eligible for insurance through an exchange system that allows them to choose from multiple health care plans. Understanding information about each plan, making comparisons across plans, and choosing a plan that best suits one's needs will be essential, and requires simple, clear information that explains plan differences. However, understanding and comparing plans is difficult, especially for individuals with low health literacy and low numeracy skills. This study will evaluate three strategies to maximize understanding and ability to compare plan information among currently uninsured Americans. Our application aims to: (1) Examine currently uninsured individuals'understanding of the terminology and details of health care plans, (2) Apply recommended strategies for enhancing the effectiveness of information about health care plans to currently uninsured individuals;and (3) Test the effects of these strategies for presenting health care plan information to currently uninsured individuals in a randomized experiment. We will evaluate the effects of presentation strategy on understanding, satisfaction with the information, perceived relevance of the information, and confidence in making a health care plan choice. We will also examine whether outcomes vary by individual characteristics including demographics, health literacy, numeracy, and health information preferences. We will use the information developed in this application to inform health reform implementation at the state and federal levels, as rules and regulations are written and health insurance exchanges are developed. Strategies found to be effective in the current study will be used in a future R01 to determine their effects on actual health care plan decisions. We will modify or supplement our communication strategies in future applications based on the results of this important formative research.

Public Health Relevance

As a result of the passage of the Patient Protection and Affordable Care Act, by 2014, 52 million Americans without health insurance will be eligible for insurance through an exchange system that allows them to choose from multiple health care plans. Understanding information about each plan, making comparisons across plans, and choosing a plan that best suits one's needs will be essential, and requires simple, clear information that explains plan differences. This study will evaluate three strategies to maximize understanding and ability to compare plan information among currently uninsured Americans. Results will provide recommendations for ways to communicate information to individuals who are new to the health care system and will be required to make plan choices in the health insurance exchange.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21HS020309-01A1
Application #
8236702
Study Section
Special Emphasis Panel (ZRG1-RPHB-P (50))
Program Officer
Brach, Cindy
Project Start
2012-04-02
Project End
2014-03-31
Budget Start
2012-04-02
Budget End
2013-03-31
Support Year
1
Fiscal Year
2012
Total Cost
Indirect Cost
Name
Washington University
Department
Surgery
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
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