A Randomized Trial Examining Three Strategies for Supporting Health Insurance Decisions among the Uninsured

Mary C. Politi, Kimberly A. Kaphingst, Jingxia (Esther) Liu, Hannah Perkins, Karishma Furtado, Matthew W. Kreuter, Enbal Shacham and Timothy McBride

Medical Decision Making, 2016, vol. 36, issue 7, 911-922

Abstract: Background. The Affordable Care Act allows uninsured individuals to select health insurance from numerous private plans, a challenging decision-making process. This study examined the effectiveness of strategies to support health insurance decisions among the uninsured. Methods. Participants ( N = 343) from urban, suburban, and rural areas were randomized to 1 of 3 conditions: 1) a plain language table; 2) a visual condition where participants chose what information to view and in what order; and 3) a narrative condition. We administered measures assessing knowledge (true/false responses about key features of health insurance), confidence in choices (uncertainty subscale of the Decisional Conflict Scale), satisfaction (items from the Health Information National Trends Survey), preferences for insurance features (measured on a Likert scale from not at all important to very important ), and plan choice. Results. Although we did not find significant differences in knowledge, confidence in choice, or satisfaction across condition, participants across conditions made value-consistent choices, selecting plans that aligned with their preferences for key insurance features. In addition, those with adequate health literacy skills as measured by the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) had higher knowledge overall ( x ¯ = 6.1 v. 4.8, P

Keywords: health insurance; health insurance literacy; health communication; Affordable Care Act (search for similar items in EconPapers)
Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:36:y:2016:i:7:p:911-922

DOI: 10.1177/0272989X15578635

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