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


Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Politi, MC; Kuzemchak, MD; Liu, J; Barker, AR; Peters, E; Ubel, PA; Kaphingst, KA; McBride, T; Kreuter, MW; Shacham, E; Philpott, SE

Published Date

  • July 2016

Published In

Volume / Issue

  • 1 /

PubMed ID

  • 28804780

Pubmed Central ID

  • 28804780

Electronic International Standard Serial Number (EISSN)

  • 2381-4683

International Standard Serial Number (ISSN)

  • 2381-4683

Digital Object Identifier (DOI)

  • 10.1177/2381468316679998


  • eng