EFFECTIVE COMMUNICATION TO IMPROVE DECISION MAKING ABOUT HEALTH CARE PLANS

描述（由申请人提供）：由于《患者保护和平价医疗法案》的通过，到2014年，5200万没有医疗保险的美国人将有资格通过一个交换系统获得保险，允许他们从多种医疗保健计划中进行选择。了解每个计划的信息，在计划之间进行比较，并选择最适合自己需求的计划将是必不可少的，并且需要简单，清晰的信息来解释计划的差异。然而，理解和比较计划是困难的，特别是对于卫生知识和计算能力较低的个人。本研究将评估三种策略，以最大限度地了解和比较目前没有保险的美国人的计划信息的能力。我们的应用程序旨在：(1)检查目前没有保险的个人对医疗保健计划的术语和细节的理解，(2)应用推荐的策略来提高医疗保健计划信息对目前没有保险的个人的有效性；(3)通过随机实验，检验这些策略在向未参保个体呈现医保计划信息方面的效果。我们将评估陈述策略对理解、对信息的满意度、感知到的信息相关性以及做出医疗保健计划选择的信心的影响。我们还将研究结果是否因个人特征而异，包括人口统计、健康素养、计算能力和健康信息偏好。我们将利用本应用程序中开发的信息为州和联邦层面的医疗改革实施提供信息，因为规则和法规正在制定，健康保险交易所正在开发。在当前研究中发现的有效策略将在未来的R01中使用，以确定它们对实际医疗保健计划决策的影响。我们将根据这项重要的形成性研究的结果，在未来的应用中修改或补充我们的交流策略。

DESCRIPTION (provided by applicant): 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.