Harvard Pilgrim Health Care Institute Researchers Reveal New Findings on Health Policy (“Pick a Plan and Roll the Dice”: A qualitative study of consumer experiences selecting a health plan in the non-group market): Health and Medicine – Health Policy

Health Policy and Law Daily

2023 DEC 29 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- New study results on health policy have been published. According to news reporting originating from Boston, Massachusetts, by NewsRx correspondents, research stated, “For consumers without access to employer-sponsored or public insurance, health plan choices in the non-group (individual) insurance market that do not meet consumer needs have the potential for negative downstream implications for health and financial well-being. This qualitative interview study sought to understand consumers’ experiences and challenges with choosing a non-group health plan, among those who later had negative experiences with the plan they chose.”

Funders for this research include Agency For Healthcare Research And Quality.

The news correspondents obtained a quote from the research from Harvard Pilgrim Health Care Institute: “We conducted semi-structured telephone interviews with a purposive sample of 36 participants from a large regional health insurance carrier in three states who enrolled in non-group plans in 2017 (21 in Affordable Care Act (ACA) Marketplace plans and 15 enrolled off-Marketplace). Participants were included if they reported negative experiences using their plan after enrollment, such as higher-than-expected medical costs. Interviews explored challenges choosing a plan; information needed for choosing; usefulness of available tools; and preferred format for interventions to improve plan choice experiences. We analyzed interview transcripts using thematic content analysis. Study participants reported experiencing substantial challenges to choosing an insurance plan. Key barriers included understanding insurance terms, finding relevant information, and making comparisons across plans. Participants valued the ability to make comparisons across carriers when using the Marketplace websites but were less satisfied with customer service. Suggestions for improvement included greater standardization of plans and language and availability of customized one-on-one assistance.”

According to the news reporters, the research concluded: “Findings from this study suggest that health plan selection in the non-group market presents challenges to consumers that may be addressed through enrollment assistance and improved presentation of information. Personalized assistance to find and choose coverage may lead to plan choices that better meet consumer needs and increase confidence choosing a plan in subsequent enrollment periods.”

For more information on this research see: “Pick a Plan and Roll the Dice”: A qualitative study of consumer experiences selecting a health plan in the non-group market. Health Policy Open, 2023,5():100112. The publisher for Health Policy Open is Elsevier.

A free version of this journal article is available at https://doi.org/10.1016/j.hpopen.2023.100112.

Our news editors report that more information may be obtained by contacting Elena Faugno, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, United States. Additional authors for this research include Melissa B. Gilkey, Lauren A. Cripps, Anna Sinaiko, Alon Peltz, Jon Kingsdale, Alison A. Galbraith.