title: Show Me My Health Plans: a study protocol of a randomized trial testing a decision support tool for the federal health insurance marketplace in Missouri.
abstract: BACKGROUND
  The implementation of the ACA has improved access to quality health insurance, a necessary first step to improving health outcomes. However, access must be supplemented by education to help individuals make informed choices for plans that meet their individual financial and health needs.
  
  
  METHODS
  Drawing on a model of information processing and on prior research, we developed a health insurance decision support tool called Show Me My Health Plans. Developed with extensive stakeholder input, the current tool (1) simplifies information through plain language and graphics in an educational component; (2) assesses and reviews knowledge interactively to ensure comprehension of key material; (3) incorporates individual and/or family health status to personalize out-of-pocket cost estimates; (4) assesses preferences for plan features; and (5) helps individuals weigh information appropriate to their interests and needs through a summary page with "good fit" plans generated from a tailored algorithm. The current study will evaluate whether the online decision support tool improves health insurance decisions compared to a usual care condition (the healthcare.gov marketplace website). The trial will include 362 individuals (181 in each group) from rural, suburban, and urban settings within a 90 mile radius around St. Louis. Eligibility criteria includes English-speaking individuals 18-64 years old who are eligible for the ACA marketplace plans. They will be computer randomized to view the intervention or usual care condition.
  
  
  CONCLUSIONS
  Presenting individuals with options that they can understand tailored to their needs and preferences could help improve decision quality. By helping individuals narrow down the complexity of health insurance plan options, decision support tools such as this one could prepare individuals to better navigate enrollment in a plan that meets their individual needs. The randomized trial was registered in clinicaltrials.gov (NCT02522624) on August 6, 2015.
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, USA. mpoliti@wustl.edu.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Politi
authors.affiliation: George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, USA. arbarker@wustl.edu.
authors.forename: Abigail R
authors.initials: AR
authors.lastname: Barker
authors.affiliation: Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City, USA. Kim.kaphingst@hci.utah.edu.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Kaphingst
authors.affiliation: George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, USA. tmcbride@wustl.edu.
authors.forename: Timothy
authors.initials: T
authors.lastname: McBride
authors.affiliation: College for Public Health and Social Justice, Saint Louis University, Saint Louis, USA. eshacham@slu.edu.
authors.forename: Enbal
authors.initials: E
authors.lastname: Shacham
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, USA. kebodeauxc@wudosis.wustl.edu.
authors.forename: Carey S
authors.initials: CS
authors.lastname: Kebodeaux
mesh_terms: D000293:Adolescent; D000328:Adult; D003661:Decision Support Techniques; D005102:Health Expenditures; D062265:Health Insurance Exchanges / Q000191:economics*; D057220:Health Literacy; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D008875:Middle Aged; D008923:Missouri; D009310:National Health Insurance, United States; D014481:United States; D055815:Young Adult