Study Finds Selecting Health Insurance Plans Is Getting Easier for Patients

Changes still needed to further improve the decision-making process for patients.

Changes still needed to further improve the decision-making process for patients.

Purchasing a health care plan can be a complex and tedious process.

With so many plans to choose from and so many factors to consider, it can be difficult for many to choose the right plan for themselves and many end up paying more than what they should due to confusion. However, the Perelman School of Medicine at the University of Pennsylvania have found that web sites for national and state health insurance marketplaces show improvement in their ability to assist patients in choosing the right health insurance plan for them.

The marketplaces, also called health exchanges, were put into place by the Affordable Care Act to allow consumers to compare and choose health insurance plans based on their needs.

“Selecting a plan is a complex task for just about anyone, regardless of your knowledge of the marketplaces or health insurance, and the way plans are presented on the exchanges and the tools available there can influence consumers’ choices,” said study lead author Charlene A. Wong, MD, a Robert Wood Johnson Foundation Clinical Scholar and fellow in Penn’s Leonard Davis Institute of Health Economics.

Patients choose their health insurance based on the marketplace’s features, such as the order in which plans are displayed, the plan features listed, and the availability of decision-support tools created for consumers, according to Dr. Wong. While improvements have been noted since the first enrollment period, changes can and should be added in the future to further improve the decision-making process for patients, the study noted.

The researchers evaluated HealthCare.gov, the national marketplace used by the majority of states, and 12 state-based marketplaces during the first and second open enrollment periods. They collected both data from individuals who browse without an account and those who browse with an account set up.

While decision tools most likely to be helpful to consumers were more prevalent in the second enrollment period than the first, they were still not universally available to patients seeking health insurance plans. For instance, most sites allowed consumers to filter plans by premium and deductible amounts. Only 3 states had out-of-pocket cost estimators that calculated the costs for customers by adding together their premium and expected costs based on consumers’ predicted use.

California was one of the only states that listed plans in order from cheapest to most expensive out-of-pocket costs. In contrast, most sites used the premium amount as their default plan order, causing many consumers to not pay enough attention to other potential out-of-pocket expenses, such as meeting a high deductible.

Of the states evaluated, only 6 provided consumers with a tool that allowed them to search plans on the basis of provider network. Just 9 sites had pop-up definitions available for common and important terms like “deductible” or “coinsurance,” despite the fact that this feature is easy for web sites to implement. While only 4 sites had health plan quality rankings, this was an improvement from the 2 with that feature in the first enrollment period.

“By including more of these tools in both real and ‘window’ shopping stages, marketplaces can help de-mystify what for many is a complex, opaque process,” Dr. Wong said.

With time, the sites should implement newer and easier-to-use tools for consumers interested in purchasing health insurance plans. For now, patients must do additional research of their own in order to find the plan that is best for them.