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Evaluating a novel online behavioural intervention to encourage cost-conscious strategies among US adults with
Alexandra Peirce1, Ying-Jen Lin2, Angela Fagerlin3
1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA ampeirce@umich.edu.
BMJ Open
|May 21, 2024
Summary
A new online program improved health insurance literacy and confidence in cost-saving strategies for patients with chronic conditions in high-deductible health plans (HDHPs). The intervention was found to be acceptable and feasible for this population.
Area of Science:
- Health Services Research
- Behavioral Science
- Health Economics
Background:
- Patients with chronic conditions enrolled in high-deductible health plans (HDHPs) experience significant cost-related access barriers and high out-of-pocket expenses.
- Effective strategies are needed to help these patients navigate healthcare costs and improve access to care.
Purpose of the Study:
- To develop a novel behavioral intervention aimed at assisting HDHP enrollees with chronic conditions in adopting cost-conscious healthcare strategies.
- To evaluate the preliminary effectiveness, acceptability, and feasibility of this intervention.
Main Methods:
- A 5-week online intervention was developed, including educational modules on cost discussions, healthcare price comparison, and future planning, supported by encouraging emails.
- A single-arm, proof-of-concept pilot study was conducted with 36 US adults with chronic conditions enrolled in HDHPs.
- Health insurance literacy and confidence in cost-conscious strategies were measured via baseline and postintervention surveys.
Main Results:
- 86% of participants (31/36) completed the study.
- Significant improvements were observed in health insurance literacy scores (56.5 to 67.1, p<0.001).
- Confidence increased in discussing costs with providers (6.1 to 7.6, p=0.0094), comparing prices (5.4 to 6.9, p=0.005), and comparing quality (6.1 to 7.6, p=0.0034).
Conclusions:
- The novel behavioral intervention is acceptable and feasible for HDHP enrollees with chronic conditions.
- The intervention demonstrated preliminary effectiveness by increasing health insurance literacy and confidence in cost-conscious strategies.
- Further evaluation in a fully powered randomized controlled trial is recommended to assess impacts on access barriers, spending, and health outcomes.
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