Addressing complexity: The development and pilot testing of a user-friendly Medicare Part D patient decision aid tool

Selecting a Medicare Part D prescription drug plan can be challenging because of limited health insurance literacy and complex plan features. Existing online tools, such as the Medicare Plan Finder (MPF), often lack personalization.

To describe the conceptualization and development of a personalized Medicare Part D decision aid (DA) to supplement the MPF.

A user-centered, iterative design process informed by the Ottawa Decision Support Framework and International Patient Decision Aid Standards was used to develop a DA that helps older adults with Part D plan selection. First, a literature review and 1-hour interviews with Medicare-eligible individuals informed the development of a prototype. These individuals formed a stakeholder advisory board (SAB). The first prototype was then alpha tested with 2 SAB focus groups. Using focus group feedback, the final prototype was developed. Beta testing participants, including Medicare-eligible individuals and Medicare counselors, were recruited and completed an online version of the DA, alongside pre-DA and post-DA questionnaires to examine DA effectiveness using a modified Health Insurance Literacy Measure, a modified System Usability Scale, and a user satisfaction survey.

Before the development of the prototype, SAB interviewees (n = 9) suggested that simplified explanations of insurance terminology and side-by-side comparisons of options would be important to the DA. Alpha testing (n = 7) feedback was used to modify the first prototype to improve usability and clarity. Among 25 beta testing participants, Health Insurance Literacy Measure scores increased from 19.76 (SD = 7.15) before using the aid to 24.13 (SD = 4.02) afterward (P = 0.0009). Approximately one-quarter of participants indicated that they would change to a new plan after the tool, whereas half affirmed that the DA validated their existing plan choice.

This pilot study shows that a user-centered, interactive DA can improve health insurance literacy and support Medicare Part D plan decisions.