VCU Schools Collaborate to Study Uninsured

Under the Patient Protection and Affordable Care Act (ACA), Virginia’s health care system will experience fundamental changes, including the creation of new health insurance exchanges. These exchanges will offer a choice of health care plans and provide information to help consumers – including the nearly 15 percent of Virginians without insurance coverage - better understand the options available to them.

But that is a lot of information to absorb, and one critical barrier to coverage expansion through exchanges is the potential for consumers to become overwhelmed with large amounts of information and to fail to use the provided information as the basis for their decisions. This could result in plan choices with higher out-of-pocket costs and less access to necessary services. 

Through a pilot study, a team of Virginia Commonwealth University researchers will examine the cognitive attributes of uninsured Virginians and determine the best way to target insurance coverage expansion efforts in the state under health reform.

The study titled, “Speaking the Same Language Before Starting the Conversation: Understanding the Literacy Levels and Risk Attitudes of Uninsured Virginians Eligible for Health Insurance Exchanges,” brings together researchers from the schools of Medicine, Business, Allied Health Professions and Pharmacy. This unique collaborative effort was made possible through the VCU Health Policy Collaborative initiative. The pilot study is supported through a newly awarded internal grant.

The VCU study will assess uninsured individuals’ attitudes towards risk, their health literacy and the extent to which they are engaged in health care decisions. Ultimately, the project’s aim is to understand how these cognitive attributes influence the quality of insurance choices among the uninsured seeking insurance. Given these influences, how insurance product information presented to consumers in exchanges could be tailored to improve coverage decisions

“Choosing health insurance is an incredibly complex decision,” said co-principal investigator Andrew Barnes, Ph.D., assistant professor of healthcare policy and research in the School of Medicine.

“With this study we hope to learn how individuals perceive this difficult choice and to find new, more effective ways to communicate insurance information to all those who will be required to purchase coverage under health reform,” he said.

According to the VCU experts, many of these “new customers” will be less educated, lower income, more racially and ethnically diverse, sicker and, importantly, will have less experience purchasing health insurance than the current privately insured population. They also may have limited medical and economic vocabulary, find it challenging to use charts, obtain, process, integrate and understand insurance plan information and make the cost calculations, risk tradeoffs and comparisons needed to reach an informed decision. Unfortunately for these consumers, the health insurance exchanges are predicated on consumers’ ability to comprehend and compare a vast amount of information on numerous insurance plans to make important choices about their coverage.

“This joint project between four different schools at VCU offers a unique opportunity for interdisciplinary work and collaboration to bring a new perspective to one of today’s most pressing health policy issues,” said co-principal investigator Laura Razzolini, Ph.D., professor of economics in the School of Business.

Investigators working with Barnes and Razzolini include David Holdford, Ph.D., professor and vice chair for graduate studies in the Department of Pharmacotherapy and Outcomes Science in the School of Pharmacy; Haeran Jae, Ph.D., associate professor of marketing in the School of Business; Edward Millner, Ph.D., professor and chair in the Department of Economics in the School of Business; and Carolyn Watts, Ph.D., professor and chair in the Department of Health Administration in the School of Allied Health Professions. 

Subscribe to the weekly VCU News email newsletter at http://wp.vcu.edu/vcunews/ and receive a selection of stories, videos, photos, news clips and event listings in your inbox every Thursday.