Mary C. Politi|Rachel L. Grant|Nerissa George|Abigail Barker|Aimee S. James|Lindsay M. Kuroki|Timothy D. McBride|Jingxia Liu|Courtney Goodwin
Improving Cancer Patients’ Insurance Choices (<i>I Can PIC</i>): A Randomized Trial of a Personalized Health Insurance Decision Aid
Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis|Washington University in St. Louis
abstract background many cancer survivors struggle choose health insurance plan meets needs high costs limited health insurance literacy lack decision support developed webbased decision aid improving cancer patients insurance choices pic evaluated randomized trial materials methods eligible individuals 1864 years diagnosed cancer 5 years englishspeaking medicaid medicare eligible randomized pic attention control health insurance worksheet primary outcomes included health insurance knowledge decisional conflict decision selfefficacy completing pic control secondary outcomes included knowledge decisional conflict decision selfefficacy health insurance literacy financial toxicity delayed care 36month followup results total 263 335 eligible participants 79 consented randomized 206 73 completed initial survey 106 pic 100 control 180 87 completed 36 month followup viewing pic control health insurance knowledge health insurance literacy item assessing confidence understanding health insurance higher pic group followup pic group retained higher knowledge control confidence understanding health insurance reassessed significant differences groups outcomes results change controlling health literacy employment groups reported limited health insurance options conclusion pic improve cancer survivors health insurance knowledge confidence using health insurance systemlevel interventions needed lower financial toxicity help patients manage care costs implications practice inadequate health insurance compromises cancer treatment impacts overall cancerspecific mortality uninsured underinsured survivors report fewer recommended cancer screenings may delay avoid needed followup cancer care costs even adequate insurance report difficulty managing care costs health insurance decision support resources help manage care costs thus paramount cancer survivors health care management developed webbased decision aid improving cancer patients insurance choices pic evaluated randomized trial pic provides health insurance information supports patients managing care costs offers list financial emotional support resources provides personalized cost estimate annual health care expenses across plan types