scholarly journals Why Westerners Are Dissatisfied: A Cross-Sectional Study Identifying State-Level Factors Associated with Variation in Private Health Insurance Satisfaction

2019 ◽  
Author(s):  
Megan McLeod ◽  
Jeffrey A. Berinstein ◽  
Calen A. Steiner ◽  
Kelly Cushing ◽  
Shirley A. Cohen Mekelburg ◽  
...  
Keyword(s):  
Health Insurance ◽  
Consumer Satisfaction ◽  
Private Health Insurance ◽  
State Level ◽  
Healthcare Spending ◽  
Cross Sectional Study ◽  
Insurance Plan ◽  
Health Insurance Plan ◽  
Cross Sectional ◽  
Per Capita

AbstractImportanceLarge regional variations in consumer satisfaction with private health insurance plans have been observed, but the factors driving this variation are unknown.ObjectiveTo identify explanatory state-level and insurance family-level predictors of satsifaction with private health insurance.DesignCross-sectional study examining regional and state variations in consumer health insurance plan satisfaction using National Committee for Quality Assurance data from 2015 to 2018, state-level health data and parent insurance family.SettingUS PopulationParticipantsPrivately insured individuals.ExposureOne of 2176 private health insurance plans.Main OutcomeConsumer satisfaction with the health insurance plan on a 0-5 scale.RESULTSConsumer satisfaction with health insurance was consistently lowest in the West (p<0.0001). Lower private health insurance plan satisfaction was associated with the percentage of the population without a place of usual medical care, the percentage of the state population that is Hispanic, and the percentage of the population reporting any mental illness. Factors associated with increasing insurance satisfaction included higher healthcare spending per capita, a higher number of for-profit beds per capita, and an increased cancer death rate. Increased consumer satisfaction was associated with the Kaiser and Anthem insurance plan families.Conclusions and RelevanceState and insurer family factors are predictive of private health insurance plan satisfaction. Potentially modifiable factors include access to primary care, healthcare spending per capita, and numbers of for-profit hospital beds. This information will help consumers hold insurance providers accountable to provide higher quality and more desirable coverage and provide actionable items to improve health insurance satisfaction.

scholarly journals Changes in employer-sponsored private health insurance among retirees in Ontario: a cross-sectional study

CMAJ Open ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. E15-E22 ◽  
Author(s):  
Fiona K.I. Chan ◽  
Kimberlyn McGrail ◽  
Sumit R. Majumdar ◽  
Michael R. Law
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

A Model of the Change, Attributable to Government Health Insurance Plans, in Location Patterns of Physicians—With Supporting Evidence from Ontario, Canada

1983 ◽  
Vol 1 (1) ◽  
pp. 45-55 ◽  
Author(s):  
G I Thrall ◽  
J G Tsitanidis
Keyword(s):  
Health Insurance ◽  
Supporting Evidence ◽  
Insurance Plan ◽  
Health Insurance Plan ◽  
Ontario Health Insurance Plan ◽  
Subsequent Change ◽  
Government Health ◽  
Geographic Accessibility ◽  
Location Patterns ◽  
Per Capita

The introduction of government health insurance programs may induce physicians to change location trends that prevailed under previous market conditions. The subsequent change in geographic accessibility of people to medical services may be measured by the change in the stock of physicians per capita across space. An example of the Ontario Health Insurance Plan suggests that following its introduction, the change in the stock of physicians per capita is most sensitive to the initial stock of physicians and whether the physician is a specialist or not.

scholarly journals Is healthy children surveillance being duplicated by family physicians and paediatricians? A cross-sectional study in Portugal

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e015902
Author(s):  
Susana Rebelo ◽  
Sofia Velho Rua ◽  
Joana d’Orey Leça ◽  
Ana Couto ◽  
Rute Teixeira ◽  
...  
Keyword(s):  
Health Insurance ◽  
Educational Level ◽  
Private Health Insurance ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Healthy Children ◽  
Net Income ◽  
Sectional Study ◽  
Cross Sectional ◽  
Number Of Children

ObjectivesTo determine if children attend the family physician (FP) or the FP/paediatrician for their surveillance medical appointments, as well as analyse the variables associated with the parents’ choice between the two physicians.DesignCross-sectional study.SettingPublic, semiprivate and private kindergartens in the city of Vila Nova de Famalicão (Portugal).ParticipantsParents of children aged 6 years or less without chronic diseases, enrolled in the selected kindergartens.Main outcome measuresProportion of children attending the FP or FP/paediatrician for their surveillance appointments; association between the chosen physician and sociodemographic and household variables (parents’ age, educational level, professional situation and marital status; household net income; number of children; the child’s age; presence of private health insurance), assessment of the parents’ perception of clinical knowledge and accessibility regarding the FP and the paediatrician.ResultsA total of 697 children were included in the analysis: 30.6% attended only the FP and 69.4% attended both the FP and the paediatrician. Using a Poisson regression, the mother’s age (PR=1.02, 95% CI 1.00 to 1.03), higher educational level (prevalence ratio (PR=1.15, 95% CI 1.00 to 1.33), private health insurance (PR=1.30, 95% CI 1.15 to 1.46), number of children (PR=0.86, 95% CI 0.78 to 0.94) and the child’s age (PR=0.95, 95% CI 0.91 to 0.98) were statistically associated with attending both the FP and the paediatrician; parents of children who attended only FP rated the FP with a higher accessibility and knowledge mean score than those who consulted both physicians (2.91vs2.38, P<0.001, and 4.11vs3.85, P<0.001).ConclusionsOur data show that 70% of our sample simultaneously attended an FP and a paediatrician. FPs are equally qualified to provide medical care to healthy children but this information is not properly transmitted to the general population.

scholarly journals Do Insurers Compete on the Federal Health Insurance Exchange?

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 25
Author(s):  
Jesse N. Cohen ◽  
Alexander Coppock ◽  
Arnab K. Ghosh ◽  
Benjamin P. Geisler
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Early Stage ◽  
Cross Sectional Study ◽  
Insurance Plan ◽  
Cross Sectional ◽  
Data Set ◽  
Insurance Premiums ◽  
The Relationship ◽  
Early Market

Background: On the U.S. Federal Health Insurance Exchange established by the Affordable Care Act, states with fewer insurers have higher insurance premiums than states with more insurers. This expected feature of a competitive market has not been studied within states, however. We tested the hypothesis that insurance premiums decrease in more competitive geographic rating areas within states in the U.S.A.Methodology/principle findings: This cross-sectional study utilized publicly available premiums from the Federal Health Insurance Exchange website, www.healthcare.gov. Univariate and multivariate analyses were used to model premiums based on the number of insurers in geographic rating areas. The relationship between premiums and the number of insurers competing in a geographic rating area was also calculated for each unique insurance plan offered on the exchange. The data set and statistical code used for this research is linked in the publication. We found that there was an unexpected, marginally positive relationship between average monthly premiums and the number of insurers in a geographic rating area (+$5.71 in monthly premiums per additional insurer, p<0.001). We also found that identical plans tend to be offered with marginally higher premiums in rating areas with more insurers (+$3.18 in monthly premiums per additional insurer, p=0.002), contrary to the relationship we expected from a competitive marketplace. The principle limitation of the study is that this unexpected relationship, which suggests a lack of competitiveness of this early market, could be due to unobserved confounding factors that influence pricing in more competitive rating areas.Conclusion: On the Federal Health Insurance Exchange, the price of insurance is higher in more competitive rating areas within states. This may be explained by lack of competition in this early stage market.

scholarly journals Awareness of Heart Disease Among Female College Students

2020 ◽  
Vol 29 (4) ◽  
Author(s):  
Ghadah Alshuwaiyer ◽  
E. Laurette Taylor
Keyword(s):  
Heart Disease ◽  
Health Insurance ◽  
Private Health Insurance ◽  
Cross Sectional Study ◽  
Female Students ◽  
Educational Opportunities ◽  
Female College Students ◽  
Sectional Study ◽  
Cross Sectional ◽  
Preventive Methods

This cross-sectional study assessed the knowledge of female students about heart disease (HD). A sample of 334 students (age=18-64 years) completed a 43-item survey. Students (32%) considered themselves “not informed” about HD. Yet, HD was identified as a main health problem (30.5%) and a leading cause of death (60%; p < .05). Students with private health insurance (54%) visited the doctor regularly versus those without private or known type of insurance (6.4% and 2.1%, respectively; p < .05). Students identified exercise (73.8%) and aromatherapy (14.1%) as preventive methods for HD. To increase HD awareness among female students, educational opportunities should be incorporated into coursework.

scholarly journals Dissemination of a Web-Based Tool for Supporting Health Insurance Plan Decisions (Show Me Health Plans): Cross-Sectional Observational Study (Preprint)

2018 ◽  
Author(s):  
Jingsong Zhao ◽  
Nageen Mir ◽  
Nicole Ackermann ◽  
Kimberly A Kaphingst ◽  
Mary C Politi
Keyword(s):  
Health Insurance ◽  
Decision Support ◽  
Health Plans ◽  
Insurance Plan ◽  
Poverty Level ◽  
Health Insurance Plan ◽  
Cross Sectional ◽  
Web Based ◽  
The Public ◽  
Advantages And Disadvantages

BACKGROUND The rate of uninsured people has decreased dramatically since the Affordable Care Act was passed. To make an informed decision, consumers need assistance to understand the advantages and disadvantages of health insurance plans. The Show Me Health Plans Web-based decision support tool was developed to improve the quality of health insurance selection. In response to the promising effectiveness of Show Me Health Plans in a randomized controlled trial (RCT) and the growing need for Web-based health insurance decision support, the study team used expert recommendations for dissemination and implementation, engaged external stakeholders, and made the Show Me Health Plans tool available to the public. OBJECTIVE The purpose of this study was to implement the public dissemination of the Show Me Health Plans tool in the state of Missouri and to evaluate its impact compared to the RCT. METHODS This study used a cross-sectional observational design. Dissemination phase users were compared with users in the RCT study across the same outcome measures. Time spent using the Show Me Health Plans tool, knowledge, importance rating of 9 health insurance features, and intended plan choice match with algorithm predictions were examined. RESULTS During the dissemination phase (November 2016 to January 2017), 10,180 individuals visited the SMHP website, and the 1069 users who stayed on the tool for more than one second were included in our analyses. Dissemination phase users were more likely to live outside St. Louis City or County (P<.001), were less likely to be below the federal poverty level (P<.001), and had a higher income (P=.03). Overall, Show Me Health Plans users from St. Louis City or County spent more time on the Show Me Health Plans tool than those from other Missouri counties (P=.04); this association was not observed in the RCT. Total time spent on the tool was not correlated with knowledge scores, which were associated with lower poverty levels (P=.009). The users from the RCT phase were more likely to select an insurance plan that matched the tool’s recommendations (P<.001) compared with the dissemination phase users. CONCLUSIONS The study suggests that a higher income population may be more likely to seek information and online help when making a health insurance plan decision. We found that Show Me Health Plans users in the dissemination phase were more selective in the information they reviewed. This study illustrates one way of disseminating and implementing an empirically tested Web-based decision aid tool. Distributing Web-based tools is feasible and may attract a large number of potential users, educate them on basic health insurance information, and make recommendations based on personal information and preference. However, using Web-based tools may differ according to the demographics of the general public compared to research study participants.

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