Several simple steps -- such as implementing a decision-support tool and providing explanations of health insurance industry vocabulary -- could significantly improve the usability of HealthCare.gov, according to a study published in the Annals of Internal Medicine, the Los Angeles Times' "Science Now" reports.

Details of Study

The study was conducted by a team of health economists, health policy experts, lawyers and physicians from the University of Pennsylvania. They observed 33 volunteers between the ages of 19 and 30 as they attempted to navigate and sign up for coverage on the federal health insurance exchange website (Kaplan, "Science Now," Los Angeles Times, 7/7).

The volunteers were considered "highly educated" and they "explained their thinking in real time."

After they were finished navigating the site, researchers interviewed the volunteers about their experience, impressions and suggestions for improving the federal health insurance exchange site (Annals of Internal Medicine, 7/8).

Findings

Overall, researchers found that participants faced several obstacles to using the site.

For example, volunteers often did not understand health care industry terminology on the site, and many terms were "inadequately explained," according to the study.  For example, the term "catastrophic" was misunderstood by some of the participants to mean that the health plan did not cover preventive primary care.

Participants also had trouble matching their preferences with available health plans, in part because of an "overwhelming" amount of information displayed on the site, the study noted.

In addition, health plan costs listed on the website did not always adequately reflect tax credits or cost-sharing options ("Science Now," Los Angeles Times, 7/7).

Recommendations

Researchers identified six actionable improvements for the site that could be implemented prior to the upcoming open enrollment period, which begins Nov. 15:

• Provide more accessible and understandable explanations of health insurance industry vocabulary;
• Highlight the mandatory inclusion of preventive primary care services in all available plans;
• Clarify or expand options for adult dental coverage earlier in the sign-up process;
• Implement a sorting or decision-support tool to help consumers determine health plan options that align with their preferences;
• Include potential premium tax credits and cost-sharing subsidies in the cost of health plans; and
• Rename the "catastrophic" health plan category to "value" or "minimal" to reduce confusion.

Researchers said the findings show how relatively small changes to the website "could improve [users'] understanding of a typically difficult process" and the usability of HealthCare.gov (Annals of Internal Medicine, 7/8).