HealthCare.Gov Upgrades Are Just What This Doctor Ordered

When the third round of open enrollment begins on the federal health insurance marketplace Nov. 1, shoppers will see some major changes. These changes might be just what the doctor ordered — if the doctor you are talking to is Charlene Wong, MD, MSHP, a health policy researcher and adolescent medicine fellow at The Children’s Hospital of Philadelphia.

Dr. Wong and colleagues have studied how young adults experience the use of the federal site, HealthCare.gov, and state-based exchanges. Access to health care in this age group is critical for the success of the Affordable Care Act (ACA), as well as for setting young adults up for healthy lives with regular preventive care services.

The research team identified a number of areas for improvement. For example, one study participant said, “I just wasn’t able to comprehend all of the things on HealthCare.gov — I got confused. I’m not a person to give up, not at all — but with the system, I just wanted to quit.” Other findings from the studies included that young adults struggle with basic insurance terms and concepts, and that young adults found the plan selection process challenging and overwhelming.

Dr. Wong, a fellow in the Craig-Dalsimer Division of Adolescent Medicine program at CHOP, shared her research findings and recommendations for improvements to HealthCare.gov with the Office of Health Reform.

She details some of the expected changes, many of which mirror her team’s recommendations, in a recent blog post for the Leonard Davis Institute of Health Economics at the University of Pennsylvania, where she is a senior fellow. These changes may include an out-of-pocket total cost estimator, tools to help shoppers know which plans include their preferred providers, and an improved window-shopping experience for site visitors who have not yet entered personal information.

“With the promised upgrades, HealthCare.gov may more closely resemble other online shopping sites, such as Amazon.com and Zappos.com, that routinely help consumers find the best products for them,” Wong wrote. “This is exactly what the young adults who shopped for insurance on HealthCare.gov asked for during its first open enrollment period.”

Dr. Wong also was quoted in a recent New York Times article further detailing some of the expected changes.

Young adults have other ways of gaining health insurance under the ACA, beyond the federal and state marketplaces. Since 2010, the ACA has extended young adults’ eligibility to stay on their parents’ insurance plans up to age 26. Another arm of Dr. Wong’s research is focused on the implications of that eligibility on young adults’ use of healthcare.

Her most recent findings, published this month in the American Journal of Public Health, are based on analysis of a large, nationally representative survey. Her team found that a larger proportion of young adults reported having had a primary care appointment in the past year after the extended eligibility provision went into effect in 2010. Still, the provision did not change the proportion of young adults who said they had a usual source of care, such as a primary care doctor — and this proportion was only about 60 percent.

The researchers also reported shifts in the type of providers young adults saw and discussed the implications of those shifts for training needs among medical professionals. To learn more about this research, see Dr. Wong’s discussion of the study findings in her post on the PolicyLab blog.