Consumer Understanding of the Medical Care Delivery System. A: How Sophisticated Are Consumers about the Medical Care Delivery System. B: Consumers' Knowledge about Their Health Insurance Coverage

摘要

This study's objectives were to examine how accurately families can describe the extent of their insurance benefits, to look at the reasons for variation in such knowledge, and to attempt to measure consumer sophistication about the health delivery system. Data was gathered from people in 3,218 families in four states - Ohio, Massachusetts, South Carolina, and Washington - selected for the RAND Health Insurance Study, a social experiment in health care financing. The data show that better than 90 percent of families accurately report whether or not they are insured. This study also found that most insured families correctly report having coverage for hospital care, but that they are less knowledgeable about which outpatient services are covered. Knowledge of benefits for covered services varied with complexity of the benefit structure. If the plan included coinsurance or fee schedules, fewer families could describe their benefits.