Focus: Improve health insurance literacy

Public health sciences researchers deomonstrate an insurance choices tool
Public health sciences researcher Mary Politi, PhD, demonstrates use of the “Improving Cancer Patients’ Insurance Choices” tool to help them better understand complexities of cost and coverage.

Navigating the choices of health insurance plans can be a daunting task for anyone. For cancer survivors focused on their ongoing care, securing the right plan can be an overwhelming additional burden. Now, a new web-based decision-support tool to help patients better understand and select health insurance is being developed at Washington University. Public Health Sciences researcher Mary Politi, PhD, calls the new tool “Improving Cancer Patients’ Insurance Choices” or, simply, “I Can PIC.” * It is based on an earlier study called Show Me Health Plans, in which Politi and colleagues evaluated the effectiveness of an online decision-aid tool that provided education, help assessing choices, and an out-of-pocket cost calculator. They found that participants improved health insurance knowledge and were 10.3 times more likely to select a plan that matched their needs and preferences, suggesting that people without full understanding of their options may default to the cheapest monthly plan over the one best suited for them.

To develop I Can PIC, the researchers asked cancer survivors to describe challenges they faced with health insurance and care costs. Survivors struggled with lack of transparency about cost and coverage. Some of their challenges are difficulty in anticipating expenses and meeting out-of-pocket costs, especially as they move to high-deductible plans. “We need to do a better job of helping people find the best insurance plan to cover needed care, so people aren’t delaying or skipping important services,” Politi says.

I Can PIC defines insurance terms, guides patients in asking about costs of care, and estimates annual insurance plus care costs so patients can make better informed choices for them and their families. The web portal also lists additional resources for help paying for cancer care. Currently, more than 100 cancer patients from Missouri and Illinois insured through both government- and employer-based plans have enrolled in a study analyzing the effectiveness of the I Can PIC website. Investigators are hoping to enroll 275 participants by the end of 2018.

“Patients have a cloud of confusion around what insurance will and will not cover,” says Politi. “Matching bills for care received months ago can be overwhelming. If we can do anything to ease that burden, it will be worth it.”

*The American Cancer Association funds the I Can PIC study.


Drs. Adetunji Torioli and Matthew Mutch work on the ColoCare Consortium

Public health sciences researcher Adetunji Toriola, MD, PhD, is helping to lead an effort to create an international repository of tissue, blood, stool and urine samples for the study of colorectal cancer. The ColoCare Consortium is a multicenter initiative to collect samples from newly diagnosed colorectal patients for molecular, genetic and other lifestyle-related studies. Toriola leads the consortium’s Microbiome Working Group and collaborates with Colon and Rectal Surgery Chief Matthew Mutch, MD, to collect specimens. Toriola also is exploring research with faculty at the Division of Oncology and the Elizabeth H. and James S. III McDonnell Genome Institute to examine how the gut microbiome influences response to treatment. One of Siteman’s major contributions is to increase the number of African-Americans recruited. has been updated for compatibility with smartphones and other mobile devices as well as desktop computers. The website, established in 2000, is a free interactive personalized health assessment tool that enables users to understand their risk for diseases, including 12 common cancers and five chronic diseases, as well as learn ways to improve health.

Epidemiologist Yikyung Park, ScD, has developed a real-time risk-adjusted outcomes assessment tool to project transplant outcomes relevant to the United Network for Organ Sharing (UNOS) and Scientific Registry of Transplant Recipient (SRTR) reporting. Transplant surgeons at Barnes-Jewish Hospital use the tool to track liver transplant outcomes as a way to monitor the quality of the transplant program. In the past year, Park has started providing the same analysis for the pediatric liver transplant program at St. Louis Children’s Hospital.