Author ORCID Identifier
0000-0002-5730-1360
Date of Graduation
5-2017
Document Type
Thesis (MS)
Program Affiliation
Genetic Counseling
Degree Name
Masters of Science (MS)
Advisor/Committee Chair
Jennifer Hoskovec, MS, CGC
Committee Member
Lauren Murphy, MS, CGC
Committee Member
Jacqueline Harkenrider, MS, CGC
Committee Member
Sandra Darilek, MS, CGC
Committee Member
Eleazar Soto-Torres, MD, MFM
Committee Member
Quinn Stein, MS, CGC
Abstract
Genetic counselors (GCs) have recently reported an increase in the discussion of insurance-related, or “genesurance,” topics during genetic counseling sessions. Despite increasing frequency, little knowledge exists about genesurance conversations and patient expectations. This study aimed to assess patient expectations of GCs in genesurance discussions and evaluate if health insurance literacy impacted these expectations. A 38-item survey, including a validated tool to assess health insurance literacy (HIL) was administered prior to patients receiving prenatal or cancer genetic counseling at three participating institutions. A total of 360 responses were analyzed. Key variables were compared using chi-square analysis and multivariable logistic regression was used to assess associations between factors, while controlling for potential confounders. Over 80% of patients expected genesurance topics to be discussed during a genetic counseling session with a majority expecting their GC to: provide them an estimated out-of-pocket (OOP) cost for a genetic test (83%), know if a genetic test is a covered benefit (82%), and provide referral information if they have additional questions (81%). In general, HIL did not impact patient expectations of GCs. This study provides evidence that patients expect their GCs to be discussing genesurance topics and further delineates their specific expectations. Further studies will be help to establish the most effective way to communicate this information to patients, evaluate current genetic counseling training programs, and assist in the development of further specialized Health Insurance Literacy assessment tools.
Keywords
genesurance counseling, genetic counseling, efficiency, health insurance literacy