Healthcare Cost Literacy: Exploration of Concept and Initial Development of a Novel Tool in a Representative U.S. Adult Population

There is a growing need for understanding and addressing the issue of healthcare cost literacy (HCL) in the United States. We conducted a survey in partnership with YouGov targeting a representative sample of 1500 American adults (median age 47, 51.4% female, 62.8% white) to help develop a novel tool to assess the prevalence of HCL, and to estimate levels of HCL and health literacy across various sociodemographic and health-related variables. An exploratory factor analysis revealed that the HCL questions mapped to three factors: 1) knowledge on health insurance terminology/interpretation, 2) ability to estimate healthcare costs ahead of time, and 3) confidence in performing cost comparisons between healthcare plans and deductibles. An understanding of Americans’ levels of HCL will help policymakers and various stakeholders in the healthcare system to develop targeted plans to educate consumers on financial planning and evaluation in the healthcare system.