Demystifying the Communication-Driven Usefulness Hypothesis: The Case of Healthcare Insurance Applications

Demystifying the Communication-Driven Usefulness Hypothesis: The Case of Healthcare Insurance Applications

Makoto Nakayama (DePaul University, Chicago, USA) and Steven Leon (Appalachian State University, Boone, USA)
DOI: 10.4018/IJHISI.2019100104

Abstract

Healthcare insurance applications are increasingly vital to and have gained popularity with consumers. Previous information systems research featured perceived ease of use and perceived usefulness as key independent variables to explain behavioural intention impacting the use of information systems. In today's environment, however, many consumers already rely on websites and mobile applications as a key means of communication with healthcare insurance providers. Examining the data from 333 survey respondents, this study reports that perceived ease of use and perceived usefulness are strongly influenced by three communication content variables (information quality, interaction ease, and provider competence). Importantly, consumers may judge applications' ease of use based on the quality of communication contents. Once applications reach some maturity, the prominence of communication quality may drive their use more significantly than before.
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1. Introduction

Health expenditures in the United States (U.S.), according to Walker & Calderon (2018), are projected to be eighteen percent (18%) of its GDP with health consumers struggling to navigate through the numerous errands that various sectors of this industry have imposed on them. In particular, the health insurance sector, as a key part of the growing healthcare marketplace, is highly complex. Specifically, health insurance consumers are routinely tasked with the critical role to seek information relating to insurance policies and procedures, and more importantly, insurance coverage details. Often, these consumers are seeking for the most appropriate health insurance policy catering to their needs, the best healthcare provider they can afford based on the stipulated requirements or prerequisites for approval to obtain certain and specific medical procedure(s), and alternative medication payment schemes that may be activated. Today, such expanding role and responsibilities expected of these consumers are beginning to overwhelm, calling for the need and use of more user-friendly healthcare insurance applications (HIAs).

Accordingly, health insurance companies have implemented HIAs, which have become commonplace in the form of websites or mobile apps, to ease information seeking and transaction tasking for consumers. A 2016 survey reported that eighty-four percent (84%) of respondents prefer to interact digitally with health insurance providers (Shea & Ramachandran, 2016). These authors claim that “the quality, maturity and effectiveness of digital customer service capabilities are clearly important influencers on members as they shop for plans and interact with [those providers] …”

Importantly, a key lesson for developers of HIAs is to enable consumers to keep track of how much healthcare expenditures are covered by their health insurance. With the advent and increasing sophistication of websites and mobile phone apps in the last decade, noticeable improvements have been made with consumer-oriented healthcare applications as mobile phone use become increasingly pervasive (Mosa, Yoo, & Sheets, 2012, 2015). Given the current reality of consumer HIA preferences, use and satisfaction, and that there are few studies that focused on HIAs and the relationship between HIA’s communication contents and usefulness, the primary research question being investigated here is:

1.1. What drives Perceived Ease of Use (PEOU), and Perceived Usefulness (PU) of HIAs?

This identified knowledge gap is termed here as “the communication-driven usefulness hypothesis.” Specifically, the study presented here aims to investigate the key factors underlying the complexity in communication about health insurance matters. Three non-information technology (IT) constructs on communication quality that substantially influence the traditional IT constructs, PEOU and PU, of HIAs are posited. Hence, the study main focus is not to extend the Davis (1989) Technology Acceptance Model (TAM) nor the Venkatesh, Morris, Davis & Davis (2003) Unified Theory of Acceptance and Use of Technology (UTAUT), but to examine to what extent communication contents (non-IT artifacts) influence the PEOU and PU of HIAs (IT artifacts).

The remainder of the paper is structured as follows. Section 2 overviews the relevant extent literature to provide background to our theoretical model with details on the hypotheses. Section 3 describes the study method and results. Section 4 lays out the study implications from both a theoretical and a practical perspective. Section 5 then offers concluding remarks followed by brief discussions on limitations and future research opportunities.

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