Date of Conferral

2022

Degree

Doctor of Business Administration (D.B.A.)

School

Business Administration

Advisor

Richard Hay

Abstract

Low health literacy can adversely affect individuals and groups without access to health information. Health insurance leaders who lack strategies to decrease low health literacy may lose their ability to provide quality health services and control care costs. Grounded in the health belief model and the Andersen health service model, the purpose of this qualitative multiple case study was to identify the strategies private health insurance leaders use to increase medical utilization to reduce healthcare costs. The three participants were from two private insurance companies in Las Vegas, Nevada. Data were gathered through semistructured, open-ended interviews via videoconferencing, a review of public documents, and journal notes. Data were analyzed using thematic analysis, and four themes emerged: (a) patient case management engagement to achieve compliance, (b) continuous patient health education, (c) health service utilization review, and (d) providers-patient collaboration. The key recommendation for private health insurance managers is to ensure patient interaction through case management. The implications for positive social change include the potential to improve health literacy knowledge, thereby increasing adequate medical utilization for the population and reducing healthcare costs for individuals and insurance companies.

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