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VERBAL REMEDIES
LITERACYHEALTH LITERACY
HEALTH INSURANCE LITERACY
Best communication practices for in-person assisters in OE3
Don Rubin
VERBAL REMEDIES
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Can you read this?
Platinum PlanGold PlanSilver PlanBronze PlanCatastrophic
PlanBenchmark Plan
Qualified
health
plan
In-network provider Advance
premium
tax creditMaximum
out of pocket expense
Life qualifying event
Household
PPOPOSHMO
Co-payCo-insuranceDeductible
Can you read this?
VERBAL REMEDIES
Comprehension of MedicarePatients with Low Literacy
PercentCorrect
Identify next appointment 73%Take medicine every 6 hours 52%Take medicine on empty stomach 46%Interpret blood sugar value 32%Upper GI instructions (4th grade) 24%Medicaid Rights (10th grade) 0%
GGa
Gazmararian et al., 1999
VERBAL REMEDIES
43% of uninsured didn’t know about government subsidies for insurance
VERBAL REMEDIES
VERBAL REMEDIES
• 1 of 6 adult Georgians reads at K-6 level• 16% of adult Georgians lack a HS
diploma• 1 of 7 unemployed Georgians has not finished
high school• 75% of incarcerated persons lack a HS diploma.• 1 in 10 Georgians is an immigrant and does not
speak English as their native language.
Adult Literacy in Georgia
VERBAL REMEDIES
Integrate Health Literacy into Adult Basic Education and ESoL
What is Health Literacy?
The Patient Protection and Affordable Care Act of 2010, Title V, defines health literacy as…
… the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.
VERBAL REMEDIES
Why is Health Literacy Important?
Persons with limited health literacy:
• Experience more preventable hospital admissions.
• Too often end up in the ER for conditions that could be treated at home or in the doctor’s office
• Are less likely to adhere to treatment.• Commit more medication errors• Do a poor job of self-management of chronic
conditions• Less likely to obtain health insurance
Health Literacy can mitigate health disparities
• Race predicts variance in HIV medication nonadherence (AOR=2.4)
• When a measure of health literacy is added to the set of predictors, race becomes non-signficant [Osborne, Paashe-Orlow & Davis, 2007]
• Similar result among elderly for self-rated health (Bennett et al, 2009)
What is Health Insurance Literacy?
• Ability to find and evaluate information about health plans
• Ability to select the best plan for their (family) financial and health situation
• Knowledge about using insurance once enrolled to obtain needed preventive and therapeutic care.
VERBAL REMEDIES
Why is Health Insurance Literacy Important?
• Consumers stay in the same plan year after year, ignore better choices (Gruber).
• 88% cannot calculate health insurance costs using a table based on income and family size (Kutner
et al.).• Consumers struggle with
cost-sharing terms, e.g., coinsurance, allowed amount, annual benefit (Quincy).
• Poor health insurance literacy leads to…– Reluctance to enroll– Selecting plan that
does not meet needs or is unaffordable
– Failing to utilize benefits
VERBAL REMEDIES
VERBAL REMEDIES
Can we make it any easier?
What’s in the Health Insurance Literacy Toolkit?
• Packaging & staging information for usability• SOCO– Single Over-riding Communication Objective
• Engaging Consumers/Dialogue– inviting Consumer questions
• Plain language• Analogies & Metaphors• Examples• Stories• Visuals
VERBAL REMEDIES
Draw this!
You got insurance from the Marketplace. So you must send in a tax return next year. You have to attach a special form called 1095A with your taxes. The 1095A form tells about your insurance cost. The Marketplace will give you the information you need for your 1095A. The information from the Marketplace will come on another form called 8962
VERBAL REMEDIES
Plain language & redesign exercise -- Can you make this notice more health literate?
Enrollment is not the finish line: Help clients access healthcare services
• Budget for monthly premiums• Choose a primary care provider• Set aside money for out-of-pocket costs• Schedule preventive services • Getting past the front desk
• Learn how to see a doctor• Shop again to e-enroll