On October 1, 2013, the Health Insurance Marketplace opened, allowing millions of Americans to compare health insurance options and purchase insurance. And in doing so, swarms of people—many for the first time—were confronted with words like deductibles, coinsurance, and premiums. Setting aside the problems with the Marketplace website, there’s another problem that’s not getting much attention. According to a Health Affairs study published last December, more than 60 percent of people targeted by the Marketplace do not understand basic health insurance information.
According to the National Assessment of Adult Literacy, 9 out of 10 adults are unable to understand health information. Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
Making Inroads for Understanding
So much of the health literacy conversation is centered on the first part—a person’s ability to understand basic health information. As health communicators, many of us have made careers out of translating health information into plain language and communicating digestible nuggets of information that help patients better understand their health. I am proud of the progress the health communication industry has made in this area, and although there remains much room for improvement, we have taken some important steps in improving understanding.
Helping Patients Make Good Decisions
But the second part of the definition of health literacy is where the real work needs to be done. To be considered health literate, a person must be able to take information and use it to make health decisions. To do that, they must know and understand more than just the words. They must also understand the complex workings of our health care system, including how health insurance works.
People with low health literacy are less likely to manage their chronic conditions, more likely to be hospitalized, and—not surprisingly—less likely to have health insurance. Open enrollment for the Marketplace ends at the end of next month. Marketplace call center operators, navigators, and other health communicators must not assume that patients understand health insurance vocabulary because many of them have not been exposed to such information.
With this in mind, American Health Insurance Plans released a report at the end of last year that examined health literacy programs of 30 of its members and highlighted eight approaches for improving health literacy regarding insurance concepts, including adopting a targeted reading level for all consumer communications and establishing a list of “words to avoid” and “words to use” in their place.
We must remember that for people to make informed decisions about their health insurance they need to have the right information and then they need to know what to do with it. Let’s also remember that as health communicators, we have still have work to do.