The complexity of the health care system can make it hard for people to make the right care choices. It will take high-tech and low-tech solutions to improve health literacy and make choosing care simpler.
Copay. Premiums. Preferred provider organization. They’re common words in the world of health plans, but it turns out few Americans know what they mean.
In fact, less than half of adult Americans are considered “health care literate.”
Being literate in health care means having the skills to get and grasp basic facts needed to make appropriate health decisions, according to the U.S Department of Health and Human Services.
And it’s not only confusing terms that limit health literacy. The complexity of the health care system overall can hold people back from making the right care choices.
People who lack these skills may struggle to fill a prescription, schedule a doctor’s appointment or manage a chronic illness.
When it comes to health insurance, the costs of low health care literacy are great — both for the consumer and the health care system.
People with a poor grasp of health benefits need more high-touch help from health plans. They call customer service 13 percent more often than people who are highly health care literate, according to Accenture.
That adds administrative costs. Accenture reports health plans could save a collective $3.4 billion each year if everyone was highly literate in health care.
But there’s a medical cost associated with health literacy, too.
“Those who have low literacy rates and also have serious health conditions are less likely to seek health care,” says Greg Brown, divisional senior vice president of service delivery and operations of the five Blue Cross and Blue Shield Plans of Illinois, Montana, New Mexico, Oklahoma and Texas. Brown recently spoke on an expert panel titled “The Hidden Cost of Healthcare System Complexity,” organized by America’s Health Insurance Plans.
On the other hand, when people are more health care literate, they’re more likely to use health care resources appropriately. They’re also less likely to delay seeking care, a study published in November in JAMA found.
The health literacy problem hasn’t gone unnoticed. The federal government acknowledged the issue in the Affordable Care Act in 2010. The ACA requires health plans to give “clear, consistent, and comparable health information in a standardized summary of benefits and coverage template.” Many states require Medicaid enrollment materials to be at or below a sixth-grade reading level to boost comprehension.
Now, insurers have started simplifying language, regardless of who they’re communicating with.
Efforts to raise health care literacy need to go further than simplifying the message.
Even people with college degrees struggle with health care terms and concepts. Nearly half of people with low health care literacy had college degrees, and 97 percent had at least a high school diploma.
Health plans and other stakeholders are also battling time. “In the limited discretionary time we have, no one is spending that looking at and trying to understand their health care benefits,” says Brown. “They’re just not.”
So efforts to raise health care literacy need to go further than simplifying the message.
“There’s a need for us to reduce complexity in the system. We need to navigate folks through it,” Brown says.
Hundreds of startups have popped up to help do just that. They provide services like care management and helping customers. Some can check the value of medical services and facilities. And health insurers like the five Blues Plans are taking their own approach to make things clear for members.
One priority is investing in digital solutions to help members get answers without tying up phone lines. “First and foremost, we need to increase digital to help educate members and provide them with answers that they’re seeking,” Brown says.
But there’s another, low-tech approach that may help people connect with and understand their care: community-focused programs.
The Blue Door Center opening in 2019 in Chicago is one such program. Anyone will be able to go to the neighborhood center to attend wellness classes, learn about their health insurance and get connected to other community resources.
“People can come in, ask questions and better understand what health care is all about,” Brown says. “We’re tapping into community in a way that we haven’t done in the past.”