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Healthcare providers are facing new challenges balancing quality of care and optimal use of dwindling resources. The cost-effective use of health services depends on patient education that incorporates self-management and empowerment. Conditions like diabetes, hypertension, asthma, and other chronic diseases, are largely self-manageable. Self-manageable, that is, only if the patient understands their treatment plan, medications, and when to come back and see the doctor. This is where health literacy enters the equation as a critical component of how healthcare organizations engage with their members and patients.

Health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

I first became aware of health literacy while working in primary care for a large health system. We were trying to manage patient utilization and mitigate costs as part of a value-based contract. I recall teaching a diabetic patient how to inject insulin by demonstrating on an orange. The patient returned a few months later for follow-up but his blood sugar levels remained unchanged. I asked him if he was injecting the insulin the way I taught him and he reassured me that he had. So what was going on? The patient explained that he injects the orange with the insulin everyday, just as I demonstrated, and then he peels it and eats it. I had assumed that the patient understood his diagnosis and I quickly jumped to the treatment plan. Simple misunderstandings cause unnecessary issues as a result of inadequate health literacy.

Health literacy is a blanket term with several components that must be understood and addressed by actors in healthcare to truly help make progress on improving overall health literacy. I’ll take a look at two areas that health plans in particular should be aware of in the remainder of this blog post.

Digital Health Literacy

Have you ever googled “diabetes”? I did and a lot of results surfaced. The internet and Dr. Google has become the first place folks go to get health information and it can be overwhelming. The wealth of content has created confusion as to what information is reliable and how health information is utilized. Digital health literacy is the ability to seek, find, and understand health information from electronic sources to address or solve a health problem – but there is more to it. We all saw the pivot required during the pandemic to get care and the marked increase in virtual and telehealth appointments. Accessibility became a concern as providers tried to assess a patient’s access to wifi and broadband services. Patient portals and the communications between providers and patients depend on digital access and digital literacy. As the healthcare industry becomes more high-tech, we need to pay attention to where and how patients are getting health information and if they understand it.

Health Insurance Literacy

I saved the best for last, the confusion around basic health insurance terms. Health Insurance Literacy is the ability to seek, obtain, and understand health insurance plans, and once enrolled use their insurance to seek appropriate health care services. Deductibles, copayments and coinsurance are the out-of-pocket costs that you pay toward covered medical expenses – and it can be very confusing to figure out. What services you get, who provides the service, and where you get the service done affect the overall medical expense. Health insurance is undeniably complicated, especially when you are trying to figure out what you are responsible to pay. People are often surprised that something as simple as getting an ex-ray can cost more or less depending on where you receive it.

So, what can health plans do to help their members?

  1. Make things as easy as possible to understand and navigate: Healthcare is not like other goods, it is expensive, confusing and very personal so ensure your site layout is easy to navigate with clear terms. Presenting accurate, easy-to-understand information is the first important step.
  2. Simplify where possible: When people are looking for a new provider, most go to their health plan first to see if they are in-network. This can present a great opportunity for health plans to improve member satisfaction and engagement. Available providers should be surfaced using plain English search terms, for example a search for “knee”could navigate a user to orthopedic specialists, ideally with the ability to schedule an appointment.
  3. Personalize communication channels: People want to be able to customize how they communicate with their health plan. In our survey of more than 1,000 individuals with health insurance, HealthSparq found that 46% wanted to choose the method of communication and 43% wanted those communications to be more personalized.
  4. Help people understand their costs: And finally, we get to cost transparency. Even with Federal mandates that provide consumers with out-of-pocket costs there is still opportunity to assist members with their overall healthcare costs. What we want is to alleviate the confusion, not add to it. Plans need to go beyond the mandates to make it a user-friendly experience.

People make choices about their health every day and we should be striving to improve the health information mismatch, remove barriers and make the navigation a little easier and personal.

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