Part one of three-part series
TUESDAY, Sept. 7 (HealthDay News) -- Are American consumers
"health literate" enough to play a leading role in their health
care and coverage decisions?
That question will be put to the test in 2014, when more than 30
million uninsured adults begin shopping for health plans through
state insurance exchanges -- a core element of the national health
reform package signed into law by President Barack Obama in
Stakeholders hope to avoid another debacle like the one that
occurred nearly five years ago when Medicare launched its then-new
prescription drug benefit, called Medicare Part D.
"If you look back at Part D, we learned a lot about how multiple choices in plans and in drug-plan coverage overwhelms, confuses, undermines people's confidence that they can manage the system," said Christina Zarcadoolas, an associate professor in the department of preventive medicine at the Mount Sinai School of Medicine in New York City and a health literacy expert.
Health literacy -- the capacity to obtain, process and
understand basic health information to make appropriate health
decisions -- isn't a new concept. But as consumers are encouraged
to play a more active role in choosing health insurance coverage,
using preventive services and screening tests and managing chronic
health conditions, it's becoming more critical.
"Health literacy is needed to make health reform a reality," U.S. Health and Human Services Secretary Kathleen Sebelius said in a statement in May announcing the National Action Plan to Improve Health Literacy, a set of goals and strategies for creating a "health-literate society."
"Without health information that makes sense to them, people can't access cost-effective, safe and high-quality health services," she said.
More than one-third of U.S. adults have only basic (22 percent)
or below basic (14 percent) health literacy. Just 12 percent have
"proficient" health literacy skills, while less educated and poorer
individuals, in general, have lower health literacy, according to a
U.S. Department of Education analysis.
To improve health literacy, the Department of Health and Human
Services (HHS) is encouraging health organizations and insurers to
use plain language and pictures or graphs to communicate with
consumers, among other enhancements.
These strategies "have the potential to both reduce the
complexity and demands of the health care delivery system and
educate and empower Americans so they are able to fully benefit
from the Affordable Care Act and take charge of their health," an
HHS spokeswoman said in statement prepared for
"Even someone who is well educated may not understand certain medical terminology," noted Ilene Margolin, senior vice president of public affairs and communications at EmblemHealth Inc., a New York City-based health insurer.
EmblemHealth uses Health Literacy Advisor, a software tool
developed by Health Literacy Innovations in Bethesda, Md., to
remove medical jargon and produce more readable brochures and other
The insurer also is working with the nonprofit Literacy
Assistance Center in New York City to tweak the letters it sends to
people explaining their health benefits.
Part of the challenge of health reform is helping Americans sift
through and understand their health plan options. Engaging people's
interest in managing their health is another, Zarcadoolas
"If people do not have enough health literacy to use these plans appropriately and effectively, we shouldn't expect that we're going to see enormous changes in health status," she said.
Just one-third of Americans consistently perform many of the
actions that would benefit their health, according to an analysis
published in May by the Center for Advancing Health in Washington,
D.C. The other two-thirds never perform these actions or do so
inconsistently or tentatively. Those who are less engaged or
disengaged in their health tend to have marginal health literacy,
the study found.
To help close the health literacy gap, Zarcadoolas sees the need
for providers and consumers to communicate in new and potentially
more effective ways.
A few health insurers, in fact, are testing non-traditional
tools, such as electronic messaging between physicians and
At Kaiser Permanente in Southern California, patients with
diabetes, hypertension or both who e-mailed their physician had
significantly better health outcomes than non-users of its secure
messaging system. The results were published in the July issue of
A few health plans and wellness vendors are testing the use of
mobile phone technology to help patients manage health conditions.
WellDoc Inc., a Baltimore-based software developer, announced this
month that the U.S. Food and Drug Administration cleared its
DiabetesManager System, which provides real-time feedback on blood
glucose readings and disease management advice via a patient's cell
Pittsburgh-based insurer Highmark Inc. recently rolled out a
free iPhone application to help members, wherever they may be,
locate participating Highmark providers, look up medical
information and get wellness tips.
"Are health insurers thinking about this and incentivized to look at this? Only very few, and that's the sad truth," Zarcadoolas said. "They are still pumping out pamphlets and sending them to you by snail mail."
Visit the U.S. Department of Health and Human Services to learn
more about the government's
health literacy action plan.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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