Abel points out that health literacy has very different meanings depending on the context, and measuring health literacy will be best achieved where content and context are well defined abel, 2008. Evaluating and measuring health literacy discussion summary. Health insurance literacy hil is defined as a persons ability to seek, obtain, and understand health insurance plans, and once enrolled use their insurance to seek appropriate health care services. Age was associated with low health literacy on the stofhla and brief, but not on the realm. Jan 22, 2014 health literacy involves the ability to obtain, process, and understand the health information necessary to make appropriate decisions, and its clearly essential to selecting health insurance. Air worked with experts across the nation to create and validate a health insurance literacy measure hilm to gauge peoples ability to find and evaluate information about health plans, select the best plan.
Although parents require health literacy skills to complete many caretaking tasks successfully for their families, 1 the low health literacy of parents in the united states was established based on the health literacy section of the 2003 national assessment of adult literacy naal. We have a federal mandate, and an international call to action. While health literacy has been widely studied and measured, health insurance literacy has not. Healthy people 2020 and the national action plan to improve health literacy. A call to action, contains the findings from an all day roundtable meeting featuring experts from health plans, academics and advocates currently working in the fields of health literacy or financial literacy. Movin g towards a health promotion perspective article pdf available in international journal of public health 534 august 2008 with 325 reads how we measure reads. If you end up needing care, the plan will pay a portion of it. Changes in economic conditions and healthcare delivery models have shifted more healthcare costs to patients, resulting in greater patient financial responsibilities. The pharmacy intervention for limited literacy study. Processes involve motion, and that inherently means change. Elizabeth lukanen, state health access data assistance center.
The health literacy guide to picking health insurance the. Health insurance policies vary in their purchase price and in the percentage theyll pay of the costs of services you use throughout the year. A call to action and report from the health insurance literacy expert roundtable. Americas health insurance plans response to health literacy. Rti international is developing and testing a new measure of health literacy. Measuring health perceptions in the health insurance experiment rand report davies, allyson ross on. Consumers have serious difficulties understanding and using health insurance. Patak l, wilsonstronks a, costello j, kleinpell r, henneman e, happ m. Allen said earlier in her presentation, if there are no data, there is no problem. Health insurance literacy survey reports health disparities. A call to action enroll america a report from enroll america detailing the connection between health insurance literacy and coverage retention may 2015 a framework on health insurance literacy for the outreach and enrollment community. Health insurance literacy measurement project center for. New consumers union report launches project to measure.
The june 20 survey of 828 people aged 2264 who were. Measuring health system responses to health literacy. A report from the health insurance literacy expert roundtable. Measuring health insurance literacy american institutes for. Health insurance literacy, the focus of our research, is defined as the degree. Evaluating and measuring health literacy follow up. Powerpoint presentation at the institute of medicine workshop on measures of health literacy.
Understanding the basics of health insurance is a key health literacy skill that gets more complicated every year. Most are focused on to reading and the ability assess health related materials. May 30, 2012 possible consensus statements and responses strongly strongly disagree disagree agree agreenew measures of health literacy need to be 1% 8% 38% 53%developed. A call to action iii for by the affordable care act. Development of the health insurance literacy measure hilm. Oct 17, 2019 research and evaluation are critical to identify health literacy needs, plan interventions and measure success. Results show statistically significant evidence of increased health insurance literacy, confidence, and capacity to make a smart choice health insurance choice. With the focus on delivering better health outcomes at lower costs, factors that influence patient behavior. Health insurance literacy measures the degree to which individuals have the knowledge, ability, and confidence to find and evaluate information about health plans, select the best plan for their own or their familys financial and health circumstances, and use the plan once enrolled measuring health insurance literacy. Different surveys measure peoples literacy, numeracy, and health literacy skills and their experiences with healthcare. Following the implementation of the affordable care act, many residents in west. In this respect, a distinction between factual and procedural knowledge is fruitful to allow a valid assessment of both subdimensions. Health insurance literacy among international college students.
There is a dearth of usable information on the precise barriers facing consumers. Putting health literacy on the agenda builds demand for measurement and action. Health insurance literacy measures the degree to which individuals have the knowledge, ability, and confidence to find and evaluate information about health plans, select the best plan for their financial and health circumstances, and use the plan once enrolled. Health insurance literacy in connecticut volume 1 april 2017 health disparities institute health insurance literacy survey report a summary of the results of the first study to measure health insurance literacy among onnecticut residents enrolled in private health insurance plans under the affordable are act. Following the implementation of the affordable care act, many residents in west louisville, kentucky, a predominantly african american community, gained health insurance coverage for the first time. Conclusion low health insurance literacy is the main cause why informants decide not to be participants in bpjs health insurance. On november 14, 2011, a 1day roundtable was held at the. Search the worlds most comprehensive index of fulltext books. The plan also calls for a response from all sectors involved in health. The only way we will know if the changes and interventions we implement are having the intended effect is. Pdf development of the health insurance literacy measure hilm.
Key considerations for enrollment stakeholders sophie stern, deputy director, best practices institute, enroll america lynn quincy, associate director, health policy, consumers union ricky gonzales, deputy director, analytics, enroll america 2. Although understanding health insurance is central to affording and accessing health care in the united states, studies of consumers and health insurance have lacked a clear definition of health insurance literacy or a conceptual framework. Addressing health insurance literacy gaps in an urban. According one definition, developed by a group led by the consumers union, and published in their report measuring health insurance literacy.
Health insurance literacy as a determinant of population health. References measures of health literacy ncbi bookshelf. Most are focused on to reading and the ability assess health related materials, and evaluate word recognition and reading comprehension. Measurement of health literacy needs to be 0% 2% 38% 60%relevant to actual experiences. In response, consumers union, along with our core partners, assembled a diverse group of stakeholder experts to discuss a key proposition and explore related questions. Major steps forward have been achieved in particular in the development, testing and application of health literacy screening instruments. As a result, it is important to understand the potential impact of financial literacy on patients healthcare behavior. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy.
Because of this timing, the ambitious goal of the project team is to complete the formulation and testing of the measure by the end of 2012. Health insurance literacy university health center. Refining and standardizing health literacy assessment. Health insurance uses the contributions of all members of the plan to cover a share of the cost of medical care for everyone under the plan. Low levels of selfreported literacy and numeracy create. The release of the national action plan to improve health literacy nap is a. Research has called for helping consumers make better health insurance decisions. In addition to the general complexity of the current health care system, the institute of medicine report on health literacy iom, 2004 identified several emerging themes or issues that are important aspects of the health system context with respect to health. Measuring health insurance literacy while most americans believe they have the knowledge and skills to choose and use health insurance, many do not, according to the nationally representative air health insurance literacy survey3 see data source. New measures of health literacy need to be 0% 5% 44% 51%based on sound theory. Health insurance literacy and health service utilization. We need leadership and resources to build the science around the public health model of health literacy as a personal and community asset to be developed.
The action plan charges health professionals with communicating in clear and simple ways to the patient. Research and evaluation are essential pieces of the health literacy improvement process and effective public health practice. Significant disparities exist in consumer health insurance. The objective of this r01 project funded by the national institutes of health nih is to create a publicly available health literacy instrument that can be used for populationbased surveillance and for measuring an individuals health literacy in intervention. Measuring health literacy health literacy measurement tools have generally focused on individual capacity rather than the skills that promote improved selfcare and health outcomes.
A call to action innovations in health literacy research ncbi. Pdf understanding health insurance is central to affording and accessing health care. This book is designed to cover what health insurance is, how to use it well, and what are the things you should be looking at when you compare coverages. Consumer education to increase health insurance literacy. In 2010, the federal government announced the plain writing act, 23. Such a measure can be used by extension as a pre and posttest for impact assessment of health insurance education and by researchers to monitor change over time which could affect public policy. Is health insurance literacy associated with financial. Bonnie braun, phd university of maryland extension. A qualitative study was conducted to assess residents health insurance and health. The study, the pharmacy intervention for limited literacy the pill study, tested a threepronged approach.
This article reports on the development of the health insurance literacy measure hilm, a selfassessment measure of consumers ability to select and use private health insurance. Considerations for a new definition of health literacy. Using a questionnaire to identify someones health literacy level may help. Development of the health insurance literacy measure hilm ncbi. Commonly used questions for measuring health literacy. Pdf development of the health insurance literacy measure. A health literate health care organization is described as easier for people to use, and critical to delivering patientcentered care ten attributes of health literate health care organizations.
Several largescale surveys provide estimates of peoples literacy, numeracy, and health literacy skills. Lnow in its third edition, this book provides a critical overview of the field of health measurement, with a technical introduction and discussion of the history and future directions for the field. Oct 02, 2014 air worked with experts across the nation to create and validate a health insurance literacy measure hilm to gauge peoples ability to find and evaluate information about health plans, select the best plan given individual financial and health circumstances, and use the plan once enrolled. The health literacy tool shed glossary includes vocabulary and terminology used to talk about features and aspects of the health literacy tool shed. Evaluating and measuring health literacy follow up health.
So its necessary to educate people about the bpjs health insurance both from the government, bpjs organization, and especially health providers in health facilities. Modes of administration in validation study how the validation study was administered e. This article, by andrew pleasant and julie mckinney describes the process and results of last years discussion on evaluating and measuring health literacy. Health insurance literacy survey reports people with private health insurance must have sufficient literacy skills to understand when, where, and how to access health services and avoid costly errors caused by using plan benefits incorrectly. Discussion centers on the impact the program had on specific groups, next steps to reach a larger audience, and implications for educators, consumers, and policymakers nationwide.
Growing evidence indicates that many adults have limited knowledge, ability, and confidence to obtain, evaluate, and use health insurance information health insurance literacy, which may prevent optimal use of health plan benefits and lead to unnecessary medical. Measuring health perceptions in the health insurance experiment rand report. Why should health plans care about health literacy. Measuring health perceptions in the health insurance.
Health insurance and health systems literacy needs are evolving with changes to the u. By now, there is limited evidence on how the development of tools measuring hl proceeded in recent years and if scholars considered existing methodological guidance when developing an instrument. Leading public health scholars have argued that health literacy is behavior change and health literacy improvement can be measured by changes in a persons or a communitys actions, practices and behaviors 3 indicating increasing autonomy and capacity to produce the identified consequences of improved health literacy. This report presents results from a 2016 survey measuring the hil of 516 adult connecticut residents enrolled in a qualified health plan qhp through access health ct. Newly insured americans dont understand basic healthcare.
Health literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Nov 24, 2014 health literacy hl is seen as an increasingly relevant issue for global public health and requires a reliable and comprehensive operationalization. The survey shows that some qhp enrollees struggle to understand basic health insurance terminology and how to. Rising costs of cancer care result in financial hardship for cancer survivors, even among those with health insurance. Understanding health insurance is central to affording and accessing health care in the united states. Health literacy as a discrete form of literacy is becoming increasingly important for social, economic and health development. Therefore, recognising people with low health literacy is difficult. In terms of measurement, there needs to be expansion beyond literacybased. Measuring health insurance literacy american institutes. The positive and multiplier effects of education and general literacy on population health, particularly womens health, are well known and researched.
Health insurance literacy hil is defined as a persons ability to seek, obtain, and understand health insurance plans, and once enrolled use their insurance to seek appropriate health. Conceptualizing and measuring consumer ability to choose and use private health insurance october 2014 journal of health communication. You can use these studies for ideas about research and evaluation questions or as benchmarks for your own results. A 1day roundtable was held on november 14, 2011, at the kaiser family foundation in washington, dc. While millions of americans have newly gained health insurance coverage under the affordable care act aca, there is evidence that coverage alone does not necessarily translate into access to health care. Minority status was associated with low health literacy on the realm and stofhla, but not the brief. The act calls for major reforms to begin on january 1, 2014, with open enrollment beginning in october 20. These health insurance difficulties take a toll on consumers health and financial wellbeing, and they have cost implications for health plans and the nation. Education was associated with low health literacy on the realm and brief, but not the stofhla.
With the passage of the patient protection and affordable care act aca of 2010, the health insurance literacy of americans became a critical issue. Literacy, health literacy, measures, emergency, nursing 1 introduction health literacy, or how health consumers understand and act upon health information, has become a priority in the delivery of health care, as consumers with limited health literacy skills experience poorer health outcomes 1 and are often high users of health services 2, 3. Understanding how your health insurance works is your responsibility. Powerpoint presentation at the institute of medicine workshop on measures of health. Mengapa pengusaha online belum memiliki asuransi bpjs. Health insurance literacy uva student health university of virginia.
Because the highest and best use of health literacy is to prevent health risk from escalating to medical need. Health literacy and health insurance literacy affect healthcare utilization. The table below lists a selection of commonly used questions and test formats instruments to. New consumers union report launches project to measure health. Health literacy measures must be implemented if there is to be balance and health literacy in the system. It explains how the online discussion worked as a consensusgauging process in order to determine the needs of the field for a new measurement tool. Understanding consumers ability to choose and use insurance kathryn paez, juli goldstein, and deepa ganachari fulfilling the potential of the patient protection and affordable care act hinges upon consumers understanding of health insurance and their options for coverage. It supports patientprovider communication to improve health care quality, reduce errors, facilitate shared decisionmaking, and improve health outcomes.1431 582 4 1548 120 143 119 227 553 469 270 867 406 413 1195 710 682 655 437 730 1392 1285 124 971 486 1410 3 737 434 1465 544 228 699 76 1095 1166 946 25 1237 891 542 829 1352