Health Literacy: Reducing Costs and Increasing Healthcare Access
‘Heath Literacy’ is a term we see used often in the healthcare world. Although it’s a somewhat vague term, it can be an overlooked part of a healthcare provider’s strategy to help reduce costs. As we wrap up Health Literacy this month, we wanted to share tips that hospitals and providers can use as they communicate with patients.
According to health.gov, Health Literacy is the ability to obtain, process and understand health information needed to make informed healthcare decisions. It encompasses many aspects in the healthcare world including:
- Numeracy skills: calculating cholesterol, reading nutrition labels, measuring medications
- Health knowledge: having information about diseases and causes, knowing the body’s functions, understanding the cause-effect relationships between lifestyle factors and health outcomes
- Product navigation: understanding health insurance
Encouraging health literacy has many benefits. Studies have shown that those with limited health literacy skills tend to skip preventive health services, have an increased chance of preventable hospital visits and admissions, and make greater use of services designed to treat complications of chronic disease and less use of services designed to prevent them. This increased usage is associated with higher healthcare costs – something most healthcare providers have a large stake in trying to reduce.
HealthLiteracy.com is Helen Osborne’s website dedicated to promoting health literacy. She founded Health Literacy Month and is the president of Health Literacy Consulting. The site offers multiple tips to help organizations and individuals improve health literacy in their communities.
In July 2012, the Institute on Medicine released a paper titled ’10 Attributes of Health Literate Healthcare Organizations’, which outlines ways organizations can improve health literacy. Osborne sat down with paper first author Cindy Brach, who works for the Agency for Healthcare Research and Quality under HHS, to discuss the paper for her podcast Health Literacy Out Loud.
“To put it very simply,” said Brach, “a health literate organization is one that makes it easier for people to navigate, understand, and use information and services to take care of their health.” The 10 attributes outlined in the paper can be grouped into two categories: internal organizations and external communications.
Internal Organizations
The first attribute of a health literate organization is that it has leadership that makes health literacy a part of its mission, structure and operations. This attribute is followed closely by integrating health literacy into planning, evaluation, patient safety and quality improvement.
“(Health literacy) shouldn’t be an add-on, or something you do on the side,” Brach said in the podcast. “Everything has to be part of your regular measurement activities and quality-improvement activities, as well as having special projects.”
Besides getting leadership buy-in and integrating health literacy into planning and execution, organizations should prepare their employees to be health literate and monitor progress. This includes all parts of the organization including receptionists, billing clerks, executives, administration, providers and more.
External Communications
The next set of attributes in the paper are geared toward the populations with whom organizations communicate externally. Organizations should include these populations in design, implementation, and evaluation of health information and services. They should meet the needs of populations with a range of health literacy skills without stigma. Orgs should also use health literacy strategies in interpersonal communications, and confirm understanding at all points of contact. They are encouraged to provide easy access to health information and services, and provide navigation assistance as well as design and distribute print, audiovisual, and social media content that is easy to understand. They should address health literacy in high-risk situations like care transitions and communications about medicines. Insurance organizations (and navigators) should also communicate clearly what health plans cover and what individual out-of-pocket costs will be.
When incorporating populations in the design and implementation, organizations should try to be sensitive to the people being served and include them, noted Brach. When dealing with these populations, there will be varying levels of health literacy and diversity within them with different needs. Identify these issues, and don’t stigmatize these populations.
“(Using health literacy strategies in interpersonal communications) is what a lot of people think about when they think about health literacy,” said Brach. “It’s about the interpersonal communication, and it includes some of the more prominent health literacy strategies, like teach-back and encouraging questions, using plain language and avoiding jargon, and all of those kinds of interpersonal communications.”
Navigation is important and paying attention to it helps people get access to information and services easily. This includes electronic information and providing assistance when needed – including teaching patients how to use EMR. It also includes navigating the physical building, and getting access to health insurance. This ties in with creating marketing pieces that are easy to understand and easy to act on.
High-risk situations are especially important in health literacy due to the implications in poor communication. If a medication directive isn’t communicated effectively, it could be dangerous for a patient. Also during care transitions in or out of the hospital directions that are easy to understand are important to increase quality of patient care. This is especially important with recent legislation and reduced reimbursements due to re-admissions.
The last piece is about health insurance and coverage. Health literacy is focused on transparency and making sure consumers understand their financial responsibilities are before agreeing to a treatment plan.
In the future, both Osborne and Brach would like to see more health literacy initiatives from organizations, health systems and statewide initiatives.
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