Measurement of health literacy needs to be 0% 2% 38% 60%relevant to actual experiences. Deakin university, in collaboration with the who regional office for southeast asia, developed health literacy measurement tools which are suitable for use in low and middleincome countries. Why should health plans care about health literacy. Evaluating and measuring health literacy discussion. Development of the health insurance literacy measure hilm ncbi. A survey about the affordable care acts first open enrollment period, op.
The health literacy items divided into two factors, representing understanding of terminology and reading comprehension. This issue brief describes the findings from interviews with health insurance counselors and other stakeholders about problems consumers face in selecting and using health insurance. A report from the health insurance literacy expert roundtable, february 2012. Enroll america and perryundem research, voices from the newly enrolled and still uninsured. There is a dearth of usable information on the precise barriers facing consumers. Therefore, recognising people with low health literacy is difficult. Consumer education to increase health insurance literacy. Health insurance literacy hil is defined as a persons ability to seek, obtain, and. A s s e s s i n g an d a d d re s s i n g h e al t h l i t. A report from the health insurance literacy expert roundtable.
Health insurance literacy university health center. Elsworth e lucy busija a roy batterham e richard h. 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. 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. Conceptualizing and measuring consumer ability to choose and use private health insurance october 2014 journal of health communication. It also lays out a strategy to develop an important new tool. Search the worlds most comprehensive index of fulltext books. Health literacy involves the ability to obtain, process, and understand the health information necessary to make appropriate decisions, and. Measuring health perceptions in the health insurance experiment rand report davies, allyson ross on. A framework on health insurance literacy for the outreach. The health literacy guide to picking health insurance the. Pdf development of the health insurance literacy measure.
On november 14, 2011, a 1day roundtable was held at the. Health literacy international health maastricht university. 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. 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 iii for by the affordable care act. 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. 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. National action plan to improve health literacy and. Insurance health literacy frameworks change4health. Nairobi call to action launched in 2009 by the world health organisation emphasized. However, the overabundance of competing measurement scales can make choosing a. 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. Understanding health insurance is central to affording and accessing health care in the united states. Oct 17, 2019 research and evaluation are critical to identify health literacy needs, plan interventions and measure success.
If you end up needing care, the plan will pay a portion of it. This article, by andrew pleasant and julie mckinney describes the process and results of last years discussion on evaluating and measuring health literacy. Studies of health literacy abilities show that many. A challenge for contemporary health education and communication strategies in the 21st century. Health literacy, at the intersection of health and education, involves more than reading ability. Health literacy is a persons capacity to find, understand, and use basic health information and services needed to make appropriate health decisions. Studies of health literacy abilities show that many americans with the greatest health care needs h. The only way we will know if the changes and interventions we implement are having the intended effect is. Report from the health insurance literacy expert roundtable, february. Nonetheless, health literacy experts tend to agree that text reading level is a critical factor in comprehension and consider a sixth grade reading level to be an adequate goal and a 5th grade or lower reading level to be a superior goal. Modes of administration in validation study how the validation study was administered e. The books have been and are currently being used in the adult continuing. Health literacy hl is seen as an increasingly relevant issue for global public health and requires a reliable and comprehensive operationalization. Friedland, new estimates of the high costs of inadequate health literacy, in pfizer inc.
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. In this respect, a distinction between factual and procedural knowledge is fruitful to allow a valid assessment of both subdimensions. Health insurance literacy survey reports health disparities. Major steps forward have been achieved in particular in the development, testing and application of health literacy screening instruments. In 2010, the federal government announced the plain writing act, 23. Health insurance literacy measurement project center for. The american institute for research air has developed an issue brief that presents a useful health insurance literacy framework that includes four domains. 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. 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. Different surveys measure peoples literacy, numeracy, and health literacy skills and their experiences with healthcare. It is important to remember that even people with good literacy skills find that understanding healthcare information is a challenge. The act calls for major reforms to begin on january 1, 2014, with open enrollment beginning in october 20. A call to action innovations in health literacy research.
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. School for public health and primary care caphri, faculty of health, medicine. Nurses must play a critical role to enhance health literacy article in nursing outlook 661 november 2017 with reads how we measure reads. Health insurance coverage is key to accessing affordable, highquality care. Minority status was associated with low health literacy on the realm and stofhla, but not the brief. Elizabeth lukanen, state health access data assistance center. Cms participated in the development of the action plan for health literacy hhs. It guides the reader in choosing among various methods, showing how to administer and score them. A call to action and report from the health insurance literacy expert roundtable. Haun et al, 2012, correlation among instruments was positive, with strongest association was between the stofhla and the realm categories of health literacy and associated factors e. Using a questionnaire to identify someones health literacy level may help. Measuring health ian mcdowell oxford university press. A s s e s s i n g an d a d d re s s i n g h e al t h l. Research and evaluation are critical to identify health literacy needs, plan interventions and measure success.
Consumers union, university of maryland college park, and american institutes for research. Chapter 4 measuring health literacy in populations. You can use these studies for ideas about research and evaluation questions or as benchmarks for your own results. Health insurance literacy among international college students. Nurses must play a critical role to enhance health literacy. Understanding how your health insurance works is your responsibility. Health insurance literacy measurement project center for patient. While health literacy has been widely studied and measured, health insurance literacy has not. 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. Measuring health insurance literacy american institutes. Section 1103 of the aca calls for cms to establish an insurance web portal.
The survey shows that some qhp enrollees struggle to understand basic health insurance terminology and. Pdf development of the health insurance literacy measure hilm. The resulting clinical trials and health services research studies require instruments to monitor the outcomes of care and the output of the health system. Literacy has been found to be a predictor of health literacy. Measuring health insurance literacy american institutes for. This book new directions in health literacy research, theory, and. The health literacy tool shed glossary includes vocabulary and terminology used to talk about features and aspects of the health literacy tool shed. Understanding the basics of health insurance is a key health literacy skill that gets more complicated every year. Evaluating and measuring health literacy discussion summary. Measuring health perceptions in the health insurance. To examine what is known about measures of health literacy, the roundtable convened a planning committee see appendix a to develop a workshop agenda that would address the following issues. 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. Were familiar with the unqiue challenges faced by large and small organizations, and have extensive experience working with large brands, small nonprofits and everything in between. Consumers have serious difficulties understanding and using health insurance.
Pdf understanding health insurance is central to affording and accessing health care. 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. Health insurance literacy the gateway to healthcare june 6, 2019 denise octavia smith, mba, chw. Measuring health insurance coverage with the current population survey and the american community survey marina vornovitsky, ph. 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. Nov 24, 2014 health literacy hl is seen as an increasingly relevant issue for global public health and requires a reliable and comprehensive operationalization. These measures focus on insurancerelated terminology and scenarios which beneficiaries are likely to encounter when obtaining and paying for their health care and choosing a health plan. Low levels of selfreported literacy and numeracy create. Because of its relevance and importance to patientcentred healthcare and health reform, health literacy is receiving increasing attention from governments, researchers, clinicians and patients.
The release 1 of the national action plan to improve health literacy 2 nap is a collaborative effort that began in 2003, with financial, moral, and intellectual support from several of the department of health and human services hhs agencies. 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. Health insurance policies vary in their purchase price and in the percentage theyll pay of the costs of services you use throughout the year. Because of the shame and embarrassment these patients experience, they often use their welldeveloped coping skills to mask their limited literacy. Knowledge about peoples health literacy is therefore central to nurses aiming at adapting health. According one definition, developed by a group led by the consumers union, and published in their report measuring health insurance literacy. Commonly used questions for measuring health literacy. Health literacy refers to an individuals ability to seek, understand, and use health information to make appropriate decisions regarding their health. Worldwide economic constraints on health care systems have highlighted the importance of evidencebased medicine and evidencebased health policy. Research and evaluation are essential pieces of the health literacy improvement process and effective public health practice. Knowledge of health insurance terms and concepts, types of healthcare services and enrollee rights. 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, the focus of our research, is defined as the degree. While millions of americans have newly gained health insurance coverage under the affordable care act aca, there is evidence that coverage alone does. Newly insured americans dont understand basic healthcare. Significant disparities exist in consumer health insurance literacy. Education was associated with low health literacy on the realm and brief, but not the stofhla. These measures focus on insurance related terminology and scenarios which beneficiaries are likely to encounter when obtaining and paying for their health care and choosing a health plan. Aug 28, 2015 redesigned health insurance questions traditional. Possible consensus statements and responses strongly strongly disagree disagree agree agreenew measures of health literacy need to be 1% 8% 38% 53%developed. 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. Healthy people 2020 and the national action plan to improve health literacy. Most are focused on to reading and the ability assess health related materials, and evaluate word recognition and reading comprehension. The action plan charges health professionals with communicating in clear and simple ways to the patient. These health insurance difficulties take a toll on consumers health and financial wellbeing, and they have cost implications for health plans and the nation.
The table below lists a selection of commonly used questions and test formats instruments to. 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 framework on health insurance literacy for the outreach and. Health literacy is a vital competence in accomplishing this. 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. New measures of health literacy need to be 0% 5% 44% 51%based on sound theory.
Development of the health insurance literacy measure hilm. The institute of medicine roundtable on health literacy serves to educate the public, press, and policy makers regarding issues of health literacy. Most are focused on to reading and the ability assess healthrelated materials. Several largescale surveys provide estimates of peoples literacy, numeracy, and health literacy skills. A measure of an individuals capacity to seek, understand and use health information within the healthcare setting author links open overlay panel joanne e. The ability to communicate effectively with patients who have low health literacy depends on our ability to recognize this problem and to create a patientcentered and shamefree healthcare environment. Seabourne has a reputation for delivering sophisticated data technology projects.
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