Care Transformation Center Blog

Health insurance literacy: A missing element in patient engagement

by Kalyn Saulsberry

Now that open enrollment is in full swing for the health insurance exchanges, millions of Americans will have to decide on health plans for themselves and their families. However, as more decision making falls on individual consumers, concerns about health insurance literacy are increasing. A recent study found that 42% of Americans are unable to define a deductible.

We recently spoke to Bonnie Braun, Extension Consultant, and Lynn Little, Extension Educator, at the University of Maryland Extension (UME), who launched Smart Choice Health Insurance© workshops to teach adults how to select an insurance plan that meets their health needs. Smart Choice workshops are two-hour long interactive sessions that use case studies to model the decision-making process of choosing an insurance plan and using health benefits across the year.

There are three reasons why UME’s Smart Choice Health Insurance© workshops are successful in improving health insurance literacy. To learn more, Health Care Advisory Board members can also join us at our 2014-2015 national meeting to hear one of our most talked-about presentations on hardwiring the patient engagement process.

Smart Choice workshops show and don't tell

Workshop leaders use case studies to model the selection process while teaching and applying key insurance vocabulary.

UME does not endorse specific health plans. The case studies presented are generic and show the students the process of selecting a plan. One case study features a family insurance plan provided by the employer and the second features a family shopping on the exchange.

While walking through the selection process, the workshop leaders are careful not to nudge participants toward a specific plan, but rather empower them to make the decision independently. In 2015 UME will launch a complementary curriculum, Smart Use Health Insurance©, to help consumers be smart about using their insurance plans.

Spread the word by engaging peer educators

The problem of low health insurance literacy is nationwide and at all education and income levels. In the year UME sponsored the Smart Choice workshops, UME partnered with other extension systems in 32 states to offer the workshops. In its first year, 1,010 adults participated in the workshops.

Each session is taught by educators who have completed a two-day extensive training on how to lead the workshop in their own communities. Extension is now working with community partners to prepare others to teach their peers. Increasing the number of workshop leaders in this way expands the program’s geographic reach.

Another patient engagement tactic: Le Bonheur's 24/7 care plan hotline

An untapped resource: Nationwide cooperative extension

Most counties in the U.S. are served by Cooperative Extension, which is part of a nationwide, non-credit educational network associated with land-grant universities. Educators, skilled in adult and youth education and in content such as health and financial literacy, are located in most counties. This network makes extension uniquely positioned to teach classes on subjects like health insurance.

Because extension programs receive funding from county, state, and federal governments, they keep class costs low for students. UME charges between $5 and $25 for participation in the Smart Choice workshops. This price covers printed materials and improves attendance at the workshop. UME found that adults were more likely to attend the class if they had committed even a small financial obligation upfront. Additionally, extension further reduces costs by holding classes in public spaces like libraries without paying location fees.

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