The Abortion pills for sale in Qatar@Doha [+27737758557] []Deira Dubai Kuwait
Aracely Rosales - Helping diverse consumers navigate health insurance exchanges
1. The Affordable Care Act –
Are We Ready?
Aracely Rosales
Chief Content Expert and Multilingual Director
Health Literacy Innovations
Improving Health Communication One Word At a Time™
2. Session Goals:
2
Explore the link between the ACA, plain language,
health literacy, and culture
List potential barriers consumers with limited literacy
face when seeking health insurance coverage
Describe ways to adapt communication strategies to be
culturally appropriate for your audience.
3. The Patient Protection & Affordable Care Act
3
In March 23, 2010, President Obama signed into law the
Patient Protection and Affordable Care Act
4. The Law Improves 4 Key Areas:
4
1. Protects people from insurance abuse
2. Makes health care more affordable
3. Gives better access to care
4. Strengthens Medicare
5. The ACA Goals
5
The goals include:
Expand Medicaid to more qualified low-income people
Expand insurance to 32 million Americans
Create Health Insurance Exchanges
• Consumers offered options/prices allowing
comparison-shopping
6. The ACA Challenges
6
Some of goals include:
Expand Medicaid to more qualified low-income people
Expand insurance to 32 million Americans
• How to successfully bring health care to consumers new to
the health care system?
Create Health Insurance Exchanges
• How to make these effective?
7. The ACA
Opportunity for Health Literacy Strategies!
7
Some of goals include:
Get more low-income people, who qualify, apply for Medicaid
Expand insurance to 32 million Americans
• How to successfully bring new health insures to a
complicated system?
Provides Health Insurance Exchanges
• How will these be effective?
The answer:
Health Literacy Strategies!
Plain Language Techniques!
Cross Cultural Communication Techniques
9. What is health literacy?
9
The ACA definition of health literacy is consistent with Healthy People 2010:
“The degree to which individuals have the capacity to
obtain, process, and understand basic health
information and services needed to make
appropriate health decisions.”
-- Healthy People 2010
10. In Plain English
10
An individual's ability to understand and act on health information.
11. Current Picture of US Health Literacy
11
Today, more than 75 million people have low health literacy.
12. Current Picture of US Health Literacy
12
In fact, according to the NAAL:
13. Future Picture of US Health Literacy
Due to the ACA
13
Today’s 75 million Americans with low health literacy
+
2014 - expansion of health care to 32 million Americans new
to health care through exchanges
-----------------------
= Hundreds of millions of new Americans with low health
literacy who will try to access a complicated health care
system
14. Current Picture of US Health Literacy
14
Individuals
with low levels of health literacy are least
equipped to benefit from the ACA
“Rates oflow literacy are disproportionately high
among lower-income Americans eligible for publicly
financed care through Medicare or Medicaid.” M. Kutner et al.
The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. U.S.
Department of Education, National Center for Education. Washington DC, 2006 .
15. Understand the law’s focus on health literacy
15
The provisions fall into six health and health care topics
in the legislation
1. Coverage expansion
2. Equity
3. Workforce
4. Patient information at appropriate reading levels
5. Public health and wellness
6. Quality improvement:
• innovation to create more effective and efficient models of care
• chronic illnesses requiring extensive self-management
16. Clarifying the Provisions
16
ACA provisions acknowledges the need to:
Communicate health and health care information clearly
Promote prevention
Be patient-centered
Assure equity and cultural competence
Deliver high-quality care
Focus on health literacy (direct & indirect)
17. Health Literacy and its Impact on Coverage Expansion
17
More affordable coverage is available through the new Exchanges by 2014.
Now consumers can -
Look for and compare private health plans.
Get answers to questions about your health coverage options.
Find out if they are eligible for health programs or tax credits that make coverage
more affordable.
Enroll in a health plan that meets their needs.
Individuals can enroll in private or public health insurance coverage
Small employers will have better choice of plans and insurers at a lower cost
More than 32 million Americans new to health care enter the system:
States have the option to cover more people on Medicaid and expand coverage to lower income
qualified people.
More individuals with pre-existing conditions will have coverage options
Young adults can to stay on their parent’s plan until they turn 26 years old
20. Direct Mention of Health Literacy
20
Provisions touch on issues of:
• Research dissemination
• Shared decision-making
• Medication labeling
• Workforce development
All four suggest the need to communicate effectively with consumers, patients,
and communities to improve the access and quality of health care.
None of these provisions create explicit health literacy programs, specify
implementation or regulatory supports, or expand further on the term “health
literacy” beyond its mention.
However, all provisions are consistent with the themes of patient-
centeredness and overall quality improvement that are found more broadly
throughout the legislation.
22. The Challenge
22
New inexperienced health care consumers will have greater
difficulty with:
Understanding eligibility guidelines for various insurance programs
Participating in the buy-in process of the exchange or high-risk pools
Providing supplemental identification and citizenship documentation needed
for enrollment
Understanding which services are covered
Recognizing cost-sharing and premium responsibilities
Choosing a health care provider
23. Implementing ACA
23
None of these reforms will fully succeed without:
Improving efforts to make all information understandable-
plain language
Targeted efforts to enroll under-resourced diverse populations
24. The Health Literacy Solutions for Success
Already Required by ACA
24
Consumer Education and Assistance
ACA provision calls for:
Development and utilization of uniform explanations of
coverage documents
• A mandate that could be strengthened with explicit
linkages to:
Health literacy principles
Plain language use and techniques
25. The Health Literacy Solutions for Success
Already Required by ACA
25
Clear and Consistent Information to Consumers About Their
Health Insurance Coverage
When? Deadline: September 23, 2012
Why? For Information when coverage – is renewed, changes,
information on demand, when shopping for coverage
How? Use the short, easy-to-understand Summary of Benefits and
Coverage (SBC)
A list of definitions (called the “Uniform Glossary”)
explaining terms such as “deductible” and “co-payment”
26. The Health Literacy Solutions for Success
Already Required by ACA
26
EXAMPLE
To design easy-to-understand forms:
Explainall policies using the same plain-English terms
– defined in the glossary
Giving examples of specific coverage
27. The Health Literacy Solutions for Success
Already Required by ACA
27
Use of Information Technology and Reducing Burden on Employers and
Insurers:
Establishment of internet portal to help individuals and businesses:
Interact with the insurance exchange
Understand eligibility guidelines for Medicaid/CHIP/Medicare/high-risk pools
The final rule ensures that in the vast majority of cases, the SBC can be
provided:
• Electronically
• Post it on its website
• Provide it by email
• Electronic disclosure is expected to reduce costs
• Consumer safeguards are designed to ensure actual receipt by individuals
http://cciio.cms.gov/resources/other/index.html#sbcug
28. Diversity Challenges
28
Starting in 2014, Medicaid could be serving 80 million
Americans — or a quarter of the U.S. population — each year
after 2014.
This “expansion population” will likely:
• Be racially and ethnically diverse
• Be predominantly childless adults
• Have high levels of substance abuse and prior jail involvement
• Require care management for complex physical and behavioral health
needs.
Addressing health literacy, language and culture could be a
significant issue for this population
29. Diversity Cultural Competence Solutions for Success
Already Required by ACA
29
Diversity and cultural competency. The Affordable Care Act expands
initiatives to increase racial and ethnic diversity in the health care
professions. It also strengthens cultural competency training for all health
care providers. Health plans will be required to use language services and
community outreach in underserved communities. Improving
communications between providers and patients will help address health
disparities particularly in Hispanic communities, which currently have
high numbers of uninsured people.
To have information presented by the national and regional exchanges be:
• Culturally appropriate
• Linguistically appropriate
Translation of all materials
Interpretation services as needed
30. Diversity Cultural Competence Solutions for Success
Already Required by ACA
30
Requirements to make insurance and enrollment
information consumer friendly for:
Readable web and print materials
Media such as phone, television, radio, social media, and in-person outreach
Use of community-based organizations
Culturally specific media campaigns
“Promotores,” lay health workers
Individual insurance brokers
31. Other Strategies for Successful
ACA Implementation
31
Simplifying Medicaid enrollment information is not a new- Health Literacy
Innovation’s -National Survey of Medicaid Health Literacy Standards:
90% -some type of health literacy standard.
67% -at least a sixth-grade reading level
22% -reading level to be even lower
96% -simple enrollment forms
82% -states offer one-on-one enrollment assistance
72 % provide onsite assistance, counseling and/or a toll-free helpline
Many racial and ethnic eligible for Medicaid or CHIP are not enrolled:
• 80% eligible uninsured African-American
• 70 % of eligible uninsured Latino children
32. Other Strategies for Successful
ACA Implementation
32
The Centers for Medicare and Medicaid Services (CMS) has:
Released readability guidelines for Medicaid print materials
to states
Mandated certain contract requirements around
communication standards for Medicaid managed care plans.
However, these guidelines lack:
Strong enforcement
Uniform oversight from any particular federal or state agency
33. Other Strategies for Successful
ACA Implementation for Diverse Audiences
33
ACA provisions, that could be helpful to make a case:
1. Eliminate and remove a common administrative burden and
impediment to participation
2. Use a new, uniform method for determining income eligibility
3. Streamline citizenship documentation requirements
4. Set up an electronic enrollment processes
38. Other Strategies for Successful
ACA Implementation for Diverse Audiences
38
The ACA offers consumer protection which allows them to:
Choose a health plan that best suits their needs, provided is in
their preferred language
Appeal a plan’s denial of coverage for needed services,
provided they get help to understand and act on it.
Select an available primary care provider of their choosing,
provided they understand the guidelines, and have access to
that information in their preferred language.
40. Implement Universal vs. Target Approach
40
Make the business case for:
• Health literacy, plain language, cultural competence, language access
Educate:
• The public and health professional:
Mandate requirements
Target ACA exchanges to ensure they use clear health communication
techniques
Address vulnerable populations such as:
• People with special needs,
• Diverse minorities (hard to reach).
• Use appropriate channels of communication
41. Improve Health ACA exchanges information
41
Make sure information is:
Clear and actionable
In the language of the target client
but-also easy to read or in plain
language
Support informed consumer decision
making
42. Improve Health Professional Skills
42
Improve Health Professional Skills to improve provider/client
communication:
Require professional trainings
Develop targeted training curriculums
Provide tools and Resources to produce and simplify
information
Use the right technology and tools to help save time and
resources
43. Promote health care systems innovations
43
Implementation of policies and best practices:
• Cultural competence standards and models
• Language access practices
• Health literate systems
44. Use Available Resources
44
The Patient Protection The Patient Protection The Patient Protection
Affordable Care Act The Patient Protection
Affordable Care Act Affordable Care Act
Resources Affordable Care Act
Resources Resources
Resources
45. Summary
45
ACA creates opportunities for health literacy in all of the key domains of
health and health care:
1.The Coverage Expansion -32 millions Americans
Low income Americans need to understand their options and
navigate the enrollment process.
2.Equity:
Paying attention to cultural differences, language, and, literacy.
3.Workforce:
There are provisions in ACA related to disparities, cultural
competency, patient-centeredness and health literacy
46. Summary
46
4. Health Care Information:
Patient information must be at appropriate reading
5. Public Health and Wellness:
The preparation of consumer must be done with low literacy in
mind
6. Quality Improvement:
Develop, test and spread best practices to improve quality and
reduce costs
This presents many new opportunities for making the case for
investments in health literacy, language and culture
47. References
47
AHRQ Report—Literacy and Health Outcomes (2004)
www.ahrq.gov/clinic/epcsums/litsum.htm
AMA Foundation Health Literacy
www.ama-assn.org/ama/pub/about-ama/our-people/affiliated-groups/ama-foundation/our-
programs/public-health/health-literacy-program.shtml
Fox, S. & Fallows, D. (2003) Internet Health Resources. Washington, DC: Pew Internet &
American Life Project www.pewinternet.org/Reports/2003/Internet-Health-Resources.aspx
Healthy People 2010, Health Communication, Objective 11-2
www.healthypeople.gov/Document/HTML/Volume1/11HealthCom.htm
Health Literacy Innovations Resources
http://www.healthliteracyinnovations.com/resources/
48. References
48
NLM Bibliography—Understanding Health Literacy and Its Barriers (2004)
www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html
The Health Literacy of America’s Adults: Results from the 2003 National Assessment of
Adult Literacy (2007) http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483
The Joint Commission Report: “What did the Doctor Say?:” Improving Health Literacy To
Protect Patient Safety (2007) www.jointcommission.org/PublicPolicy/health_literacy.htm
Medical Library Association “Top 10” Most Useful Consumer Health Websites
www.mlanet.org/resources/medspeak/topten.html
IOM Report (2004) – Health Literacy: A Prescription To End Confusion
www.iom.edu/report.asp?id=19723
IOM Report—Health Literacy: A Prescription To End Confusion (2004)
www.iom.edu/CMS/3775/3827/19723.aspx
Health Literacy Implications of the Affordable Care Act Commissioned by: The Institute of
Medicine, Authored by: Stephen A. Somers, PhD, Roopa Mahadevan, MA