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Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
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Facilitating State Health Exchange
Communication Through the Use of

HEALTH LITERATE PRACTICES

Workshop Summary

Maria Hewitt, Rapporteur

Roundtable on Health Literacy

Board on Population Health and Public Health Practice

INSTITUTE OF MEDICINE

OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
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THE NATIONAL ACADEMIES PRESS   500 Fifth Street, N.W.   Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This study was supported by contracts between the National Academy of Sciences and the Agency for Healthcare Research and Quality (HHSP233200900537P), Aetna, the American College of Physicians Foundation, the Association of Health Insurance Plans, GlaxoSmithKline, the Health Resources and Services Administration (HHSH25034004T), Johnson & Johnson, Kaiser Permanente, Merck and Co., Inc., and the Missouri Foundation for Health (09-0290-HL-09). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

International Standard Book Number-13:  978-0-309-22029-3

International Standard Book Number-10:  0-309-22029-7

Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu.

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Copyright 2012 by the National Academy of Sciences. All rights reserved.

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The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested citation: IOM (Institute of Medicine). 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
×

“Knowing is not enough; we must apply.
Willing is not enough; we must do.”

                                                 —Goethe

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Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
×

PLANNING COMMITTEE ON FACILITATING STATE
HEALTH EXCHANGE COMMUNICATION THROUGH
THE USE OF HEALTH LITERATE PRACTICES
1

FRANK FUNDERBURK, Director, Division of Research, Center for Medicare and Medicaid Services, Department of Health and Human Services, Baltimore, MD

JILL GRIFFITHS, Vice President, Communications, Aetna, Hartford, CT

MARCIA J. NIELSEN, Associate Professor; Department of Health Policy and Management, Associate Dean for Health Policy, Kansas University Medical Center, Kansas City

WINSTON WONG, Medical Director and Director, Community Benefit, Disparities Improvement, and Quality Initiatives, Kaiser Permanente, Oakland, CA

______________

1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
×

ROUNDTABLE ON HEALTH LITERACY1

GEORGE ISHAM (Chair), Medical Director and Chief Health Officer, HealthPartners

SHARON E. BARRETT, Health Literacy Staff Consultant, Association of Clinicians for the Underserved

CINDY BRACH, Senior Health Policy Researcher, Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality

CAROLYN COCOTAS, Senior Vice President, Quality and Corporate Compliance, F.E.G.S. Health and Human Services System

ARTHUR CULBERT, President and CEO, Health Literacy Missouri

MICHAEL L. DAVIS, Senior Vice President, Human Resources, General Mills, Inc.

BENARD P. DREYER, Professor of Pediatrics, New York University School of Medicine, and Chair, American Academy of Pediatrics Health Literacy Program Advisory Committee

LEONARD EPSTEIN, Senior Advisor, Clinical Quality and Culture, Health Resources and Services Administration

DEBBIE FRITZ, Director, Policy and Standards, Health Management Innovations Division, GlaxoSmithKline

MARTHA GRAGG, Vice President of Program, Missouri Foundation for Health

JILL GRIFFITHS, Vice President, Communications, Aetna

LINDA HARRIS, Team Leader, Health Communication and eHealth Team, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services

BETSY L. HUMPHREYS, Deputy Director, National Library of Medicine, National Institutes of Health

JEAN KRAUSE, Executive Vice President and CEO, American College of Physicians Foundation

MARGARET LOVELAND, Global Medical Affairs, Merck & Co., Inc.

PATRICK McGARRY, Assistant Division Director, Scientific Activities Division, American Academy of Family Physicians

RUTH PARKER, Professor of Medicine, Emory University School of Medicine

YOLANDA PARTIDA, Director, National Program Office, Hablamos Juntos, University of California, San Francisco, Fresno Center for Medical Education & Research

______________

1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
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CLARENCE PEARSON, Consultant, Global Health Leadership and Management

SUSAN PISANO, Director of Communications, America’s Health Insurance Plans

ANDREW PLEASANT, Health Literacy and Research Director, Canyon Ranch Institute

SCOTT C. RATZAN, Vice President, Global Health, Johnson & Johnson

WILL ROSS, Associate Dean for Diversity, Associate Professor of Medicine, Washington University School of Medicine

PAUL M. SCHYVE, Senior Vice President, The Joint Commission

PATRICK WAYTE, Vice President, Marketing and Health Education, American Heart Association

WINSTON F. WONG, Medical Director, Community Benefit, Disparities Improvement and Quality Initiatives, Kaiser Permanente, Oakland, CA

Study Staff

LYLA M. HERNANDEZ, Staff Director

ANDREW LEMERISE, Research Associate

ANGELA MARTIN, Senior Project Assistant

ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice

Page viii Cite
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Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
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Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:

David Coultas, The University of Texas Health Science Center at Tyler

Elizabeth Hahn, Center on Outcomes, Research and Education (CORE)

Alice Horowitz, University of Maryland

Aileen Kantor, Health Literacy Innovations

Kathleen Mazor, University of Massachusetts Medical School

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by Hugh H. Tilson, University of North Carolina. Appointed by

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
×

the Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the rapporteur and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
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Acknowledgments

The sponsors of the Institute of Medicine Roundtable on Health Literacy made it possible to plan and conduct the workshop Facilitating State Health Exchange Communication Through the Use of Health Literate Practices. Sponsors from the U.S. Department of Health and Human Services are the Agency for Healthcare Research and Quality and the Health Resources and Services Administration. Nonfederal sponsorship was provided by Aetna; the American College of Physicians Foundation; the Association of Health Insurance Plans; GlaxoSmithKline; Johnson & Johnson; Kaiser Permanente; Merck and Co., Inc.; and the Missouri Foundation for Health.

The roundtable wishes to express its gratitude to the following speakers for their thoughtful and stimulating presentations: Sabrina Corlette, Frank Funderburk, Marilyn Maultsby, Yolanda Partida, Susan Pisano, Lynn Quincy, Rima Rudd, and Alice Weiss. The roundtable also wishes to thank the planning committee members for their work in developing an excellent workshop agenda. Members of the planning committee were Frank Funderburk, Jill Griffiths, Marcia Nielsen, and Winston Wong.

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/13255.
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Implementation of the Affordable Care Act (ACA) of 2010 will result in significant changes to the U.S. health care system. Among its many provisions, the ACA will extend access to health care coverage to millions of Americans who have been previously uninsured. Many of the newly eligible health insurance consumers will be individuals of low health literacy, some speakers of English and others more comfortable using languages other than English. Health insurance terms such as "deductible," "co-insurance," and "out-of-pocket limit" are difficult to communicate even to those with moderate-to-high levels of health literacy and so health exchanges will face challenges as they attempt to communicate to the broader community. In addition to having to convey some of these basic, and yet complex, principles of insurance, state exchanges will be attempting to adapt to the many changes to enrollment and eligibility brought about by ACA.

The Institute of Medicine (IOM) convened the Roundtable on Health Literacy that brings together leaders from the federal government, foundations, health plans, associations, and private companies to discuss challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors. The roundtable sponsored a workshop in Washington, DC, on July 19, 2011, that focused on ways in which health literacy can facilitate state health insurance exchange communication with potential enrollees. The roundtable's workshop focused on four topics: (1) lessons learned from existing state insurance exchanges; (2) the impact of state insurance exchanges on consumers; (3) the relevance of health literacy to health insurance exchanges; and (4) current best practices in developing materials and communicating with consumers.

Facilitating State Health Exchange Communication Through the Use of Health Literate Practices summarizes the presentations and discussion that occurred during the workshop. The report provides an overview of health insurance exchanges, presents evidence on the extent to which consumers understand underlying health insurance concepts, and describes the relevancy of health literacy to health insurance reform and how health literacy interventions can facilitate the implementation of health insurance reforms. The report also provides a review of best practices in developing materials and communicating with consumers, and concludes with reflections on the workshop presentations and discussions by members of the roundtable and its chair. Further information is provided in the appendixes, the workshop agenda (Appendix A), workshop speaker biosketches (Appendix B), and testimony provided by the organization America's Health Insurance Plans (AHIP) (Appendix C).

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