literacy, and multiple indirect provisions where health literacy could be included in broader efforts such as expanding coverage, patient-centered care, or improving quality.
Title V, Subtitle A of the ACA defines health literacy for the purposes of the legislation as “the degree to which an individual has the capacity to obtain, communicate, process, and understand health information and services in order to make appropriate health decisions.”2
In addition, four provisions in the ACA include direct mention of the term “health literacy”:
- Sec. 3501: Health Care Delivery System Research; Quality Improvement Technical Assistance;
- Sec. 3506: Program to Facilitate Shared Decision-making;
- Sec. 3507: Presentation of Prescription Drug Benefit and Risk Information; and
- Sec. 5301: Training in Family Medicine, General Internal Medicine, General Pediatrics, and Physician Assistantship.
Indirect provisions for health literacy fall into six major health and health care domains:
- Coverage expansion: Enrolling, reaching out to, and delivering care to health insurance coverage expansion populations in 2014 and beyond;
- Equity: Assuring equity in health and health care for all communities and populations;
- Workforce: Training providers on cultural competency and diversifying the health care provider workforce;
- Patient information: At appropriate reading levels in print and electronic media;
- Public health and wellness; and
- Quality improvement: Innovation to create more effective and efficient models of care, particularly for individuals with chronic illnesses requiring extensive self-management.
2Patient Protection and Affordable Care Act, Public Law 148, 111th Cong., 2nd sess. (March 23, 2010).