Health Insurance and Insights from Health Literacy Helping Consumers Understand: Proceedings of a Workshop (2017) / Chapter Skim
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6 Moderated Panel Discussion to Review Lessons from the Day
6 Moderated Panel Discussion to Review Lessons from the Day
Pages 73-84
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From page 73... ...
In terms of partnerships, she said the opportunities are to get better at engaging partners in identifying and developing 1 This section is based on the presentation by Cara James, director of the Office of Minority Health at CMS; Kim Parson, strategic consultant for Proactive Care Strategies at Humana; Mila Kofman, executive director of the DC Health Benefit Exchange Authority; and Laura Morris, assistant project director in Connecticut's Office of the Healthcare Advocate, and the statements have not been endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 74... ...
For Laura Morris, whose standalone state agency works to educate consumers about their rights and responsibilities under their health insurance plans and offers assistance when they encounter problems, her biggest lesson from the day was the importance of having the in-person assister help not only with enrollment but also with education about how to best use the benefits afforded by their plans. One concern Morris has is about securing the funding needed to ensure these in-person assisters remain available to help consumers.
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From page 75... ...
Mila Kofman noted she was the sole representative of state-based health insurance marketplaces and that the Washington, DC, marketplace was one of only four state marketplaces to open on time. One lesson she and her colleagues learned during the DC marketplace's first year was that its efforts were so focused on the technology piece of the marketplace that little attention was paid to what consumers needed to make the marketplace useful to them.
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From page 76... ...
In its first year, the DC marketplace had multiple working groups, and while there are fewer today, the DC marketplace still has a standing advisory board and committees, all of which have representatives from different stakeholders, including consumer and patient advocates, insurance brokers, health plans, business owners, physicians, and hospitals. "What we do is challenge them with a problem to give us a consensus-based solution," explained Kofman.
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From page 77... ...
As a final comment, she said the DC marketplace has now added standardized plans with standard benefits, co-pays, co-insurance provisions, and deductibles. "The standardized products are the hottest selling products this year," said Kofman.
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From page 78... ...
Peer-to-peer messaging is key, she said, and the same phenomenon appears to be true with how people are using their coverage, particularly with regard to nocost preventive services. Morris added that, as funding is cut for in-person assisters, community-based organizations will become critical partners in reaching consumers, getting them to the marketplaces, and teaching them how to use their benefits.
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From page 79... ...
She then pointed to an organization, the Maricopa Integrated Health System, that has cultural health navigators. These individuals work with and train individuals to conduct home visits to assist members of a largely refugee population.
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From page 80... ...
Parker added that such training could become a competency requirement for getting a degree in public health. DISCUSSION Terry Davis started the discussion by noting that she finds standardized plans appealing because they represent a less-is-more approach, similar to
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From page 81... ...
Kofman noted that the health plans, advocates, and providers worked together to develop a consensus on what the standardized plans should include. She also said that some of the carriers have looked at their own product offerings, concluded there were too many, and are now offering fewer, more popular products.
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From page 82... ...
Jennifer Dillaha with the Arkansas Department of Health referred to a document called "Ten Attributes of Health Literate Health Care Organizations"2 and noted that the 10th attribute says a health-literate health care organization communicates clearly what health plans cover and what individuals will have to pay for services. Thinking about that attribute, Dillaha wondered if there is an opportunity for payers to help clinics communicate with the people they serve, as well as an opportunity to use online portals for the same purpose, particularly with regard to how to use a health plan.
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From page 83... ...
He commented that the Plain Writing Act of 2010 allows each state to specify a reading level for its information that ranges from third grade to eighth grade, but defining those grade levels is complicated and depends on which of several available scales regulators use. His prescription is to simplify plan language, make it more understandable and protective of everyone in an organization, and by doing so, systems might save a great deal of money, which could then go to health literacy programs that would benefit consumers.
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From page 84... ...
The notices still have to be approved by the marketplace's legal department and the state social services department, but she said that with the exception of one or two suggestions made by the advocacy groups, the documents are now readable and down to five pages in length.
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