Health Literacy And Health Insurance Literacy: Do Consumers . - NASMHPD
Health Literacy and Health InsuranceLiteracy: Do Consumers Know WhatThey Are Buying?By Zsofia A. Parragh and Deanna Okrent, with contributions from Bijan Mehryar,Alliance for Health ReformProduced with support from the Robert Wood Johnson FoundationThe second open enrollment period,during which eligible individuals may enroll ina Qualified Health Plan for 2015 in amarketplace, runs from November 15, 2014to February 15, 2015. Some studies showthat many do not understand the very termsand concepts necessary to make informedchoices.9 For many people, it is the first timethat they will have coverage. In addition,insurance is becoming more “consumerdriven,” and often includes higherdeductibles, which shifts financial risk to thepatient. That increases the stakes andrequires an even more sophisticatedunderstanding of health insurance.This toolkit addresses the extent andsignificance of both health literacy and healthinsurance literacy for Americans buying andusing health insurance.Knowing how to find a doctor, fill aprescription, how to use and pay for thatmedication, and understanding the medicalprovider’s explanations are all measures ofhealth literacy.1www.allhealth.orgHealth Literacy Nearly nine out of ten adultshave difficulty using healthinformation to make informeddecisions about their health,according to America’s HealthInsurance Plans.January 6, 2014 Nearly nine out of ten adults have difficultyusing health information to make informeddecisions about their health, according toAmerica’s Health Insurance Plans. 1 Only 12 percent of English-speakingAmerican adults had proficient health literacyskills, according to the Department ofEducation’s National Assessment of HealthLiteracy, which used 2003 data - the latestcomprehensive information on healthliteracy. 2 The cost of low health literacy to the U.S.economy was estimated by one study atbetween 106 billion and 238 billion in2006. This represented between 7 percentand 17 percent of all personal health careexpenditures. 3 Adults ages 25 to 39, those who are whiteand Asian-Pacific, people with higher levelsof education, and those with higherincomes are more health literate thanadults ages 65 and older, most minoritygroups, people with less education andpeople with low incomes.4 About half (51 percent) of Americans donot understand the basic healthinsurance terms premium, deductible andcopay.5 When people need to do math to figureout out-of-pocket costs, the lack ofunderstanding grows. Only 16 percent ofrespondents in a Nov. 2014 KaiserFamily Foundation survey could calculatethe cost of an out-of-network lab test, forexample. 6 79 percent of all Americans know that ahealth insurance premium has to be paidevery month, but only 64 percent ofuninsured adults know that. 7Alliance for Health ReformKey Points
An Alliance for Health Reform ToolkitA landmark Department of Education study identifiedlow levels of health literacy as a problem. Using theInstitute of Medicine (IOM) definition of health literacy– the capacity to obtain, process and understandbasic health information and services needed tomake appropriate health decisions - the authorsconcluded that only 12 percent of adults hadproficient health literacy, 53 percent hadintermediate, 22 percent had basic and 14 percenthad below basic health literacy. The report attributeddifferences in health literacy to such factors aseducation, age, race/ethnicity, sources of informationand health insurance coverage.10The Institute of Medicine (IOM) has conductedseveral roundtable discussions on health literacysince 2006, the latest on November 6, 2014. Thediscussions bring together leaders from academia,industry, government, foundations, associations, andpatient and consumer organizations who are workingto improve health literacy. The most recentroundtable explored various aspects of health literacyin such areas as oral health, medications, and theuse and delivery of health care.15Health Insurance LiteracyHealth insurance literacy focuses more specifically oninsurance coverage, and the ACA brought the subjectto the forefront. A health insurance literacy expertroundtable in 2011 defined health insurance literacyas “the capacity to find and evaluate informationabout health plans, select the best plan givenfinancial and health circumstances, and use the planonce enrolled.”16And, there are economic implications. The cost of lowhealth literacy to the U.S. economy is between 106billion to 238 billion annually, analysts at GeorgeWashington University estimates in 2007. Thisrepresents between 7 percent and 17 percent of allpersonal health care expenditures.11The Department of Education study found that adultswho spoke languages other than English, or spokemultiple languages including English, had belowaverage health literacy, as compared to adults whospoke only English.12Upon passage of the ACA, the Obama administrationcreated the HealthCare.gov website in an effort tohelp consumers compare health coverage options.The ACA also funded navigator and in-personassister programs to help individuals, families andsmall businesses compare and contrast plans,identify what type of financial assistance may beavailable and help complete and send applicationforms for insurance.Only 12 percent of adults hadproficient health literacy, 53 percenthad intermediate, 22 percent had basicand 14 percent had below basic healthliteracy, a landmark Department ofEducation study concluded.Findings from recent surveys vary, but generallyshow some deficit in people’s understanding ofinsurance terms, and larger problems in the ability tocalculate cost sharing. Three-quarters of Americansages 22-64 report that they know how to use healthinsurance, yet only about one-fifth could calculate thecost of a routine doctor visit.17In a Kaiser Family Foundation survey from October2014, most people (79 percent) knew that a healthinsurance premium must be paid each month, and 72percent were able to identify the correct definition of adeductible. However, math was an issue. Only abouthalf of respondents correctly calculated the out-ofpocket cost for a hospital stay involving a deductibleand copay, and only 16 percent were successful indetermining the cost of an out-of-network lab test witha capped allowable charge.18The results showed that individuals’ most importantsource of information on health topics was healthprofessionals in 2003. For each health literacy level,print materials such as newspapers were not asimportant as non-print materials, which includedbroadcast media such as television and radio.13 Morerecently, a post-enrollment national survey showedthat news, websites and online searches are topsources of health information in 2014.142
An Alliance for Health Reform ToolkitAnother report, from 2013, found that 51 percent ofAmericans did not understand such basic healthinsurance terms as premium, deductible and copay.19Thirty-seven percent of marketplace enrollees did notknow their deductible, and 47 percent of thosereceiving subsidies did not know the amount offederal assistance they were getting. 202010 launched the Plain Language Initiative toensure that its documents are understandable.29On October 14, 2014, the Pharmaceutical Researchand Manufacturers of America (PhRMA) launchedthe AccessBetterCoverage.org website, which is aneducational resource to help consumers gaininformation about how health insurance works, whatto expect from health coverage, and how to accessprescription medicines.30Health insurance literacy is low among racial andethnic minority groups, and, in particular, amongminority groups with low incomes, and those who areuninsured, surveys have shown. Hispanic adultshave the lowest health insurance literacy while whiteadults have the highest.21ResourcesHealth Insurance Literacy and the AffordableCare ActAlso, the abundance and complexity of insurancechoices can overwhelm consumers and impact theirunderstanding of plan features. Studies of Medicare’sprescription drug program (Medicare Part D) havefound that enrollment wanes when consumers facetoo many choices. As part of a study published inHealth Affairs in 2011, when consumers had fewerthan 15 choices, enrollment was lower because theyhad trouble finding what they wanted. However,enrollment also dropped off when consumers hadmore than 30 choices. In addition, hyper-variationcan make it difficult for consumers to compare thefeatures of plans.22A Little Knowledge Is a Risky Thing: Wide Gap inWhat People Think They Know About HealthInsurance and What They Actually KnowPaez, Kathryn & Coretta, Mallery. American Institutefor Research (AIR), October 2014.http://goo.gl/uNR1LuThe issue brief summarizes the results of a nationalhealth insurance literacy survey. The survey shows agap in knowledge and perceived knowledge abouthealth insurance.JAMA Forum: Why Health Insurance LiteracyMattersLevitt, Larry. Journal of American MedicalAssociation. November 26, 2014.http://goo.gl/WT0L3sThis article provides an analysis of a recentlyconducted Kaiser Family Foundation survey:“Assessing Americans' Familiarity with HealthInsurance Terms and Concepts.” The survey foundthat consumers understood some insurance conceptsand terms, but had a greater difficulty whencalculations were involved.Public and Private InitiativesThe federal government has several initiatives inplace to improve health and health insurance literacy.In 2010, the federal government announced the PlainWriting Act,23 Healthy People 2020 and the NationalAction Plan to Improve Health Literacy.The action plan charges health professionals withcommunicating in clear and simple ways to thepatient. It concludes that patients cannot adopthealthy behaviors and comply with recommendationsif they do not understand the problem and their partin helping to improve their health status.Consumers’ Misunderstanding of HealthInsuranceLoewenstein, George, et al. Journal of HealthEconomics, June 26, 2013.http://goo.gl/xN57tBThe authors surveyed Americans with privateinsurance to see whether they found co-payinsurance easier to understand and use thantraditional insurance, with deductibles and coinsurance. The authors concluded that consumersbetter understood co-pay only plans, but found onlyweak evidence that these plans would cause peopleto make different choices and lower costs.Before the first ACA open enrollment period, thefederal government launched a marketplace assisterprogram with more than 28,000 full time-equivalentstaff and volunteers helping consumers tounderstand their insurance choices.24Some states also have health and health insuranceliteracy programs, including Minnesota, Kentucky,Pennsylvania and New York.25 26 27 28Moreover, some commercial health insurance planshave initiated programs. For example, WellPoint in3
An Alliance for Health Reform ToolkitDeveloping a Measure of Health InsuranceLiteracy: Understanding Consumers’ Ability toChoose and Use InsurancePaez, Kathryn et al., American Institutes forResearch, February 20, 2013.http://goo.gl/WKXbsrIn this issue brief, the authors describe consumerproblems selecting and using health. According to thebrief, the American Institutes for Research wasdeveloping a measure of health insurance literacy toobjectively assess what consumers with privateinsurance do and do not understand about insurance.This blog post, explaining survey findings, concludesthat half of young adults were aware of provision inthe ACA allowing individuals up to age 26 to remainon their parents’ private health insurance policies.Low Levels of Self-Reported Literacy andNumeracy Create Barriers to Obtaining and UsingHealth Insurance CoverageLong, S. et. al. The Urban Institute, Health PolicyCenter, October 2014.http://goo.gl/POjDGNThe report finds that limited numeracy –mathematical proficiency - is a bigger challenge thanlimited literacy for nonelderly adults.Health Literacy Implications of the AffordableCare ActSomers, Stephen & Mahadevan, Roopa. Center forHealth Care Strategies, Inc., November 2010.http://goo.gl/BFMfq5This study provides an analysis of the ACA andinsights into the opportunities it presents forpromoting health literacy, including in the areas ofcoverage expansion, equity, workforce, patientinformation, public health and wellness and quality.Measuring Health Insurance Literacy: A Call toAction, A Report from the Health InsuranceLiteracy Expert RoundtableConsumers Union, University of Maryland CollegePark, American Institutes for Research,February 2012.http://goo.gl/FywWmLThis event called together a group of experts fromacademia, advocacy, health plans, and privateresearch firms to address the problem of healthinsurance literacy. Attendees began creating ameasure of health insurance literacy, preliminarilydecided what a literate person would be able to do,defined health insurance literacy, discussed apreliminary conceptual model and offeredsuggestions about how a measure would be used.Knowledge Is Power: Focusing on HealthInsurance Literacy May Increase Health CoverageRetentionStern, Sophie. Enroll America, August 22, 2014.http://goo.gl/1D5bQLIn this blog post, the author analyzes a nationallyrepresentative post-enrollment consumer survey fromApril 2014 and concludes that people who enrolledhad greater knowledge about the provisions of theACA, and were more comfortable with the financialcommitment than those who remained uninsured.Newly Insured Americans Don’t UnderstandBasic Healthcare TermsGarcia, Sofia. The Atlantic, January 22, 2014.http://goo.gl/LKsmulThis article, by a psychologist who works with cancerpatients, highlights the effect of low health and healthinsurance literacy on treatment decisions.Large Racial and Ethnic Differences in HealthInsurance Literacy Signal Need for TargetedEducation and OutreachUrban Institute Health Policy Center and the RobertWood Johnson FoundationLong, Sharon and Goin, Dana, February 6, 2014.http://goo.gl/HK8MphThis brief examines the differences in healthinsurance literacy among racial and ethnic groups,and finds that literacy is the highest for white, nonHispanic adults, and lowest for Hispanic adults.Preparedness of Americans for the AffordableCare ActBarcellos, Silvia H. et al., Proceedings of the NationalAcademy of Sciences, April 15, 2014.http://goo.gl/T1DFYkThe authors of this paper conclude that large portionsof the population are not sufficiently informed to makethe best possible choices in marketplace healthplans. They cite a survey concluding that half ofrespondents did not know about marketplaces, and42 percent could not correctly describe a deductible.Low ACA Knowledge and Health Literacy HinderYoung Adult Marketplace EnrollmentLong, Sharon et al., Health Affairs Blog, February 12,2014.http://goo.gl/Vzflnv4
An Alliance for Health Reform ToolkitTaking Stock and Taking Steps: A Report fromthe Field after the First Year of MarketplaceConsumer Assistance under the ACAGrob, Rachel et al., Kaiser Family Foundation,October 1, 2014.http://goo.gl/QTl0WlIn this report, authors analyzed the first year ofmarketplace assister programs, which are intended tohelp consumers understand their coverage options,apply for financial assistance and enroll. The reportcalls for increased education, and emphasizes therole of assisters.Health Literacy at the Food and DrugAdministration: Current Initiatives in Prescriptionand Nonprescription DrugsMichele, Theresa. IOM Health Literacy Workshop,November 6, 2014.http://goo.gl/t9iOBFThe author prepared this presentation for the Instituteof Medicine (IOM) Health Literacy Roundtable, andaddressed health literacy in regards to prescriptionand nonprescription drugs. The author is the directorof the Division of Nonprescription Drug Products,Office of New Drugs at the U.S. Food and DrugAdministration.USC survey reveals low health care literacyWu, Suzanna. University of Southern California, USCNews, March 24, 2014.http://goo.gl/OsqIhqThis article concludes that health insurance literacy isparticularly low among younger and low-incomeAmericans.Health Literacy: Statistics at a GlanceNational Patient Safety Foundation, 2011.http://goo.gl/WD7ShxThis fact sheet addresses the scope and impact oflow health literacy.Oral Health Literacy – Activities to Educate theProfessionRobinson, Lindsey. IOM Health Literacy Workshop,November 6, 2014.http://goo.gl/lrStbxThe author prepared this presentation for the Instituteof Medicine (IOM) Health Literacy Roundtable, andaddressed health literacy concerns when it comes tooral care.Voices from the Newly Enrolled and StillUninsuredPerryUndem Research/Communication, EnrollAmerica, the Robert Wood Johnson Foundation andThe California Endowment, July 2014.http://goo.gl/vGHDVfThis document summarizes a national survey ofnewly-enrolled adults and still-uninsured adults ages18 to 64 to gain insights into the ACA’s first openenrollment period between April 10 through 28, 2014.The survey finds that knowledge and education levelsare barriers to enrollment efforts. According to theresults of the survey, news, websites and onlinesearches are top sources of information.The Health Literacy of America’s Adults: ResultsFrom the 2003 National Assessment of AdultLiteracyKutner, Mark, et al.U.S. Department of Education, September 2006.http://goo.gl/bUufeAAlthough this assessment of health literacy waspublished in 2006, it is frequently cited as a baselineupon which later health literacy study has been built.Health LiteracyHealth LiteracyNational Network of Libraries of Medicinehttp://goo.gl/LP9vQThis federal website provides a summary of basichealth literacy terms. It includes a definition of healthliteracy and addresses cultural considerations, theskills needed for health literacy, the prevalence ofhealth literacy and the economic impact.Federal Health Literacy InitiativesNew Federal Policy Initiatives To Boost HealthLiteracy Can Help The Nation Move Beyond TheCycle Of Costly ‘Crisis Care’Koh, Howard, et al. Health Affairs, January 2012.http://goo.gl/ik1pNBThe authors, all current or former Obamaadministration officials, describe three federal policyinitiatives and state that both public and privateorganizations have an important role to play inaddressing the challenge of limited health literacy.5
An Alliance for Health Reform ToolkitSelected ExpertsFinal Guidance on Implementing the Plain WritingAct of 2010Executive Office of the President, Office ofManagement and Budget, April 13, 2011.http://goo.gl/SK3NTxThis document concerns the Plain Writing Act of2010 that President Obama signed into law in 2010.It requires federal executive agencies to have clearand understandable communication with the public.David Adler, program officerRobert Wood Johnson Foundationdadler@rwjf.org(877) 843-7593Drew Altman, president and chief executive officerKaiser Family Foundationdaltman@kff.org rsingh@kff.org(650) 854-9400Healthy People 2020U.S. Department of Health and Human Services,December 2, 2010.http://goo.gl/SzmJPEThis document provides 10-year goals and objectivesfor health promotion and disease prevention, andincludes health literacy limits national objectives.Cynthia Baur, senior advisor, health literacyOffice of the Associate Director for CommunicationCenters for Disease Control and Preventioncynthia.baur@cdc.hhs.gov(404) 498-6411John Beshears, assistant professor of businessadministrationHarvard Business Schooljbeshears@hbs.edu(617) 496-6543National Action Plan to Improve Health LiteracyU.S. Department of Health and Human Services,Office of Disease Prevention and Health Promotion,2010.http://goo.gl/tB3zjmFormer Health and Human Services SecretaryKathleen Sebelius launched the National Action Planto Improve Health Literacy in 2010. The documentpoints out the plan’s basic elements.Linda Blumberg, senior fellowHealth Policy Center, The Urban Institutelblumberg@urban.org(202) 261-5709Cindy Brach, senior health policy researcherAgency for Healthcare Research and Qualitycindy.brach@ahrq.hhs.gov(301) 427-1444Private Sector Health Insurance LiteracyInitiativesNew resource on health coverage, Highlightshurdles patients may face accessing neededmedicines, October 14, 2014.Pharmaceutical Research and Manufacturers ofAmerica (PhRMA), October 14, 2014http://goo.gl/JuEfpJThis news release announced the PharmaceuticalResearch and Manufacturers of America’s (PhRMA)patient education website:AccessBetterCoverage.org. The website is intendedto educate consumers about health insurancecoverage and access to prescription drugs.James J. Choi, professor of financeYale School of Managementjames.choi@yale.edu(203) 436-1833Joelle Friedman, associate directorUniversity of Pennsylvaniajoellef@mail.med.upenn.edu(215) 746-5873Rachel Grob, director of National IntitiativesThe Center for Patient Partnershipsrachel@patientpartnerships.org(608) 265-6267Health Literacy and America’s Health InsurancePlans: Laying the Foundation and BeyondAmerica's Health Insurance Plans, November, 2013.http://goo.gl/JToBTRIn this publication, the health plan associationreviews the health literacy programs of 30 membercompanies. The programs vary in approach andfocus on clear communication and the need forincreased consumer health literacy.Linda Harris, director of Division of HealthCommunication and eHealthU. S. Department of Health and Human Services,Office of Disease Prevention and Health Promotionlinda.harris@hhs.gov(240) 453-82626
An Alliance for Health Reform ToolkitGenevieve M. Kenney, co-director and a seniorfellowThe Urban Institutejkenney@urban.org(202) 261-5568Roopa Mahadevan, program officerCenter for Health Care Strategiesrmahadevan@chcs.org(609) 528-8400Kathryn Paez, principal researcher, Health andSocial Development ProgramAmerican Institutes for Researchkpaez@air.org(202) 403-5000Howard K. Koh, Professor of the Practice of PublicHealth LeadershipHarvard School of Public Healthhkoh@hsph.harvard.edu(617) 432-1090Terri Ann Parnell, principal and founderHealth Literacy Partners, LLCtparnell@healthliteracypartners.com(516) 528-6485Jonathan Kolstad, assistant professor of health caremanagementThe Wharton School, University of Pennsylvaniajkolstad@wharton.upenn.edu(215) 898-6861Karen Pollitz, senior fellow, health reform andprivate insuranceKaiser Family Foundationkpollitz@kff.org(202) 347-5270Mark Kutner, senior vice president and programdirector, IDER ProgramAmerican Institutes for ResearchMKutner@air.org(202) 403-5000Lynn Quincy, associate director, Health ReformPolicyConsumers Unionlquincy@consumer.org(202) 462-6262David Laibson, Robert I. Goldman Professor ofEconomicsHarvard University, Department of Economicsdlaibson@harvard.edu(617) 496-3402Sophie Stern, deputy director of the Best PracticesInstituteEnroll Americasstern@enrollamerica.org(202) 809-7425Larry Levitt, senior vice president for specialinitiativesKaiser Family Foundationllevitt@kff.org(650) 854-9400Michelle Theresa, director of Division ofNonprescription Drug ProductsU.S. Food and Drug Administration, Office of NewDrugstheresa.michele@fda.hhs.gov(301) 796-1593George Loewenstein, Herbert A. Simon Professor ofEconomics and PsychologyCarnegie Mellon Universitygl20@andrew.cmu.edu(412) 268-8787Sheida White, Assessments Division: NationalAssessment Branch, NCESNational Center for Education StatisticsSheida.White@ed.gov(202) 502-7473Sharon K. Long, senior fellowHealth Policy Center, The Urban Instituteslong@urban.org(202) 261-5217Brigitte Madrian, Aetna Professor of Public Policyand Corporate ManagementHarvard Kennedy SchoolBrigitte Madrian@harvard.edu(617) 495-8917Stephen Zuckerman, co-director and a senior fellowHealth Policy Center, The Urban Instituteszuckerm@ui.urban.org(202) 261-56797
An Alliance for Health Reform ToolkitWebsitesNational Center for Education Statisticshttp://nces.ed.gov/GovernmentAgency for Healthcare Research and Qualityhttp://www.ahrq.govNational Health Information Center http://health.govCenter for Consumer Information and InsuranceOversight http://www.cms.gov/cciio/index.htmlRobert Wood Johnson Foundationhttp://www.rwjf.org/Centers for Disease Control and Preventionhttp://www.cdc.gov/The Urban Institute www.urban.orgDepartment of Health and Human Serviceswww.dhhs.govHealthCare.gov: https://www.healthcare.gov/Healthy People.gov - onal Institutes of Health http://www.nih.govSenate Health, Education, Labor and PensionsCommittee http://www.help.senate.gov/The Plain Language Action and Information Network(PLAIN) http://www.plainlanguage.gov/OtherAHIP Coverage http://www.ahipcoverage.com/American Enterprise Institute http://www.aei.org/American Institutes for Research http://www.air.org/America’s Health Insurance Planshttp://www.ahip.org/Center for Patient and Consumer Engagementhttp://aircpce.org/Consumers Union http://consumersunion.org/Enroll America http://www.enrollamerica.orgThe George Washington University, Milken InstituteSchool of Public Health http://publichealth.gwu.edu/Institute of Medicine http://www.iom.edu/Kaiser Family Foundation www.kff.orgNational Association of Insurance Commissionershttp://www.naic.org/8
An Alliance for Health Reform ToolkitEndnotes12Kutner. M. et. al. “The Health Literacy of America’s AdultsResults From the 2003 National Assessment of AdultLiteracy.” U.S. Department of Education. Washington, DC:National Center for Education Statistics & AmericanInstitutes for Research. September 2006.http://goo.gl/bUufeA34Vernon, J. et. al. “Low Health Literacy: Implications forNational Health Policy.” The George Washington University,10/04/2007. http://goo.gl/JbUQqv8Health Literacy: Past, Present and Future. Institute ofMedicine, November 6, 2014. http://goo.gl/MV7zXM16Measuring Health Insurance Literacy: A Call to Action, AReport from the Health Insurance Literacy ExpertRoundtable. Consumers Union, University of MarylandCollege Park, American Institutes for Research, February2012. http://goo.gl/FywWmLPaez, K. & C. Mallery. “A Little Knowledge Is a Risky Thing:Wide Gap in What People Think They Know About HealthInsurance and What They Actually Know.” AmericanInstitutes for Research, October, 2014. http://goo.gl/uNR1Lu18Levitt, L. “JAMA Forum: Why Health Insurance LiteracyMatters.” Journal of American Medical Association.November 26, 2014. http://goo.gl/WT0L3s19Half of U.S. Adults Fail ‘Health Insurance 101,’ MisidentifyCommon Financial Terms in Plans. American Institute ofCPAs, August 27, 2013. http://goo.gl/aCGRN8Half of U.S. Adults Fail ‘Health Insurance 101,’ MisidentifyCommon Financial Terms in Plans. American Institute ofCPAs, August 27, 2013. http://goo.gl/aCGRN8Norton, M. et. al. “Assessing Americans' Familiarity WithHealth Insurance Terms and Concepts.” The Henry J.Kaiser Family Foundation, November 11, 2014.http://goo.gl/z79tuW71517Kutner. M. et. al. “The Health Literacy of America’s AdultsResults From the 2003 National Assessment of AdultLiteracy.” U.S. Department of Education. Washington, DC:National Center for Education Statistics & AmericanInstitutes for Research. September 2006.http://goo.gl/bUufeA56Enrollment Period. PerryUndem Research/Communication& Enroll America, July 2014. http://goo.gl/vGHDVfNew Report Highlights Health Plans’ Commitment to HealthLiteracy. AHIP Coverage, December 10, 2013.http://goo.gl/lehMlg20Altman, D. “A Perilous Gap in Health Insurance Literacy.”The Wall Street Journal, September 4, 2014.http://goo.gl/hhQ4Fg21Long, S. and D. Goin.” Large Racial and Ethnic Differencesin Health Insurance Literacy Signal Need for TargetedEducation and Outreach.” Urban Institute Health PolicyCenter and the Robert Wood Johnson Foundation, February6, 2014. http://goo.gl/HK8MphLevitt, L. “JAMA Forum: Why Health Insurance LiteracyMatters.” Journal of American Medical Association.November 26, 2014. http://goo.gl/WT0L3s22“McWilliams, Michael, et al. Complex Medicare AdvantageChoices May Overwhelm Seniors—Especially Those WithImpaired Decision Making.” Health Affairs, August 2011.http://goo.gl/Xp7d6S23Plain Language: It's the law. PlainLanguage.gov, October 13,2010. http://goo.gl/dLi3gGPaez, K. & C. Mallery. “A Little Knowledge Is a Risky Thing:Wide Gap in What People Think They Know About HealthInsurance and What They Actually Know.” AmericanInstitutes for Research, October, 2014. http://goo.gl/uNR1Lu9101112Blavin, Frederic, et al. “What Health Insurance CoverageChanges Are the Uninsured Anticipating for 2014?” TheUrban Institute. January 21, 2014. http://goo.gl/nzS2LX24Grob, Rachel et al. “Taking Stock and Taking Steps: A Reportfrom the Field after the First Year of Marketplace ConsumerAssistance under the ACA.” Kaiser Family Foundation,October 1, 2014. http://goo.gl/QTl0WlKutner. M. et. al. “The Health Literacy of America’s AdultsResults From the 2003 National Assessment of AdultLiteracy.” U.S. Department of Education. Washington, DC:National Center for Education Statistics & AmericanInstitutes for Research. September 2006.http://goo.gl/bUufeA25Partnering for the Health of all Minnesotans. MinnesotaHealth Literacy Partnership, 2014. http://goo.gl/fDMsUg26About Us. Health Literacy Kentucky, June 19, 2014.http://goo.gl/pNQQYS27A Healthy Understanding. Regional Health Literacy Coalition.2014. http://goo.gl/ZURhJs28Health Literacy Campaign. The City of New York. Office ofWorkforce Development, 2007. http://goo.gl/tm65BMVernon, J. et. al. “Low Health Literacy: Implications forNational Health Policy.” The George Washington University,10/04/2007. http://goo.gl/JbUQqvKutner. M. et. al. “The Health Literacy of America’s AdultsResults From the 2003 National Assessment of AdultLiteracy.” U.S. Department of Education. Washington, DC:National Center for Education Statistics & AmericanInstitutes for Research. September 2006.http://goo.gl/bUufeA13Ibid.14Voices from the Newly Enrolled And Still Uninsured - ASurvey about the Affordable Care Act’s First Open929Health Literacy and America’s Health Insurance Plans:Laying the Foundation and Beyond. America's HealthInsurance Plans, November, 2013. http://goo.gl/J
Health insurance literacy focuses more specifically on insurance coverage, and the ACA brought the subject to the forefront. A health insurance literacy expert roundtable in 2011 defined health insurance literacy as "the capacity to find and evaluate information about health plans, select the best plan given
Traditionally, Literacy means the ability to read and write. But there seems to be various types of literacy. Such as audiovisual literacy, print literacy, computer literacy, media literacy, web literacy, technical literacy, functional literacy, library literacy and information literacy etc. Nominal and active literacy too focuses on
health literacy is complex and fluid. Research in this area has focused largely on 'functional health literacy', which reflects basic reading and writing skills [25, 26]. Two other dimensions of health literacy have received in-creasing attention in recent decades: interactive and crit-ical health literacy. Interactive health literacy refers to
Keywords: Health literacy, Digital literacy, eHealth literacy, Self-rated health, Nursing students, HLQ, eHLQ, eHLA . self-reported capability to navigate and act in the health-care sector. In 2013, the World Health Organization (WHO) re-ported a positive correlation between self-rated health (SRH) and HL [25]. SRH is a reliable indicator of .
The king's insurance options 5 Things you need to know 7 The stuff you need to do 14 How to claim 16 Our commitment to you 20 Car insurance 22 Car warranty 37 Shortfall cover 45 Scratch and dent 46 Tyre and rim 48 Motorbike insurance 53 Trailer and caravan insurance 64 Watercraft insurance 68 Home contents insurance 77 Buildings insurance 89
Part VII. LIteracy 509 Chapter 16. A Primer on Literacy Assessment 511 Language Disorders and Literacy Problems 512 Emergent Literacy 514 Emergent Literacy Skill Acquisition 516 Assessment of Emergent Literacy Skills 520 Assessment of Reading and Writing 528 Integrated Language and Literacy Skill Assessment 536 Chapter Summary 537
and other insurance and non-insurance support mechanisms (e.g. health insurance, travel insurance, the NDIS, workcover). In late 2014 - to build on that research - Zurich commissioned CoreData to undertake a deeper analysis of this issue, by examining the levels of 'insurance literacy' within the community.
The health literacy scale and health literacy tasks were guided by the definition of health literacy used by the Institute of Medicine and Healthy People 2010 (a set of national disease prevention and health promotion objectives led by the U.S.Department of Health and Human Services).This definition states that health literacy is:
Prosedur Akuntansi Hutang Jangka Pendek & Panjang BAGIAN PROYEK PENGEMBANGAN KUR IKULUM DIREKTORAT PENDIDIKAN MENENGAH KEJURUAN DIREKTORAT JENDERAL PENDIDIKAN DASAR DAN MENENGAH DEPARTEMEN PENDIDIKAN NASIONAL 2003 Kode Modul: AK.26.E.6,7 . BAGIAN PROYEK PENGEMBANGAN KURIKULUM DIREKTORAT PENDIDIKAN MENENGAH KEJURUAN DIREKTORAT JENDERAL PENDIDIKAN DASAR DAN MENENGAH DEPARTEMEN PENDIDIKAN .
