By Nicholas S. Imperato DO, MPH, Kamini Doobay MD, MS

 

There are numerous states throughout the country which have identified poor health insurance literacy as a crucial issue that impacts the physical, mental, and financial well-being of their citizens. There have been a few innovative interventions to address this issue that have been implemented, with varying degrees of success. Some have opted to address the educational gaps related to health insurance literacy, while others have worked to centralize information and resources related to insurance.

For instance, the state of Maryland developed and launched the Health Insurance Literacy Initiative program. Through this initiative, a Health Insurance Literacy Hub was organized, and literacy resources were localized in one website for individuals to access. Additionally, through the initiative, a Smart Choice Smart Use campaign was developed. This paved the way for educational material and courses, targeted the most at-risk demographic groups, and highlighted information that was most important for their insurance needs.

Other organizations, such as the Ryan White HIV/AIDs Program, have developed online health insurance literacy modules for their staff members. This was created to better inform staff members who would be aiding community members on their health insurance choices and answering questions that arose. This online module, which consists of numerous sections, covers topics such as the variety of available insurance options and how to select and efficiently use your health plan. A hallmark of this module is the Teach Back and Show Me technique, where they teach staff members how to identify when individuals do not understand certain topics, and how to discuss them in an easily digestible format.

While there are various methods to both impact and improve health insurance literacy levels within the community, there are a few potential interventions that we believe could be viable options for the state of New Jersey. Each of these potential solutions will be discussed in our focus groups with community members and refined to select an initiative that is feasible, effective, and tailored to the unique needs of local communities in the Garden State. A few of the interventions that we will propose, include:

  1. Health Insurance Literacy Hand-Out Materials: Many hospitals across the country have various “kits” that they provide patients. For instance, many institutions have Narcan kits, which include doses of naloxone, information on opioid overdose, and contact information for support groups. We would like to reimagine these kits and develop ones specific to the health insurance literacy needs of local communities. These could either be in the form of physical folders with paper copies of information, or QR codes that allow for online access to materials. These health insurance literacy kits could potentially include brochures, pamphlets, QR codes allowing for access to videos, contact information for insurance navigators, or worksheets which could help individuals calculate the true cost of various health plans. We would develop information that is tailored to various demographics and bring together information that is particularly important to those individual’s needs. We could then provide these completed kits to hospitals or community groups, allowing them to distribute that information as they are able. Or we could provide each organization access to a shared online folder, where they could access forms that we have developed and choose whichever forms they would like to include in their own kits.
  2. Health Insurance Literacy Course Toolkits: Various organizations or medical societies have developed “toolkits,” which are outlines for courses, classes, or lectures on a multitude of topics. These toolkits are often developed to allow smaller groups or organizations the ability to select which courses are of interest to their members. It is generally a cost-efficient option, as groups can use their own staff to teach the courses, as all necessary resources are provided in the toolkit. Our toolkit would consist of lesson plans, PowerPoint presentations, and links to videos, covering important health insurance literacy topics or information that is useful to various demographics. The toolkit would then be distributed to community organizations. This toolkit would provide these organizations with all the information necessary to give the presentations to their community members, on their own schedule. This option would essentially eliminate the step of hiring new staff and would save community organizations the time required to prepare educational content.
  3. Health Insurance Literacy Library Workshops: Improving health literacy has been a major focus across the country over the past decade, and libraries have been central to that goal. Many states utilize local libraries as hubs of health literacy by holding events, classes, and offering educational material to individuals who visit. In this possible intervention, we would provide libraries with resources and informational materials, then promote them throughout the community as locations where health insurance information can be obtained, and questions could be answered.

This list is not finalized, and new, potentially better interventions are likely to be developed after meeting with community members. After meeting with various community organizations, we will work to identify and refine a potential intervention that has the most likelihood of successfully being implemented. These are all ideas that we believe could work, but input from the local community is invaluable, as their perspectives will truly drive the outcome in a positive direction.

 

Nicholas S. Imperato, DO, MPH is an Emergency Medicine resident physician at Rutgers New Jersey Medical School and Kamini Doobay, MD, MS is an assistant professor of Emergency Medicine at Rutgers New Jersey Medical School.