By Nicholas S. Imperato DO, MPH and Kamini Doobay MD, MS
For any community initiative or legislative effort to be successful, it is tantamount to solicit input from the those living within the area. Focus groups and community engagement are powerful tools that can help shape the development of potential initiatives. By bringing together a diverse group of individuals, professionals, and community stakeholders with varied perspectives on a particular issue, we can learn about the intricacies involved and better understand real-life experiences, challenges, and perceptions in addressing health insurance literacy. Additionally, if there is no “buy-in” from the community, then the theoretical benefit of an initiative will never be carried out to fruition. Developing a collaborative approach not only fosters a sense of shared ownership but also ensures that any resulting strategies or materials resonate with the people who would most benefit from them.
Our goal with this project has been to raise awareness regarding health insurance literacy and bring about improvements in understanding through interventions that will truly benefit communities throughout New Jersey. The reality is that no one understands the community’s needs quite like the community itself. We want to listen to and prioritize the voices of community members and organizations and work to tailor our project specifically towards their identified needs. With these thoughts in mind, we have begun to hold meetings with community organizations, as well as social workers and care navigators. Each offers a unique, yet vital, view on the subject of health insurance and offers recommendations to improve understanding of its nuances. From these early meetings we have learned a tremendous amount, including what the community actually thinks about health insurance, understands about the topic, and what resources might be most beneficial to them.
From our meetings with care management staff we learned that most hospitals do not currently have many printed forms or resources focused on health insurance to provide patients when being discharged from the hospital. They also noted that across the country, most hospital staff have limited knowledge of health insurance, which is potentially a hinderance to providing adequate advice to patients. One of the main points that was highlighted throughout our discussions was that there are many patients who are eligible for Medicaid coverage or could apply for charity care but are currently unaware of their eligibility. Additionally, there are large portions of patients who are covered by Medicaid but unknowingly have their coverage lapse because instructions to reapply are often difficult to obtain.
When meeting with community members in Newark, it was continually stressed how confusing health insurance was to understand. One individual brought up an interesting point, stating that often health insurance information was only made available or easily accessible when you were in a time of need, such as in the hospital, and needing immediate access to utilize your health coverage. Each individual found that it was nearly impossible to understand and select a health insurance plan that was best for their needs, because every plan seemed so similar. They hoped that there could be more video resources, or how-to guides on navigating the complexities of health insurance. While each was unsure of where resources could be obtained, many turned to family or other community members when insurance-related questions arose. Their hope was that those individuals had gone through similar situations and could provide advice when needed.
We plan to continue meeting with community members and hospital staff to gather useful information, which will help to further tailor the resources that will be developed. Health insurance literacy will only improve if the community is a central part of the path forward.
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.