By Nicholas S. Imperato, DO, MPH and Kamini Doobay, MD, MS
Health insurance literacy can be broadly defined as “the degree to which individuals have the knowledge, ability, and confidence to find and evaluate information about health plans, select the best plan for their financial and health circumstances, and use the plan once enrolled” (American Institute for Research, 2012). While health insurance coverage is vital, it is equally important for consumers to thoroughly understand their health insurance plans in order to use them effectively and efficiently. Poor health insurance literacy can lead to numerous adverse outcomes, such as avoidance of care, reduced utilization of preventive services, increased emergency department visits, increased medical debt, and confusion surrounding obtaining and enrolling in health insurance plans. This can significantly harm patients. Therefore, it is increasingly important to expand our focus from merely increasing coverage to ensuring that resources and programs are in place to improve overall understanding of health insurance plans.
Our project, titled “Evaluating the Policy Implications and Impact of Health Insurance Literacy Initiatives,” has several distinct goals. First, we aim to better evaluate health insurance literacy through a literature review covering academic manuscripts, legislation, and position papers while also describing the complex and dynamic nature of the current health financing landscape and differences between states. This will lead to the second part of the project: the first state-by-state report outlining the health insurance literacy initiatives, legislation, and resources available in each state. We will discuss and thoroughly evaluate these programs and initiatives to understand which are most effective as well as identify potential gaps that could be filled.
Following the state-by-state report, we will select a few of the more well-developed initiatives and discuss their strengths and limitations, considering how they could guide the development of programs in New Jersey. The fourth part of this project involves using various public health theoretical frameworks to understand health insurance literacy in New Jersey and develop a community-based initiative that could be implemented in the state. In addition to this theoretical framework evaluation, we will conduct focus groups with local communities to better understand how to overcome critical gaps. The overarching goal of this project is to develop a health insurance literacy initiative that is culturally tailored and developed in a structurally competent manner that will be implemented in conjunction with a variety of community organizations’ input. We want to ensure that the specific needs of our local communities are being met, and therefore we understand how important it is to have community participation at every step of the project. Our community-based initiative will be supplemented with the development of health insurance literacy videos and pamphlets/brochures. The final part of the project will be a condensed policy issue brief discussing health insurance literacy and outlining policy proposals that could be provided to legislators throughout the state.
We believe that health insurance literacy is an important topic that has unfortunately garnered little attention despite our increasingly confusing healthcare and health insurance system. Our hope is that this project will help to better explain the topic, propose feasible legislation to improve literacy throughout the state, and outline a community-based initiative that can meet the unique needs of local communities while being efficiently and cost-effectively implemented across the state.
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.
References:
American Institute for Research. (2012, February). Health Insurance Literacy Round Table. https://advocacy.consumerreports.org/wp-content/uploads/2013/03/Health_Insurance_Literacy_Roundtable_rpt.pdf