How Health Plans Can Support the Role Primary Care Plays in Health Literacy


With the number of PCPs declining, health plans can come in to support PCPs and play an active role in improving overall health literacy.

Health literacy is defined as a person’s ability to obtain, communicate, process, and understand health information and services to make decisions about his or her health. Without factual and unbiased information around health, members are more likely to make ill-informed decisions that lead to poorer outcomes and higher costs.

One negative anecdote from a friend or relative about a colonoscopy, for instance, could deter someone from getting one early enough to detect and prevent disease. To make matters worse, false or biased information around health is plentiful on the internet.

Considering that an estimated 80 million adults in the U.S. have limited-to-low health literacy, addressing this problem should be a healthcare priority. Primary care physicians (PCP) are in the best position to bridge the gap and improve health literacy as trusted sources of unbiased, useful healthcare information. They’re also able to share information directly with their patients, many of whom they’ve worked with over time, gaining an in-depth understanding of their health literacy limitations and any potential bias.

The problem, however, is that the number of PCPs is declining. Alongside it, then, goes a member’s ability to receive the quality information necessary for making prudent healthcare decisions. That’s where health plans can come in to support PCPs and play an active role in improving overall health literacy.

How to bridge the gap and improve health literacy

As the amount of biased, inaccurate information around health grows and the number of PCPs declines, payer-provider collaboration is the key to addressing the problem — thereby improving member outcomes and reducing costs. Here are four strategies health plans can utilize to help providers bridge the health literacy gap:

1. Reimburse providers for measuring health literacy. One way health plans can address the problem is by reimbursing providers who measure health literacy. For providers to help educate patients and boost health literacy, the first step is assessing patients’ literacy levels: their knowledge about screening tests, treatments for various conditions, family history, and other factors that may lead to potential bias.

Validated tools such as the REALM, the Rapid Estimate of Adult Literacy in Medicine, can help physicians measure health literacy. Health plans can encourage providers to do so with a reimbursement model similar to how some plans reimburse physicians for performing the PHQ-9 depression questionnaire.

2. Raise awareness among physicians. Whether in person or online, all physicians must participate in continuing medical education — or CME — to remain certified. Payers and providers can collaborate to sponsor CME that focuses on the importance of health literacy and strategies to improve it. The investment is nominal, but the reach could be in the thousands, and the returns could have a significant impact on the health outcomes of populations with low health literacy.

3. Employ visual aids. Health plans can also utilize simple, clear graphics and charts to illustrate the benefits of adhering to a certain course of treatment, such as a diabetes management program. Members with low health literacy might not have prior knowledge of these treatments or understand their importance, which could lead them to take medications incorrectly or abandon the treatment plan altogether. By reinforcing verbal or even written communication about a medication’s importance in easy-to-understand ways, however, plans can potentially encourage greater member adherence.

4. Arm providers with health literacy tool kits. Payers can develop and distribute health literacy tool kits to providers that offer materials, including talking points, tips for success, sample communications, lists of community organizations, and pieces specifically geared to share directly with members. These resources can help providers learn how to meet patients where they are with regard to health literacy and improve their skills over time.

PCPs are the best-positioned members of the healthcare sector to address the pressing health literacy problem, but with fewer physicians, the remaining ones need more support. Health plans can take a few simple steps to provide an extra layer of support to help bridge the gap and improve health literacy and population health.

Author, Dr. Frank Crociata serves as a divisional Medical Director for Envolve Health, providing oversight into initiatives focused on member engagement to improve health outcomes. Dr. Crociata is a board-certified family physician, giving him unique insight into population health management, medical trends, and managed care.

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