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Health Literacy at the Workplace

Health-care literacy is a major issue facing today’s small businesses.

By David Connell

The rising costs of health care have many scratching their heads these days, particularly those in small businesses who are increasingly finding employee-sponsored health plans to be a burden. But what can curb costs? According to the International Foundation for Employee Benefits Plans, a nonprofit educational association with 35,000 members composed of plan sponsors, service providers and advisors, a significant part of the answer is health-care literacy. We discussed this growing trend with Barbara Swarthout, SPHR, CEBS, director of educational programs for the IFEBP, and found out how advisors can help their clients increase health-care literacy among their employees and drive down costs. How do you define health-care literacy, particularly in reference to the workplace and employee benefits?

Swarthout: Health-care literacy certainly has to deal with the issues of people who may not be able to read or write or have cultural differences in terms of language barriers. But it goes beyond that. Health-care literacy is really concerned with things like: Does a patient understand what the doctor is prescribing? Do they understand they should take the prescription for the entire time the doctor has prescribed it? Do they know what tests the doctor is giving them and do they know why they’re being done? Are they asking what the results of those tests are? Do they even know what a doctor’s visit costs? It’s more than a $10 or $20 co-pay. Many employees think that’s really the cost of a doctor’s visit. So it enters into all of these issues surrounding the employees’ health. What do you see as the primary challenges to health-care literacy? What’s standing in the way of this becoming a primary component of employee-sponsored health plans?

Swarthout: I don’t know that the employers can’t get them the information. It’s more a matter of, are the employers ready to take the information, understand it, accept it and deal with employees as health-care consumers? It’s very critical that we help educate individuals about health care and how they’re utilizing it and what the cost is. We actually spend more time researching the purchase of a car … than we do finding a doctor or finding a hospital. Have their been successes recently in getting health care literacy into the workplace?

Swarthout: Employers have done a variety of things. We’ve seen them use written information that’s relatively easy to go through and understand. We’ve also seen them provide toll-free telephone numbers to talk to a nurse that’s on staff at a hospital. We’ve seen them use their intranets—their internal internet websites for their employees—to send out information about health care or about their providers. Many of them actually go to their providers and ask them for materials they can use to educate their employees. So there’s a variety of ways employers are attempting to increase health-care literacy.

I think the ultimate success of HSAs hinges a great deal on having well-educated and better-educated health-care consumers.
— Barbara Swarthout, SPHR, CEBS Many of our viewers set up and administer health plans for small businesses. What resources are available to help them educate their clients on the importance of health-care literacy?

Swarthout: We have a variety of sources here at the Foundation—resources that plan sponsors can use. We have a series of health-at-home books that many employers purchase and give to their employees. We have also just published a book called Effective Benefits Communication, by Anne Black, and it has chapters that just talk about teaching the value of health care benefits and encouraging healthy lifestyles … Of course, we have other sources they can go to via the government or websites they can access and the employer can utilize. If they wanted to administer a health-care literacy program, where should they start?

Swarthout: I think they have to start in a practical manner and very simply and talk about things as simple as “What’s the cost to see a doctor?” They should go down to the practical things the employees are dealing with in the health-care system and help them understand that the decisions they make impact their health-care plan, in terms of cost and accessibility. … We’re going to talk about, in a teleweb conference that’s coming up on Jan. 20, some of the practical things employers have done in this area. What, if any, relationship do you see between health savings accounts and health literacy? It seems to me that if HSAs catch on, we’ll need to have health-care consumers who are much more educated than they are now.

Swarthout: I think the ultimate success of HSAs hinges a great deal on having well-educated and better-educated health-care consumers. It’s really no different from educating people about their 401(k) investments. It’s very similar in helping them understand the choices they have and the types of decisions they need to make on their own. You mentioned a teleweb conference on Jan. 20. Tell me what you’ll be discussing during this, and can you give us an idea of how a “teleweb” seminar is run?

Swarthout: We’re going to talk about how health-care literacy impacts employer health plans, the cost of the health plan and the impact to the health-care system. We’re also going to give employers examples of what they can do to empower plan participants to make better decisions and better utilize their benefit packages, and ultimately utilize our health-care system in a more efficient manner.

The teleweb will be 90 minutes long and the audio is accessed by an 800-number we give you when you register. And you access the PowerPoint presentation that the presenter is using through the internet. So the first 60 minutes are given over to a panel discussion or a formal presentation from an expert in the industry. The last 30 minutes allow for questions from the audience. … They can ask questions by emailing or live through the telephone.

The other thing I wanted to mention is that several of the brokers who have small-business clients have emailed me and said they’ve purchased a registration and invited their clients in for the 90 minutes. This gives them an opportunity to educate their clients at a very minimal cost, and they’ve said their clients really appreciate it.

Web Links

Information on IFEBP telewebs

Effective Benefits Communication by Ann Black
Guide for employers with two chapters addressing health-care communication specifically.

Free resources for employers to get more information on health-care literacy:

Partnership for Clear Health Communication

U.S. Surgeon General

American Medical Association

Agency for Healthcare Research and Quality

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