5Ways to engage employees

Transcription

1 5Ways to engage employees in health education and build health literacy A White Paper by Jennifer Benz Benz Communications

2 There is strong evidence that workers simply lack the ability to successfully navigate the complex and technical nature of healthcare. Employee Benefits Research Institute

3 In support of health literacy: The ultimate employee benefit challenge According to the Centers for Disease Control (CDC), nearly 90 million Americans have difficulty understanding and acting on health information. The CDC defines health literacy as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Health literacy has a direct relationship to health outcomes,¹ and poor health has a direct correlation to stress. A recent Harvard Public Health poll found that health incidents contribute to Americans top stresses.² Of those surveyed, 49% reported that they had a major stressful event or experience in the past year, and 43% reported that the most stressful experiences are related to health. However, close to three-fourths (74%) of respondents identified their health as an aspect of their lives affected by stress. Health literacy has a direct relationship to health outcomes. The impacts of workplace stress on employee health and financial wellness are well documented. Successful companies recognize that healthy, productive employees have a positive impact on the company s bottom line. While benefits professionals are well aware of the real-life struggles and financial consequences employees experience when they don t choose the appropriate coverage or avoid care altogether, the role low health literacy plays in these problems is not commonly acknowledged. Benz Communications 5 Ways to engage employees in health education and build health literacy 3

4 While improving health literacy on a national level may feel like an abstract or daunting problem better left to public health care systems to solve, there are simple ways every company can affect change. Employers are uniquely positioned to make the greatest impact on health literacy and, ultimately, influence better health outcomes for employees. Employees want and trust health and financial information from their employers. By stepping up education efforts, employees will learn what they need to do to ensure they receive the best and safest medical care. 74% of respondents identified their health as an aspect of their lives affected by stress. Starting with an overview of the health literacy landscape, this paper presents the top five ways to engage employees in health education and build health literacy. It also includes some communications tips and best practices to help your employees make the most of their benefits. Health literacy is vital in our evolving health care system We can t overestimate the importance of health education and literacy to the overall health and wellness of the American public, and the importance they have in the evolution and success of our nation s health care system. The Affordable Care Act attempted to standardize how health insurance terms are defined and presented in the Summary of Benefits and Coverage.3 But in a surprising twist, the effect of government intervention has in many ways made health insurance more confusing, confounding, and frustrating for consumers. Insurance companies, doctors, nurses, hospitals, pharmaceutical companies, translators, and employers all have a role to play in giving patients simple, actionable information. In most purchasing transactions, the buyer knows what she s buying, and the seller knows he s dealing with an informed buyer. But this isn t true when it comes to health care. Buyers and sellers both agree that health care purchasing decisions are so difficult largely because of this information imbalance.4 It s not just that buyers don t have information; the problem is that they don t understand the information they do have. Employers are uniquely positioned to make the greatest impact on health literacy and, ultimately, influence better health outcomes for employees. Benz Communications 5 Ways to engage employees in health education and build health literacy 4

5 According to The National Assessment of Adult Literacy, only 12% of adults have proficient health literacy. This means that almost 9 out of 10 adults lack the skills needed to manage their health and prevent disease.5 Employees who understand their benefits are more likely to use their benefits and make informed decisions about their health. Employees who do not understand their benefits due to limited health literacy are more likely to skip routine preventive care and are more likely to have chronic health conditions.6 9 out of 10 adults lack the skills needed to manage their health and prevent disease. Moreover, low health literacy is associated with severe adverse health outcomes and increased use of health care services including hospitalizations and emergency room visits.7 This level of health illiteracy comes at a high price. In 2006, it cost the U.S. economy anywhere from $106 billion to $238 billion, which represents 7% to 17% of all personal health care expenditures.8 To solve the literacy problem, health sellers need to provide information in a way that buyers can understand in language that s free of jargon and insurance-speak. At the same time, buyers need to meet sellers halfway and become more fluent in basic, universal benefits terminology. Employers can play a vital role in improving the health literacy of their workforce, but building health literacy will require establishing a baseline for health education. Employers must first recognize the barriers to employee comprehension: 1. Complex jargon. The health care industry has its own culture and language that is not clear to the average individual. Employees rely upon their employer to decode complex jargon. 2. Promoting the value of health insurance. The need for health insurance goes beyond maintaining physical health. Most employees don t understand how health insurance works and the financial protection it provides them. The effect of government intervention has in many ways made health insurance more confusing, confounding, and frustrating for consumers. Benz Communications 5 Ways to engage employees in health education and build health literacy 5

6 The system continues to get more complex As industry professionals, we know what a deductible is, and we re well aware of its importance in selecting and using a medical plan effectively. Employees, however, don t have this same basic knowledge. When it comes to evaluating plans during enrollment, most are not asking themselves, Which services count toward my deductible? or How do my family members costs help satisfy the family deductible? It s hard to ask employees to evaluate financial risk if they lack the basic understanding of a deductible. To add to the challenge of employee health education, insurance term definitions continue to change and update. Even employees with proficient health literacy will struggle to keep up with evolving jargon and will look to their employers for an explanation. For example, the new regulations for out-of-pocket limits beginning in 2016 don t make it any easier when it comes to understanding financial risk. The new definition of, and term for, out-of-pocket (OOP) maximum embedded MOOP (maximum-out-of-pocket), otherwise known as a deductible accumulator is bound to tax the limits of even the most health literate among us.9 OOP: Out-of-pocket MOOP: Maximum-out-of-pocket or deductible accumulators. Here s how insurance companies explain it: Family health plans that begin in 2016 cannot allow any individual to spend more than the Affordable Care Act (ACA) individual out-of-pocket (OOP) maximum, which is $6,850 in Here s the translation for employees: In 2016, once one family member meets the individual deductible, the plan will start sharing expenses with that person. No more having to meet the entire family deductible before the plan kicks in for health care costs. Legally required notices, such as summary plan descriptions (SPD), and other plan materials are notoriously dense and hard to read. Relying on SPDs to educate employees only compounds the issue of low health literacy. It s important to distinguish between compliance documents and educational benefits communications. The challenges to comprehension don t end there. Making informed health care purchasing decisions requires not only an understanding of the terminology and cost sharing, but also the purpose of health insurance. Benz Communications 5 Ways to engage employees in health education and build health literacy 6

7 The value of the financial protection of health insurance When we talk and complain about health insurance, the focus is usually on immediate access to health care services and out-of-pocket costs. Who s in the network? What s the deductible? How much is the copay? How many hoops will I have to jump through to use the plan? If we hope to help employees become more savvy health care consumers and protect them from crippling financial bills, they need to understand that health insurance is first an insurance plan, not a payment plan for routine health problems.10 Currently, what s missing from the dialogue is the insurance side of the equation. The main role of health insurance, after all, is financial protection. Still, one s total out-of-pocket risk is rarely calculated during the buying decision. Without clarity about the financial protection that comes with health insurance, employers cannot accurately educate employees about the value of their benefits. Without clarity about the financial protection that comes with health insurance, employers cannot accurately educate employees about the value of their benefits. And in today s world of high-deductible health plans (HDHPs) with high out-of-pocket costs, the financial protection is where the real value comes in. We know that prevention and wellness feel good, and a lot of effort is put into communicating the value of those benefits as part of health insurance. But we must also talk about the financial security that health insurance affords. Annual enrollment is a powerful time to do that, especially for employers who need to educate employees about the value of their plans. Employees rely upon their employer to decode complex jargon. Benz Communications 5 Ways to engage employees in health education and build health literacy 7

8 5Ways to engage employees in health education and build health literacy Employees need you now more than ever to help them understand their health benefits. The health care system is flawed stacked against them and, despite everyone s best efforts, it just keeps getting more complex. HDHPs and narrow networks either through public exchanges, private exchanges, or employer-sponsored plans are land mines of potentially devastating financial mistakes. They need you to help them navigate and to set themselves and their families up for success. And, because they look to you as a trusted source of health and financial information, you can use effective communication to strengthen that trust, even in these times of unprecedented change. Here's how: Go to great lengths to simplify information. Give broader context to employees. Promote resources year-round. Support all ways to engage with the health care system. Use your influence in the industry. Benz Communications 5 Ways to engage employees in health education and build health literacy 8

9 1 Go to great lengths to simplify information Simplify language wherever you can, and provide materials that are easily accessible to all readers. Make it a practice to test the reading levels of every communication you create for employees, and set a goal to write at a middle-school level.¹¹ Remember, it s not patronizing to send engineers information that s written at an eighth-grade reading level it s just considerate. Give your health literacy efforts an extra boost with our 8 Insurance Terms Every American Needs to Know.¹² This 12-page guide offers plain-language definitions and simple visuals to explain common health insurance words and phrases that are critical for every consumer to know. Set a goal to write at a middle-school level. Taking a one-size-fits-all approach to your benefits communications won t allow you to create materials that are relevant and meaningful to everyone.¹³ To create communications that have maximum impact, be thoughtful about whom you want to reach the most, how you can help them engage, and what action you want them to take. Give your health literacy efforts an extra boost with our 8 Insurance Terms Every American Needs to Know. Benz Communications 5 Ways to engage employees in health education and build health literacy 9

10 2 Give broader context to employees Don t be shy about saying you re self-insured. Talking about how your company funds health insurance, and the ever-important difference between self-insured and fully insured plans,¹⁴ provides a good illustration of financial benefit and risk. If your company is self-insured, give yourself credit for that investment in employees financial security. Financial decisions are emotionally loaded for most people, as is managing your health. Storytelling allows us to give context, provide facts, and examples. When you provide scenarios that compare your plan options, in addition to including out-of-pocket cost information, be sure to mention the financial protection the plans provide. Expand the conversation to discuss the value of health plans, including lower negotiated rates for providers and medical care, limits on out-of-pocket expenses, and payment via easy payroll deductions. Storytelling allows us to give context, provide facts, and examples. Benz Communications 5 Ways to engage employees in health education and build health literacy 10

11 3 Promote resources year-round Like most people, our employees will be more receptive to and better at absorbing bite-sized chunks of information. And when it comes to the health and wellness resources you offer, there s a lot of information for them to digest in one sitting. One of the biggest mistakes employers make is rolling out all this information once a year during annual enrollment, instead of incrementally, throughout the year. If you want your employees to use their benefits and take steps to improve their overall health and wellness, this message needs to be reinforced through frequent, easy-to-understand messaging. Consciously or not, each interaction is a chance to practice using terms and grow health literacy. Plan for year-round communications to support employees with their daily decisions about health and financial security. You can also take advantage of free and low-cost resources from your vendors, consultants, and brokers to promote the valuable services you offer. All health care decisions contribute to employees personal knowledge base each small action informs the next. Consciously or not, each interaction is a chance to practice using terms and grow health literacy. Make sure you promote health plan comparison and health care shopping tools and help employees connect the dots among the various aspects of the health care system. Plan for year-round communications to support employees with their daily decisions about health and financial security. Benz Communications 5 Ways to engage employees in health education and build health literacy 11

12 Take advantage of these resources to help educate your employees year round: The Choosing Wisely Toolkit, which we created with the National Business Coalition on Health and the Pacific Business Group on Health, helps tee up the broader conversation about quality and costs, and can help employees have meaningful discussions with providers.¹⁵ The toolkit contains dozens of ready-to-use articles and tip sheets for your communication. You can put them on your website and send them to employees to help them understand their role in getting the best care and outcomes. Choosing Wisely Toolkit The infographic, Ten Behaviors of an Engaged Health Consumer, which is posted on Janet McNichol s Workplace Wellness blog, is an easy-to-digest, visually engaging guide to best practices.¹⁶ Tips and tools from the Centers for Disease Control and Prevention.¹⁷ Communications materials from all your vendors, which you should co-brand and assemble according to the type of care they support (e.g., long-term care, accident/injury, vision, dental). Benz Communications 5 Ways to engage employees in health education and build health literacy 12

13 4 Support all ways to engage with the health care system We all have an amazing amount of health resources at our fingertips.¹⁸ With the explosion of wearable fitness We can t forget that individuals technology and health-related apps, people are paying operate emotionally, not attention to and tracking their own health in ways that rationally, when shopping for would have been unthinkable a decade ago. Patient health services. sharing sites such as PatientsLikeMe not only grow consumers confidence but also empower them to ask questions and request information about alternative treatment options.¹⁹ And cost transparency tools, such as those from Castlight Health, Carrum Health, and Change Healthcare, continue to evolve and help consumers make smart health care purchasing decisions.²⁰ This is especially important because of the stigma associated with low health literacy. Those with low health literacy skills often feel ashamed of their skill level;²¹ they may hide their difficulties, compounding the problem even further. Confidence is a transferable attitude one doctor visit, one diagnosis at a time. We all have an amazing amount of health resources at our fingertips. You can also help your employees by connecting the dots among the various aspects of the health care system. As employers, focus on small steps and specific behaviors that you want your employees to take. We can t forget that individuals operate emotionally, not rationally, when shopping for health services. To deliver meaningful information, we need to frame our messages in a way that acknowledges this complex mental state. Benz Communications 5 Ways to engage employees in health education and build health literacy 13

14 5 Use your influence in the industry Advocate with your insurers to use consistent definitions of deductible and out-of-pocket maximum for every plan, and use simple language to educate employees about their meanings. Partner with your health plans to improve the readability of their member materials, including their websites, Explanation of Benefits (EOB), s, and mailers. Participate in the training of your member service teams to ensure they understand the nuances of your company culture and language. Advocate and influence the broader system. You can also advocate for employees with your health insurance partners to use standardized terms, so employees have a consistent experience at every touch point. Slip that demand into your next renewal as an imperative. Going a step further, the ERISA Advisory Council has recommended that the Department of Labor use its influence to push insurers to create a standard EOB.²² Employers can lend their voices to support that recommendation. Advocate for employees with your health insurance partners to use standardized terms, so employees have a consistent experience at every touch point. Slip that demand into your next renewal as an imperative. Benz Communications 5 Ways to engage employees in health education and build health literacy 14

15 In conclusion Health education and literacy are vital as the nation s health care system continues to evolve. As a trusted source of health information, employers can use their influence to help employees make good decisions. As you continue to focus on benefit design and administration, look for ways to step up your health care education efforts as well. Using the tips and best practices included in this paper will help you engage employees in health education and build the health literacy they need to make informed choices. Feeling inspired? We hope so! Armed with inspiration and information, you re one step closer to breakthrough results with your benefits communication. Get more from your benefits. Learn how you can increase results on your benefits communication. Call us: us: hello@benzcommunications.com Benz Communications 275 9th Street, San Francisco, CA Benz Communications 5 Ways to engage employees in health education and build health literacy 15

16 References 1 Low health literacy and health outcomes: An updated systemic review, Annals of Internal Medicine, July 19, The burden of stress in America, NPR/Robert Wood Johnson Foundation/ Harvard School of Public Health, July 17, Has transparency arrived? What the SBCs can mean for your benefits communication, June 6, Health literacy and health insurance literacy: Do consumers know what they are buying? Alliance for Health Reform, January 6, National action plan to improve health literacy, U.S. Department of Health and Human Services, Quick guide to health literacy, U.S. Department of Health & Human Services. 7 Low health literacy and health outcomes: An updated systematic review, Annals of Internal Medicine, July 19, Low health literacy: Implications for national health policy, The George Washington University, October 4, Little-known federal health regulation is hitting up business for hundreds of millions of dollars, Forbes, June 4, Medical debt among people with health insurance, Kaiser Family Foundation, January 7, Test your document s readability. Microsoft, health insurance terms every American needs to know, Benz Communications Targeting and segmenting benefits communications: What you need to know, Benz Communications blog, March 8, Self-insured vs. fully-insured medical plans, Benz Communications blog, June 5, Choosing Wisely Toolkit, Benz Communications, behaviors of an engaged healthcare consumer infographic, Inside Workplace Wellness blog, March 28, CDC Health Literacy webpage, Centers for Disease Control and Prevention website. 18 Stay well, e-health, HealthIT.gov. 19 Sharing health data for better outcomes on PatientsLikeMe, Journal of Medical Internet Research, June 14, Unveiling the cost of care: How transparency changes the patient perspective, Becker s Hospital Review, November 20, Shame and health literacy: The unspoken connection, Patient Education and Counseling, ERISA Advisory Council report on health care literacy, U.S. Department of Labor, Benz Communications Benz Communications is a San Francisco-based marketing firm specializing in employee benefits, founded in The company creates strategic benefits campaigns for employers committed to nurturing high-performing and satisfied employees. Its clients include Fortune 500 companies and Fortune 100 Best Companies to Work For. An established thought leader in the benefits industry, Benz Communications invests in research and resources to help companies educate employees about health and financial benefits. Learn more at Benz Communications 5 Ways to engage employees in health education and build health literacy 16