How to help employees become health literate Featured

8:00pm EDT May 26, 2010

In a perfect world, patients would leave their doctors’ offices knowing everything about their medical conditions and treatment options. They’d know when to get health screenings, how to take their medicines, what immunizations their children need, exactly what their insurance covers and where to submit insurance forms.

According to the Institute of Medicine, however, in the real world, low health literacy prevents some 90 million people from clearly understanding and correctly using health information.

“Health literacy is a crucial part of receiving quality health care,” says David P. Crosby, president of HealthAmerica. “Research shows that it’s vital to good patient care and for positive health outcomes. Because low health literacy influences health care costs, employers have a stake in making sure their employees are health literate.”

Smart Business spoke with Crosby about why employers should be concerned about low health literacy and how they can help their employees become health literate.

What is health literacy?

Health literacy is the ability to read, understand and act on health information. Health care is complicated, and health care providers require a special language to do their jobs.

Low health literacy is not caused by a lack of education; it’s about miscommunication caused by the use of unclear language and overly technical terms.

Who is affected by low health literacy?

It affects people of all socioeconomic backgrounds. A person who has finished high school and knows how to read may still not be able to navigate the health system. Even well-educated, professionally skilled people have trouble from time to time understanding their doctor or their recommended treatment.

What is the economic impact of low health literacy?

One report suggests that low health literacy is a major source of economic inefficiency in the U.S. health care system, costing the United States anywhere from $106 billion to $236 billion annually.

When we account for the future costs that result from current actions (or lack of action), the real present-day cost is closer to a range of $1.6 trillion to $3.6 trillion.

How does this translate to an employer level?

First, employees who are health literate understand what makes their health worse and what makes it better. They also know when, how and in which setting to seek care from a professional. They save money, too, because they make cost-effective choices.

Second, employees who are not health literate are more likely to end up in the hospital and use emergency services more often. Frequent use of these services results in higher out-of-pocket costs for these patients — and for all consumers — in copayments, coinsurance or deductibles.

Third, we’re moving toward health benefit plans with initiatives that support employees to better manage their own health and to share some of the financial responsibilities.

As employees try to become better consumers when it comes to their health care, it is important that they understand what they have signed up for and what they get for their money.

What can employers do to help their employees become more health literate?

Make sure you can answer yes to these questions:

  • Are the printed materials about the company’s health plan written at a level everyone can understand?
  • Is there someone to whom employees can go for help in dealing with insurance matters, and are workers encouraged to seek help from that person?
  • Do you seek feedback from employees about the ease of interacting with the health plan, pass along issues of concern to your insurance representative, and then follow up on them?

Where should employers go for help?

There are a couple of sources employers can rely on. The first one is your health insurance carrier. Account representatives are well-trained in your employees’ benefit plans and how to explain them clearly.

Employees can also take advantage of the 24-hour, toll-free help lines offered by HealthAmerica and other health insurers. The lines are answered by nurses who can respond to questions on health issues and benefits.

The Partnership for Clear Health Communication also provides employers with a number of cost-effective ways to educate employees about the importance of clear health communication between health providers and patients.

Download free materials to provide to employees at

Other helpful sources include the Agency for Healthcare Research and Quality at and the Institute of Medicine at


Health Literacy: A Prescription to End Confusion, the Institute of Medicine (IOM 2003)

Low Health Literacy: Implications for National Health Policy, University of Connecticut, National Bureau of Economic Research (October 2007)

David Crosby is president of HealthAmerica. Reach him at