Thursday, May 5, 2011

Guest Commentary: Health Literacy and the PPACA

Marlon Satchell, MPH
Project Director
Jefferson School of Population Health

A little over a year after Congress passed the Patient Protection and Affordable Care Act (PPACA), the United States is gradually implementing the key features of this legislation. With a timeline of approximately 5 years to full implementation, it is important to recognize the opportunity that is being given to legislators, insurers, health care providers, community groups and other stakeholders not only to reshape the health care system itself, but also to reshape the way in which health care-based information is transmitted to and understood by consumers.

Some of the milestones in the PPACA related to providing information directly to consumers, and their expected completion dates include:

• Putting information for consumers online (Implemented July 2010)
• Establishing consumer assistance programs in the US (Funding awarded October 2010)
• Free preventive care; Preventing disease and illness (Beginning 2010)
• Free preventive care for seniors (Effective January 2011)
• Improving care for seniors after they leave the hospital (Effective January 2011)
• Understanding and fighting health disparities (2012)

Evidence shows that only 12% of the US population has adequate health literacy. The US Department of Health and Human Services (HHS) 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 is dependent upon factors including communication by health care professionals, lay and professional knowledge of health topics, and the context in which information is provided. It directly affects individuals’ ability to navigate the health care system, fill out forms and documentation, locate providers and services, share their own health history, manage their medications, engage in self-care and chronic disease management, and understand health-related risks and benefits. HHS has identified the improvement of health literacy as a key goal and released the National Action Plan to Improve Health Literacy in 2010. This plan provides seven steps towards creating information that is “accurate, accessible, and actionable.”

Adequate health literacy is crucial to the success of the aforementioned milestones because these milestones involve a degree of understanding and buy-in from the patients and consumers themselves. Individuals must be able to understand the risks inherent in certain behaviors, they must be aware of the importance of preventive care, and they must know how to manage their own care, particularly after an event such as hospitalization.

Historically, some of the challenges associated with the improvement of health literacy have included a lack of funding for provider training and patient education; the breadth of institutions, services, providers and products available; and a lack of understanding of rapidly changing medical terminology, technology, and treatment.

The implementation of these components of the PPACA provides an ideal opportunity for health care providers, insurers, and others to better inform the public, and to create a foundation upon which the public can gain a better understanding of their health care. While health literacy and the challenges associated with providing information in a manner that is comprehensible for patients and consumers is not a new problem facing the American public, the PPACA provides a prime opportunity for government, health care, insurers, and community groups to develop and disseminate appropriate and consistent health care-related information enabling all patients and consumers to be better informed of their own health and health care-related information.

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