Health Insurance Literacy:
Smart Choices for Health and Wealth
Bonnie Braun, PhD
University of Maryland Extension
10-04-13
http://www.iom.edu/~/media/Files/Activit
y%20Files/PublicHealth/HealthLiteracy/Co
mmissioned%20Papers/Health%20Literacy
%20Implications%20of%20Health%20Care
%20Reform.pdf
October 2010
Direct References to Health Literacy
Section 3501
Requires AHRQ research
be available to the public
... to reflect varying needs
of … providers and
consumers and diverse
levels of health literacy.
Section 3506
“Decision aids must
reflect varying needs of
consumers and diverse
levels of health literacy.”
Section 3507
“To consult with …
experts in health literary.”
Section 5301
Preferences for training
grants in cultural
competence and health
literacy.
Indirect References in 6 Domains
1) Insurance Reform,
Outreach and
Enrollment
2) Individual
Protections, Equity n
Special Populations
3) Workforce
Development
4) Health Information
5) Public Health, Health
Promotion and
Prevention &
Wellness
6) Innovations in
Quality and Delivery
and Costs of Care
Consumer Challenge Posed by ACA
“The ongoing evolution of the health care system is leading
US households toward greater responsibility for their
own well-being.
… comes an increasing need to be able to find, trust, use,
and act on relevant information to make informed choices.
…continues to be a substantial mismatch between the
high literacy burden … the health and financial literacy
skills of individuals who use them.” p. 874
Martin, L. T. and Parker, R.M. (August 9, 2011). Insurance expansion and health literacy.
Journal of American Medical Association On-line.
http://jama.jamanetwork.com/article.aspx?articleid=1104248
Three Gifts …
Of, By and For the People
 The Morrill Act
 The Hatch Act
 The Smith-Lever Act
2014
Celebrating 100 Years of Extension
SMITH-LEVER ACT
Act of May 8, 1914, ch. 79, 38 Stat. 372, 7 U.S.C. 341 et seq.Chap. 79.
—to aid in diffusing among the people of the United States useful and
practical information … and to encourage the application of the same …
…extension work shall consist of the development of practical applications
of research knowledge and giving of instruction and practical
demonstrations of existing or improved practices or technologies
… to persons not attending or resident in said colleges in the several
communities, and imparting information on said subjects through
demonstrations, publications, and otherwise and for the necessary
printing and distribution of information in connection with the
foregoing.
Health Insurance Literacy
The degree to which individuals have the
knowledge, ability, and confidence to:
a) Find and evaluate information about
health plans;
b) Select the best plan for his or her family’s
financial and health circumstances, and
c) Use the plan once enrolled.
Measuring health insurance literacy: A call to action and report from the
health insurance literacy expert roundtable. (2011), Washington, D.C.: Consumers Union. Available at:
http://www.consumersunion.org/pub/Health_Insurance_Literacy_Roundtable_rpt.pdf
Health literacy principles suggest
that health information must be:
•
•
•
•
•
User-focused
Easy to understand and do
Culturally appropriate
Emotionally appealing
Scientifically sound
Extension Education
Theoretical Framework
Social
Cognitive
Youth
Development
Empowerment
Adult
Education
Evaluation
Stages of
Change
Communication
Planned
Health
Behavior
RC + IC & IC = SC
Reduce Confusion +
Increase Capability &
Increase Confidence
=
Smart Choice
Pilot Testing
Employees of UMD, Hispanic & English Sessions
Graham McCaulley and Molly Vetter-Smith Missouri
Key Questions I Need to Answer
Why?
• Why do I need health insurance?
• Why is it important?
What?
• What do I need and want?
• What are my choices?
How?
• How much can I afford?
• How much will it cost?
My SMART CHOICE
My Health Insurance Needs Worksheet
My Monthly Spending Plan
Extension.umd.edu/insure
Extension.umd.edu/insure
Smart Choice Health Insurance
Educator Workshops
Toolkit Explanation
 Annotated PowerPoint
 Workshop handouts
 Planning & Preparation
tools
 Workshop promotion
 Theory & Research
 Adult Education Principles
 Evaluation protocol &
process
Class 1 Certified Educators
Smart Choice Health Insurance
Educator's Training
October 9-10
October 14-15
October 30-31
Beltsville MD
St. Louis MO
Portland OR
For a Certification Fee of $200, Early-bird,
or $250, Regular, Educators receive the
following benefits:
Access to the Educators Toolkit
Consultation with teaching team
Updated and new information
Data compiled and returned in
comparative reports
Mia Baytop Russell, Lynn Little
Teresa McCoy, Virginia Brown
http://extension.umd.edu/insure
Coming
 Smart Choice Health Insurance—Young Adults
 Smart Choice Health Insurance—Senior Adults
 Smart Choice for Farm Families
 Impact reports from Smart Choice Health
Insurance
 Smart Use Health Insurance
 Other ideas yet to be conceived!
Acknowledgements
This pilot project was developed with funding from the
University of Maryland Extension, the College of
Agriculture and Natural Resources
and an eXtension Fellowship.
Development Team
University of Maryland Extension:
Bonnie Braun, Virginia Brown, Shannon Dill, Nicole
Finkbeiner, Christine Garcia, Jinhee Kim, Lynn Little,
Teresa McCoy, Megan O’Neil, Mia Baytop Russell,
and Andrew Williams
University of Delaware Extension: Maria Pippidis
Bonnie Braun, PhD., Professor, Department
of Family Science;
Specialist University of Maryland Extension;
Faculty Scholar, Horowitz Center for Health
Literacy, School of Public Health
bbraun@umd.edu