Health Literacy Improves Medicare Spending, Member Outcomes

October 27, 2020 - Health literacy is key to improving member health outcomes, particularly among Medicare beneficiaries, a UnitedHealth Group research report emphasized.

“Health literacy represents the ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health for themselves, their families, and their communities,” the report explained. “Individuals with limited health literacy can encounter challenges interpreting basic health information, such as hospital discharge and medication dosing instructions.”

Several factors are instrumental in determining individual health literacy levels, including education level, language, health behaviors, and the health systems that they access.

Across the nation, health literacy is sorely lacking. The highest health literacy levels tended to exist in the northern counties, the report found, whereas much of the deep south suffered from low health literacy.

That being said, even in the counties with the best health literacy levels, 15 to 27 percent of the county still did not have high health literacy. In counties with low health literacy, anywhere from 36 percent to 59 percent of the residents demonstrated low health literacy.

The researchers identified a strong pattern of Medicare beneficiaries with higher health literacy having improved outcomes compared to their lower health literacy counterparts.

For example, Medicare beneficiaries in counties with higher health literacy received 31 percent more flu shots, experienced 26 percent fewer unnecessary hospitalizations, had 18 percent fewer emergency department visits overall, and nine percent fewer hospital readmissions.

Not only were their health outcomes better, but their healthcare spending levels were also more desirable in comparison to Medicare beneficiaries in counties with lower health literacy. Beneficiaries with higher health literacy had 13 percent lower healthcare spending, corroborating previous data.

The implications of this data could be transformative if it drove greater health literacy nationwide.

If every US county boasted high health literacy, it could influence preventive care utilization, hospital visits, and healthcare spending. Four percent more Medicare beneficiaries would receive their annual flu shot, hospital visits could drop by 993,000 visits per year, and Medicare healthcare spending could drop by $25.4 billion.

More specifically, avoidable hospitalizations could fall by six percent, hospital readmissions could drop by five percent, and emergency department visits could see a four percent decline.

Also, the report indicated that healthcare is $700 less expensive for Medicare beneficiaries in counties with high health literacy.

Health plans can target certain populations in particular to ensure that they have high health literacy and improve member outcomes.

“Seniors — who use more health care services, have more chronic conditions, and take more medications compared to other age groups — benefit from increased health literacy levels because it helps them make informed decisions and enhances their health care experience,” the report pointed out.

It also noted that the healthcare system spending for Medicare beneficiaries is almost three times the amount that it spends on adults younger than 65. Low health literacy can have a negative impact on seniors’ ability to select an appropriate health plan during Medicare open enrollment.

Health plans have a pivotal role to play in reforming health literacy, as do providers and employers. The researchers advised several action steps to improve health literacy in the US.

Across the industry, healthcare professionals who are “consumer-facing” should commit to better communication and actively improving member health literacy. This includes both providers and payer agents.

However, supporting health literacy may not come naturally to many healthcare professionals. Thus, as a second action item, the industry should provide health literacy training to help give payers and providers the language to communicate more effectively with their patients and members.

Third, payers and providers must be sure to test their messaging to ensure that consumers will understand it and be able to leverage it to move toward the best health outcomes.

Fourth, ensuring that all communications come in various languages to serve each county’s particular population is also critical. If a member cannot find instructions in her language or only in a language with which she is somewhat familiar, then she will not be able to achieve health literacy on that subject.

Fifth, the report also encouraged using video and visual aids to communicate concepts with consumers.

Sixth, the researchers found that it was critical to provide members with multiple avenues or opportunities to receive support.

Lastly, the report pointed out that health literacy is not solely about addressing clinical conditions. Instead, it encompasses social determinants of health as well. Payers must communicate opportunities for social determinants of health support in clear, understandable language just as they should communicate on medical and general coverage issues.

“By increasing counties’ health literacy levels, the health outcomes of seniors could improve significantly,” the report said.