What your clients' employees don't know about their health plans hurts everyone

Health care consumers who do not have a good understanding of health plan terminology can create unnecessary costs for themselves, their employers and the economy, and may lead to less than optimal health outcomes. ^1 2  

But new approaches to help educate consumers about health plans show promise in turning around what has been a persistently low health insurance literacy rate.

We take a look at the significance of the health insurance literacy problem, its potential consequences and how employers can help people to become more knowledgeable, effective health care consumers. 

Only 12 percent of adults have proficient health literacy, according to the National Assessment of Adult Literacy. In other words, nearly 9 out of 10 adults may lack the skills needed to manage their health and prevent disease.  A UnitedHealthcare Consumer Sentiment Survey recently found what while respondents could successfully define plan premium (60 percent) and deductible (54 percent), respondents had a more difficult time defining out-of-pocket limit (34 percent) and coinsurance (24 percent). Most people (64 percent) were able to successfully define copayment.³ Overall, the recent survey results show little improvement over similar surveys, such as those by Kaiser Family Foundation⁴ and American Institutes for Research (AIR).⁵

It is not lost on your clients in the c-suite that engaging employees in their health plans may improve the health of the employee and reduces health care costs.¹⁴ That’s why a recent survey showed 87 percent of executives said that increasing employee engagement in their health plan is “very important” over the next 3 years.¹⁵

Although the intention is good, engaging employees shouldn’t be your clients’ first step. That’s because, as Beth McGuire, vice president, engagement solutions, national accounts for UnitedHealthcare said, it can be hard to engage a member with low health insurance literacy. 

“We have to help improve literacy before we can engage,” McGuire said.

Since the lack of literacy and engagement can make it harder for your clients’ employees to be effective consumers of health care, some companies are dialing back their full-replacement consumer-driven health plans (CDHPs) strategy and reintroducing preferred provider organization (PPOs), McGuire said. For example, the number of employers offering CDHPs as a sole option in 2019 will drop by 9 percentage points, from 39 percent to 30 percent, according to the 2019 Large Employers' Health Care Strategy and Plan Design survey from the National Business Group on Health^.16

Employers can do more to introduce education about health insurance literacy, McGuire said. In 2014 UnitedHealthcare introduced the Just Plain Clear® Glossary, a searchable online glossary that contains common health care and health insurance terms in clear, plain language. The site now has more than 12,000 terms, all of which have been reviewed for accuracy by appropriate experts such as physicians, nurses, psychologists, attorneys, dentists, pharmacists and others.¹⁷ The glossary is available in English, Spanish and Portuguese. UnitedHealthcare applies this trademarked reviewing methodology to help ensure all Engagement Solutions communications are easily understood.¹⁸

Other ways that “click” when introducing education materials to consumers include surveys with a few quick questions, light gamification and e-learning, McGuire said. UnitedHealthcare has found that any time a consumer interacts with information they are more likely to remember it, she said.

UnitedHealth Group recently set out to raise awareness about Health Savings Accounts (HSAs) among its own employees. The goal was to help educate UnitedHealthcare employees about how HSAs work so they can take control of their HSA dollars. UnitedHealthcare created a 15-minute video, and to entice their employees to watch and learn from it, offered a $100 contribution to the HSAs of employees who watched the video and passed a related 10-question quiz. To promote the campaign, more than 130,000 e-card, email and letters were sent out to employees.

The campaign: 

• Exceeded the participation goal, with total participation at 69.2 percent. 
• Attracted increased contributions from 3,500 employees (82 percent of employees now contribute to an HSA), adding $1.8 million in new employee HSA contributions. 
• Won 96 percent approval from those who earned an incentive, saying that they agreed or strongly agreed the video increased their HSA knowledge.

Likewise, UnitedHealthcare helped design a campaign for a major airline client to help get employees to complete an online course on HSA benefits; 67 percent of its employees completed the course, and HSA enrollment increased from 10 percent to nearly 50 percent. 

In addition, custom gamified sites allow members to choose their own health care education journey, McGuire said. In fact, gamification and competition has become one of the most common digital engagement tactics, and is now offered by 63 percent of employers.¹⁹ For a major retail client, UnitedHealthcare used gamification to allow medically enrolled members to choose their own journey based on the plan they were enrolled in as part of an effort to educate and engage employees about their health care benefits. Members who participated had a chance to win a $100 gift card for completing all 4 lessons. The result was 37.4 percent participation.²⁰

 “If we fail to help consumers become literate, the vision of empowering people to take charge of their own health and health care will fail,” McGuire said. “We need people to become more active consumers – everyone can benefit when people are more health literate.”

Visit the Engagement Solutions site to see demos and success stories of how employers can better engage employees in their health care, including helping to improve their health care literacy.  

For more information, talk with your UnitedHealthcare representative.