Healthcare Webinar How to be compliant and engaging with your member communications. Ensure even the most legal content is customer experience-driven. With guest speaker Prof. Christopher R. Trudeau, JD.
01. Introductions 02. Key findings of the 2019 Health Insurance Report AGENDA 03. Prof. Christopher R. Trudeau, JD - Connecting while complying: Why clear communication is vital in healthcare 04. Q & A
WEBINARHOUSEKEEPING • Our call will last approx. 1 hour. • Please ask your questions in the ‘Question’ facility. ˇ ˇ • We have a Q&A session at the end. • Please complete the survey at the end of the session. • The recording will be shared a few days after this webinar . Evelyn Wolf CMO @ VisibleThread Evelyn.wolf@visiblethread.com
MEET OUR GUEST SPEAKER Prof. Christopher R. Trudeau, JD Christopher R. Trudeau, JD, is an Associate Professor at the University of Arkansas Little Rock, Bowen School of Law. He also leads the Regulatory Knowledge & Support function for the University of Arkansas for Medical Sciences’ Translational Research Institute. Professor Trudeau is a recognized expert on clear legal communication, informed consent, and health literacy. He is the first lawyer to be appointed to the US National Academies’ Roundtable on Health Literacy and the Food & Drug Administration’s Risk Communication Advisory Committee. He frequently speaks on creating clear legal documents that people can understand on reducing organizational risk and while increasing compliance. He is also the author of the first U.S. study to focus on the public’s perception of legal communication. In 2018, he published a follow-up study with an international focus. Both of those studies can be found here: The Public Speaks: An Empirical Study of Legal Communication The Public Speaks, Again: An International Study of Legal Communication
2019 HEALTH INSURANCE REPORT Key Findings
2019 HEALTH INSURANCE REPORT • Medicare Focus • When it comes to Medicare, do the top insurers communicate clearly? • 30 of the leading U.S. health insurers • Medicare documents available online, often PDFs • More than 169,000 words
ONE KEY FINDING 86.6% of insurers surveyed are not communicating with their target audience The National Center for Education measured ˇ health literacy in 2003. They found that 51% of ˇ adults aged 65-75 have a basic or below basic health literacy level. We recommend a reading grade level of 6 for this age bracket to ensure everyone can easily digest information.
KEY FINDING TWO Complex Simple Only 6 out of 30 insurers have an accrue add, gain acceptable complex word density advantageous helpful We recommend a level of complex heretofore until now language of 1 or lower. is in consonance with agrees with, follows pertaining to about, of, on Complexity Example: remainder rest The patient is required to notify us. therefore so VS The patient needs to tell us. validate confirm VS You need to tell us. https://plainlanguage.gov/guidelines/words/use-simple-words-phrases/
KEY FINDING THREE 1/3 of insurance companies communicate in academic tone ˇ ˇ Passive voice levels should be at 4% or lower.
FOUR KEY FINDING Health insurers use 2x the recommended level of long sentences. Firms should aim for 5% long sentence use or less. Our research reveals and average score of 9.98% ˇ ˇ If you choose Original Medicare, you can You can purchase Medicare Supplemental purchase Medicare Supplemental Insurance Insurance plans with Original Medicare. These plans — also called Medigap plans — to help plans are also called Medigap. They will help you pay for care not covered by Parts A and B . you pay for care not covered by Parts A and B. 1 Sentence – 31 Words, 15.5 Grade Level 3 Sentences – Grade level of 7.6
KEY FINDING FIVE 2/3 of insurers produce content more difficult to read than Moby Dick ˇ ˇ
Connecting while complying: why clear communication is vital in healthcare Ch Chris Trudea eau, JD JD Associate Professor of Law, University of Arkansas, Little Rock, Bowen School of Law; University of Arkansas for Medical Sciences, Translational Research Institute Twitter: @proftrudeau
I have no other relevant financial interests to disclose My opinions are not legal advice & not necessarily those of these organizations
Selling you Telling you V. something something
Wh What I’ I’ll ll talk alk ab about today The importance of HL The business & regulatory case for integrating HL Tips to get started
Th The i impor ortance of c of clear, h health- lit literate communic unicatio tion
Which of the following is the best predictor of an individual’s health status? a. Age b. Income c. Race/ethnicity d. Education Level e. Literacy Skills 75% of patients who reported being in poor health also tested in the below-basic HL category Source: Weiss BD. Health Literacy: A Manual for Clinicians. American Medical Association / American Medical Association Foundation, 2003. p. 7.
US US a adults a and h health l literacy cy 14% Below Basic: Identify how often to have a medical test, based on info in clearly written pamphlet 22% Basic : Give 2 reasons a person with no symptoms of a specific disease should be tested for the disease 53% Intermediate: Find the age range for child to receive a vaccine, using a chart 12% Proficient: Find information to define a medical term by searching through a complex document
Literacy cy Levels among US Adults
US State of Arkansas: Health Literacy by County
We know people struggle with forms In one of the largest studies conducted on health literacy, researchers using patients from two public hospitals found that: 86% of people did not understand the rights and responsibilities section of a Medicaid Application 60% of people did not understand a standard informed consent form Source: http://www.ncbi.nlm.nih.gov/pubmed/7474271
Advanced Directives = the ultimate informed consent An anecdote from a patient of Dr. Rebecca Sudore at UCSF:
Th The busin iness & le legal al cas ase for health literacy cy
Hap Happy Patien ients, Healt Healthy Mar argin ins (Accenture study) “A superior customer experience doesn’t just strengthen patient engagement — it also correlates to 50 percent higher hospital margins.” “[A] hospital system earning $2B in revenue would have to cut 460 jobs (assuming a loaded salary of $100K) to achieve the same 2.3 percent margin benefit that improving the consumer experience might bring through revenue growth.” https://www.accenture.com/t20151003T033201__w__/us-en/_acnmedia/Accenture/Conversion- Assets/DotCom/Documents/Global/PDF/Industries_17/Accenture-Happy-Patients-Healthy-Margins.pdf
The SCAN Foundatio Th ion Report on Patie ient- Ce Centered Ca Care ( (June 2 2016) “For the person receiving care, PCC results in a greater sense of empowerment, a focus on wellness and quality of life, and a better care experience. There is also evidence that it improves the job satisfaction of health care providers, who enjoy connecting meaningfully with patients and working as a team.” “[For older adults], Medicare pays the hospital a certain amount for a hospitalization based on the person’s diagnosis, regardless of length of stay. . . . [W]hen the PCC program shortens stays, the hospital receives the same compensation but has lower costs and it realizes a return on its investment in PCC.” http://www.thescanfoundation.org/person-centered-care-todays-health-care- environment-business-case-stronger-ever-issue-brief
If If you could save e $15 per er call, would you? “Everytime someone calls us, it costs $15, at it takes time out of the caller’s day.” – Chris Carlson, VP at United Health At $15 per call, United Health had a clear incentive to focus on clear communication with its customers. One useful resource for everyone: • Just Plain Clear Glossary - https://www.justplainclear.com/en Chris Carlson, p. 51-52 https://www.nap.edu/download/25068
La Laws, regu egulations, & accr ccrediting standards encourage integrating cl clear co communica cation
Many government healthcare agencies care about improving understanding: Strategic Goal #1 from US HHS’s Strategic Plan: “Engage individuals and families as partners in their care by incorporating patient and caregiver preferences; using clear and productive communication strategies; improving the experience of care for patients, caregivers, and families; integrating health literacy principles; and promoting patient self- management.”
US US CM CMS’s Co Conditions o of P Partici cipation ( (tag C C-0320) 0320) s says t this ab about patien ient under erstan andin ing of f consen ent: “Informed consent requires that a patient have a full understanding of that to which he or she has consented. An authorization from a patient who does not understand what he/she is consenting to is not informed consent.” Ctr. for Medicare & Medicaid Serv., State Operations Manual, Appendix W, at C-0320 (2015).
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