Health Literacy Implications for Health Care Reform: Workshop Summary (2011)
Chapter: Front Matter
HEALTH LITERACY IMPLICATIONS
FOR HEALTH CARE REFORM
WORKSHOP SUMMARY
Theresa Wizemann, Rapporteur
Roundtable on Health Literacy
Board on Population Health and Public Health Practice
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This study was supported by contracts between the National Academy of Sciences and the Agency for Healthcare Research and Quality (HHSP233200900537P), Health Resources and Services Administration (HHSH25034004T), Association of Health Insurance Plans, American College of Physicians Foundation, GlaxoSmithKline, Johnson & Johnson, Kaiser Permanente, Merck and Co., Inc., and the Missouri Foundation for Health (09-0290-HL-09). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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Copyright 2011 by the National Academy of Sciences. All rights reserved.
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Suggested citation: IOM (Institute of Medicine). 2011. Health Literacy Implications for Health Care Reform: A Workshop Summary. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE ON HEALTH CARE REFORM AND HEALTH LITERACY1
ARTHUR CULBERT, President and CEO, Health Literacy Missouri
GEORGE ISHAM, Medical Director and Chief Health Officer, HealthPartners
RUTH PARKER, Professor of Medicine, Emory University School of Medicine
SUSAN PISANO, Director of Communications, America’s Health Insurance Plans
WINSTON WONG, Medical Director, Community Benefit, Disparities Improvement and Quality Initiatives, Kaiser Permanente
________________
1Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
ROUNDTABLE ON HEALTH LITERACY1
GEORGE ISHAM (Chair), Medical Director and Chief Health Officer, HealthPartners
SHARON E. BARRETT, Health Literacy Staff Consultant, Association of Clinicians for the Underserved
CINDY BRACH, Senior Health Policy Researcher, Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality
CAROLYN COCOTAS, Senior Vice President, Quality and Corporate Compliance, F.E.G.S. Health and Human Services System
ARTHUR CULBERT, President and CEO, Health Literacy Missouri
MICHAEL L. DAVIS, Senior Vice President, Human Resources, General Mills, Inc.
BENARD P. DREYER, Professor of Pediatrics, New York University School of Medicine, and Chair, American Academy of Pediatrics Health Literacy Program Advisory Committee
LEONARD EPSTEIN, Senior Advisor, Clinical Quality and Culture, Health Resources and Services
DEBBIE FRITZ, Director, Policy and Standards, Health Management Innovations Division, GlaxoSmithKline
MARTHA GRAGG, Vice President of Program, Missouri Foundation for Health
LINDA HARRIS, Team Leader, Health Communication and eHealth Team, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services
BETSY L. HUMPHREYS, Deputy Director, National Library of Medicine, National Institutes of Health
JEAN KRAUSE, Executive Vice President and CEO, American College of Physicians Foundation
MARGARET LOVELAND, Global Medical Affairs, Merck & Co., Inc.
PATRICK McGARRY, Assistant Division Director, Scientific Activities Division
RUTH PARKER, Professor of Medicine, Emory University School of Medicine
YOLANDA PARTIDA, Director, National Program Office, Hablamos Juntos, University of California, San Francisco, Fresno Center for Medical Education & Research
____________________
1Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
CLARENCE PEARSON, Consultant, Global Health Leadership and Management
SUSAN PISANO, Director of Communications, America’s Health Insurance Plans
ANDREW PLEASANT, Health Literacy and Research Director, Canyon Ranch Institute
SCOTT C. RATZAN, Vice President, Global Health, Johnson & Johnson
WILL ROSS, Associate Dean for Diversity, Associate Professor of Medicine, Washington University School of Medicine
PAUL M. SCHYVE, Senior Vice President, The Joint Commission
PATRICK WAYTE, Vice President, Marketing and Health Education, American Heart Association
WINSTON F. WONG, Medical Director, Community Benefit, Disparities Improvement and Quality Initiatives, Kaiser Permanente
Study Staff
LYLA M. HERNANDEZ, Staff Director
SUZANNE LANDI, Senior Project Assistant (until November 1, 2010)
ANGELA MARTIN, Senior Project Assistant (beginning November 1, 2010)
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
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Reviewers
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:
Robert Logan, National Library of Medicine
Rima Rudd, Harvard School of Public Health
Steven Rush, United Health Group Alliances
Paula Simpson, Center for Health Literacy
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by Hugh Tilson, University of North Carolina School of Public Health. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the rapporteur and the institution.
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Acknowledgments
The support of the sponsors of the Institute of Medicine Roundtable on Health Literacy made it possible to plan and conduct the workshop on the implications of health literacy for health care reform that this report summarizes. Sponsors from the Department of Health and Human Services are the Agency for Healthcare Research and Quality and the Health Resources and Services Administration. Non-federal sponsorship is provided by the Association of Health Insurance Plans, the American College of Physicians Foundation, GlaxoSmithKline, Johnson & Johnson, Kaiser Permanente, Merck and Co., Inc., and the Missouri Foundation for Health.
The roundtable thanks Stephen A. Somers and Roopa Mahadvan for preparing a commissioned paper that carefully and expertly analyzed ways in which health literacy could contribute to implementation of the provisions of the Patient Protection and Affordable Care Act. This paper provided a basis for the presentations of the other speakers. The roundtable also wishes to thank the workshop speakers whose excellent presentations generated lively discussion. These speakers were: Cheryl Bettigole, Harold Fallon, Frank Funderburk, Gerald K. McEvoy, Anand K. Parekh, Susan Pisano, Lee Sanders, and Sara Hudson Scholle.
The roundtable also wishes to thank the workshop planning committee members for their hard work in putting together a fascinating and stimulating agenda. Members of the workshop planning committee were: Arthur Culbert, George Isham, Ruth Parker, Susan Pisano, and Winston Wong.
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Contents
2 HEALTH LITERACY AND HEALTH CARE REFORM
Health Literacy and the Affordable Care Act
2010—The Year of Health Literacy
3 OPPORTUNITIES AND CHALLENGES FOR INDIVIDUALS UNDER THE ACA
Senior Citizens with Health Problems
4 OPPORTUNITIES AND CHALLENGES FOR THOSE IMPLEMENTING THE ACA
5 HOW CAN HEALTH LITERACY FACILITATE HEALTH CARE REFORM?
B WORKSHOP SPEAKER BIOSKETCHES
C HEALTH LITERACY IMPLICATIONS OF THE AFFORDABLE CARE ACT
D HEALTH LITERACY AND HEALTH REFORM: WHERE DO CHILDREN FIT IN?
FIGURES
3-1 Readability of CHIP forms in all 50 states
4-1 Flow chart simplifying Medicare choices
D-1 Life course perspective on health literacy
BOXES
2-1 Major Health Policy Initiatives Released in 2010
3-1 Making the ACA work for Children in Low-Literacy Families
