Americans Still Struggling With Health Care Literacy, Survey Finds

A new report, 2021 Consumer Report: All Eyes on Health Care – But Not Enough on Health Care Literacy, revealed that 55% of consumers don't know that they can compare treatment or service costs before choosing where to get care, highlighting the importance of personalized benefits education and health care transparency ahead of next year's transparency regulations.

The COVID-19 pandemic has led to more people paying close attention to health care, but many still lack the knowledge required to make informed choices about their health plan and care. According to DirectPath's new report, almost one-third (31%) of employees know they have received an inaccurate medical bill in the last three years, yet 52% say they don't know how to dispute or fix a medical bill.

According to the Kaiser Family Foundation, almost half of Americans receive their health insurance through employer coverage. Yet, the DirectPath survey reveals that only more than one-third (37%) take advantage of the available employer resources to learn how to choose and use their health plans.

Instead, many people turn to family (24%) and friends (14%), or self-conducted Internet research (34%) to help inform their plan choices. Turning to these outside sources can be problematic, as most are unfamiliar with the employer's plans or the employee's individual needs—and can be factually inaccurate.

COVID-19 changed the way employees accessed information about their benefits, with 34% taking advantage of online resources to learn more about their coverage. This corresponds with a slight decrease in the use of more traditional materials, with 27% using their employer's HR presentations compared to 33% in 2020, and 29% using printed materials versus 41% in 2020.

Receiving Care: When and Where
Not only did the pandemic change the way consumers received information about their care, but it also changed the way they sought care. Nearly one-quarter (24%) of consumers reported cancelling or postponing all health care appointments, while 23% reported skipping all preventive care appointments – only seeking care when they were sick. Encouragingly, employees showcased their willingness to explore new ways of receiving care as more than one-third (36%) of consumers reported using telemedicine for the first time, compared to 22% who used it previously.

These shifts in the way care and information about care is delivered should raise questions for employees regarding how they choose and use their benefits. While 28% of employees report their employer offers the opportunity for confidential one-on-one conversations with HR representatives, and 16% offer conversations with benefits experts, few employees take advantage of the offering when it is available. Just 19% report taking advantage of a conversation with an HR representative and 10% report talking with benefits educators. Reassuringly, over 80% of employees that did take advantage of one-on-one conversations found them to be very or extremely helpful.

Knowledge gaps in health insurance literacy – the degree to which individuals have the knowledge, ability and confidence to evaluate, choose and use their health plan – is a root cause of many poor health care decisions which lead to lower quality care and higher costs. For example:

• Only 23% of survey respondents report taking advantage of cost-comparison solutions offered by their health care carrier.
• 57% report they only check if a provider is in-network when they plan to visit a new provider or facility, and 25% only do so when their health plan changes.
• Of the respondents who were aware that they received an inaccurate medical bill within the past three years, an alarming 7% admitted they knowingly received an inaccurate medical bill and did nothing about it – with 52% of those people failing to take action because they didn't know they could.

"Despite the COVID-19 pandemic drawing attention to health and health care more than ever before, employees still do not understand what they can do to get the most from their plans and to manage their costs. For something that touches not only consumers' personal health, but also their financial well-being, most are woefully unprepared to take control," said Kim Buckey, vice president of client services at DirectPath. "Providing individualized support is critical to 'making it real' for employees, so they can learn to improve health care decision making and health plan use.

"While this survey shows some progress in employee understanding of how their plans work, too many still don't grasp why – or how – they should learn to use their plans. Increased one-on-one benefits education and more transparency in the health care industry are critical to ensuring employees are able to choose and use their plans effectively."

For more information about the health care literacy gap, download the DirectPath report.

Methodology
DirectPath conducted an online survey of more than 1,050 U.S. based people with employer-sponsored insurance (excluding those who work in the insurance industry). The survey closed in July 2021.