Friday, October 18, 2013

How to critique Open Enrollment without being a critic: that's the bind


We know the motivation of those who are using every dirty trick in the book in a futile attempt to undo the ACA.  This week they're busy highlighting the glitches in the federal HealtCare.gov portal (many of which arise when an older, underfunded IT platform is asked to do extreme heavy lifting to accommodate thousands of people each day who are enthusiastically trying to get affordable health insurance).  

But I'm not going there. 

There's another group of "critics" that shouldn't get lumped in with the bad guys. 

People like me and my colleagues.  We're trying to figure out how to critique elements of enrollment based on our research with health consumers. 


We believe in the ACA and the powerful change that can come when more people in the US have access to affordable health care. We see things that can  be done to improve consumer engagement and decision-making.  BUT we run the risk of being caste as "friendly fire" - good motivations, but deadly just the same. 

Based on years of research with patients/consumers, studying how they take in and understand information - countless patient participants in the lab telling us, showing us, what they do and don’t understand, and even being gracious enough to tell us how to do our job better - we’re bringing that empirical knowledge to our assessment of current open enrollment practices.

And so we’re commenting on the literacy, health literacy and financial literacy demands (load) of what we see.  Karen Palladino's story today in US News and World Report, “When Buying Insurance on the Exchanges, It Helps to Have Help” reports on some of the areas where we know consumers have historically had difficulties in understanding and making good choices.
       understanding health insurance terms – network, co-pay, generic…
       understanding insurance concepts – deductibles, out of pocket limits…
   health literacy skills – specifically numeracy – working with numbers
  health literacy concept – recognizing the connection between you/your family's health needs and the plan you choose…

We are spot on.
It’s smug and I hate when I find myself saying this to my bright student, but we have years of experience dissecting information and watching people trying to work with this information.  Some of us predicted and now are seeing some problems here in River City. But they're fixable problems. 


We want to point out the needed repairs because we live in a world we're “review and repair” happens every day, and all to the good. 
No successful software or app today is designed without this imperative.  And the tools that win are the product of user centered design.  That’s how your bank’s ATM and your favorite Apps, Facebook, Google Maps and Yelp all made it to the big time.

It takes careful analysis, time and money and input from experts.

So now, anyone have ideas on how to get our best information on users, health choices and health insurance to the toolmakers?