Numeracy Requirements for Health Insurance Enrollment

Ellen Peters gave an introduction to numeracy. She also discussed how numeracy is relevant to the Affordable Care Act (ACA). Numbers instruct, inform, and give meaning to information about health plans, medicines, and treatments, Peters said.

But not all people can understand and use numbers effectively. Even highly educated people can be innumerate, she said. Less numerate people are more likely to be female, older, less educated, and poor. Plus, they are less likely to have health insurance, Peters said. Thus, the average numeracy skills in the ACA population will be lower than those of currently insured consumers. The newly insured will also have less knowledge and experience in healthcare settings, Peters said. “They may not know as well how to be a good patient — how to interact with doctors and nurses, how to record symptoms.”

Peters talked about numeracy skills that we learn in school. She also listed numeracy skills that we use to make decisions. We use these skills when we:

• Seek information
• Pay attention to numeric information
• Ignore irrelevant information
• Recall numeric information
• Are sensitive to numeric information
• Derive affective meaning from numeric information

Peters gave some examples of using numeracy. “Healthcare providers often underestimate how difficult these tasks are. And patients are often reluctant to admit that they don’t understand,” she said.

The way information is presented can reduce numeracy differences, Peters said. She offered strategies for providers to communicate with less numerate people:

• Provide numeric information. “Numbers help whether you’re more numerate or less numerate,” she said.
• Do the math for people.
• Provide evaluative meaning, particularly when numeric information is unfamiliar. “If people don’t know how good or bad the number is, they’re not able to use the information,” Peters said. But take care when providing evaluative meaning, because it’s a big responsibility.
• Draw attention to important information.
• Set up appropriate systems to assist consumers and patients.