Sweeping reforms to the US health care system now require consumers to understand complex health plans, become more aware of the costs of their care, and make related decisions independently. This presents a challenge for all health care consumers; the new demands are especially daunting for those who do not speak English.
In June 2015, the New York Community Trust (the Trust) awarded a grant to FAIR Health—an independent, national, nonprofit organization that offers consumer engagement tools powered by its vast database of health insurance claims—to develop, promote, and distribute a Spanish-language mobile phone app to help New York City’s Latinos become more engaged and better informed health care consumers. The newly released app, FH®CCSalud (Calculadora de Costa Salud), provides information in Spanish about how health insurance coverage works and enables users to look up quickly and easily the costs of thousands of medical and dental procedures by geographic area. (Consumers anywhere can download the free app at iTunes or Google Play.)
Convenient Access to Information in Users’ Preferred Format
Providing Spanish-language health care literacy and cost transparency tools in a mobile app is a particularly effective approach. According to a 2015 Pew report, Latinos rely on mobile technology as an information source more than the overall population.
When looking up the typical costs of procedures in a specific geographic area, users are also given educational guides and glossaries that contextualize the price information. Perhaps most important, the app makes that information available to users where and when it is needed. The price information available through FH CCSalud helps consumers discuss expenses with their doctors and decide whether to go in-network or out-of-network for care. The app also is helpful when people are enrolling in a health plan, and it supports appeals of claim denials.
Serving Latinos in New York City
While the app provides health care cost information for communities throughout the United States, the Trust funds FAIR Health’s distribution efforts for the app in New York City, where this community foundation’s Health and People with Special Needs Program aims to improve health care systems, policy, and services.
Hispanics/Latinos make up nearly 30 percent of New York City’s population. And the percentage (31 percent) of uninsured Hispanic adults was more than twice the percentage (12 percent) for White adults, according to a 2012 survey. Few culturally sensitive resources in Spanish are available to help Latino consumers navigate the health care system. Spanish-language resources designed for the uninsured or newly insured are particularly scarce. Without information on insurance and costs available in their primary language, many Latinos face challenges in making informed and prudent decisions about selecting a plan and managing benefits and expenses once enrolled.
For example, a 2015 FAIR Health study conducted with Opinion Research Corporation revealed that Latinos were nearly twice as likely as the general population to say that they would rely on the emergency department (ED) for nonemergent care. Use of the ED for routine care can lead to greater out-of-pocket expenses for consumers and potentially deprive them of the guidance of a primary care physician. Improved health care literacy has been shown to be an effective strategy to combat this challenge.
Spreading the Word
To help ensure the acceptance and use of FH CCSalud, FAIR Health’s dissemination strategy includes outreach to Latinos from diverse countries of origin through community organizations and events and through social media and digital campaigns. FAIR Health also is working with community members and health care navigators who help people use New York State’s (state-based) health insurance exchange, the New York State of Health.
Making a Big Impact with Big Data
The Trust awarded the grant to FAIR Health in recognition of the organization’s experience developing consumer information and tools, including mobile apps, to bring its robust data and educational materials to individuals. FH CCSalud is driven by FAIR Health’s proprietary database, which includes more than 19 billion billed claims for medical and dental procedures, including more than 1 billion claims from New York State alone. FAIR Health’s pricing data will be updated on FH CCSalud twice yearly to keep pace with changes in the insurance market. FAIR Health’s consumer website, available in English and Spanish, and its English-language consumer app also use the organization’s comprehensive claims data.
By building upon popular mobile technology, FH CCSalud can help create a sustainable impact on health insurance literacy and health care engagement among Latino community members, thereby helping to reduce the disparities in health care access and enrollment in New York City.