The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71959

James T. Nguyen¹, Ed Mendoza, MPH², Mona Desai, MPH¹, Katherine Simpson, MA¹, Shelley Martin, MPH, CHES¹, and Lacy Clayton, MA¹. (1) School of Public Health Center for Community Wellness, University of California, Berkeley, 2140 Shattuck Avenue, 10th Floor, Berkeley, CA 94704-1210, 510-643-0016, JTNguyen@uclink.berkeley.edu, (2) California Office of the Patient Advocate, 980 9th Street, Suite 500, Sacramento, CA 95814

In 1999, California's governor and legislature passed the nation's most comprehensive HMO reform initiative, which established the Office of the Patient Advocate (OPA). OPA is the only state office of its kind in the nation. Its mission is to educate nearly 20 million HMO enrollees about their rights and responsibilities as members. In a collaborative effort, OPA and the University of California, Berkeley, Center for Community Wellness (UCB) developed California's HMO Guide and La Guía de los Planes de Salud HMO de California (Spanish version). This first-ever statewide resource guide for HMO members was created to help consumers use their health plan more effectively.

The complexity of California's managed care system posed unique health literacy challenges. The project used a participatory approach, involving managed care organizations, consumer advocacy groups, and HMO enrollees in the guide's development, distribution, and evaluation. A series of focus groups in English and Spanish played a major role in both the design and content. This approach identified topics relevant to HMO consumers and societal and environmental factors that impact access to quality health services. The guide includes tips on dealing with common problems and phone numbers and websites for additional assistance and information. It also uses photographs, an eighth-grade reading level, and design elements to enhance health literacy. A qualitative evaluation, conducted by UCB, indicates that consumers found the guide informative, easy-to-use, and empowering, particularly among seniors and Spanish-speakers.

Learning Objectives:

• Describe the statewide partnership to educate HMO consumers about their rights and responsibilities;
• Explain the participatory approach used in developing California's HMO Guide; and
• Identify the successes, challenges, and recommendations to improve this health literacy and consumer education campaign

Keywords: HMOs, Health Care Managed Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: California Office of the Patient Advocate and University of California, Berkeley, Center for Community Wellness
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.