Highmark Uses AHRQ Materials in Health Literacy Outreach Program

Prevention and Care Management
May 2012

AHRQ's "Health Literacy Universal Precautions Toolkit" and "Questions Are the Answer" public education initiative have been influential in Highmark's health literacy outreach program to physicians, hospitals, and consumers.

Pittsburgh-based Highmark, one of the Nation's largest Blue Cross and Blue Shield health plans serving 4.9 million members in Pennsylvania and West Virginia, has been addressing health literacy for more than a decade. The plan has undertaken several outreach efforts, including a 2-day conference held in 2001 to increase health literacy awareness for western Pennsylvania health care providers and community agencies.

In 2008, Highmark's Health Equity & Quality Services—dedicated to reducing disparities among the health plan's increasingly diverse membership—included health literacy as part of its core health equity focus. Limited health literacy was identified as a contributing factor to health care disparities.

Health Equity & Quality Services developed a multipronged approach to improving health literacy. One prong focuses on provider outreach, educating physicians about the relationship between health literacy and outcomes. Another targets Highmark's own staff, with a focus on improving the plan's communications with its members. A third, inspired by AHRQ's "Questions Are the Answer" campaign, encourages consumers to ask questions if they don't understand instructions or information from their providers.

The health plan's provider Web site features AHRQ's "Health Literacy Universal Precautions Toolkit," which is supplemented by a training module that summarizes the toolkit and offers guidance on getting started with one tool. The training module includes 13 slides that can be completed in 5 to 7 minutes, a concise summary for busy doctors. The provider Web site also features a downloadable health literacy brochure, a resource guide, a checklist, and other tools—including promoting the "Questions Are the Answer" campaign to encourage patients to seek more information about and fully understand their care. The health literacy section on its Web site also links to AHRQ's Web site.

Additionally, Highmark supported the local Aligning Forces for Quality Physician Clinician Learning Network by hosting a physician training program conducted by Darren DeWalt, MD, MPH, who led development of the AHRQ toolkit. Under the Aligning Forces initiative, DeWalt, assistant professor of general internal medicine at the University of North Carolina at Chapel Hill School of Medicine, led six monthly training sessions to teach five practices (comprising approximately 15 physicians and residents) on how to use tools from the toolkit. The participating practices shared best practices at the end of the program and plan to continue using the tools.

Highmark is working to increase awareness of health literacy and usage of its health literacy resources. Nearly 300 Highmark staff and network providers have received health literacy training via online resources, live programs, and presentations. Additional information about Highmark's health literacy outreach is available in its Provider Resource Center.

More information about AHRQ's "Health Literacy Universal Precautions Toolkit", and information about "Questions Are the Answer".

Impact Case Study Identifier: 
AHRQ Product(s): Health Literacy Universal Precautions Toolkit, Questions Are the Answer Public Service Campaign
Topics(s): Health Literacy
Geographic Location: Pennsylvania, West Virginia
Implementer: Highmark, Inc.
Date: 05/01/2012
Page last reviewed October 2014
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