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Why Healthcare Jargon Hurts Patient Experience

A young boy looks very confused!

Are Americans illiterate when it comes to healthcare jargon? According to a consumer survey by Policy Genius, the answer is yes. But are the patients to blame, or is the healthcare industry itself?

Patients Don’t Understand Healthcare Jargon

Policy Genius surveyed 2,000 Americans, and asked them a seemingly simple question: Can you define four basic health insurance terms? The four terms were: deductible, co-insurance, co-pay and out-of-pocket maximum.

A healthy 83% of respondents were confident that they “definitely understand” what a co-pay is, maybe because they have to physically reach in their wallet and hand money to a receptionist. This compared to 74% who were confident that they “definitely understand” what a deductible is; 67% who said they knew what out-of-pocket maximum means; and just 47% who claimed to understand co-insurance.

But here’s the rub: The percentage of people who could actually recite the correct definition was just 52% for co-pay, 50% for deductible, 42% for out-of-pocket maximum and 22% for co-insurance. Worse, only 4% of Americans could correctly define all four terms.

What’s remarkable is that these are not uncommon terms. In fact, they represent some of the main functioning aspects of any health insurance plan. Consumers were likely confident about the words because they recognize them from the inappropriately-named document called the “Explanation of Benefits” – inappropriate because it rarely provides a satisfactory explanation, and that explanation is many times not to the patient’s benefit.

Related: Why Language Is Critical In Customer Experience

The industry gibberish doesn’t stop there, with lists of drugs being called “formularies” and Medicare having Parts A, B, and D but not C. .

Terms like “out-of-pocket maximum” are almost intentionally misleading; it sounds like the amount of money a patient has to reach into his or her pocket in order to pay for healthcare, but that definition contains a major asterisk (lawyer-speak for “but there’s fine print.”) That definition is right, asterisk, as long as the doctors that you are visiting are always in your network.  If you go out of network, your “out-of-pocket maximum” is usually much higher, and the in-network and out-of-network amounts are not combined. Confused yet?

Even more remarkable than the existence of all these confusing terms, though, is that the Policy Genius survey is several years old and healthcare companies are still using the same language – even though they know consumers don’t understand it.

Stop Blaming The Regulations

As is the case with many facets of the patient experience, lawyers and regulations often shoulder the blame. But is this fair?

Yes, regulations are lengthy and confusing, and yes, the healthcare rules and regulations often use the same confusing industry jargon. And often, well-intentioned legislation mandates so much of the solution that marketers and patient experience professionals are left without much leeway for innovation.

But companies also hide behind legislation, with answers like “Well, legally we have to do it.”

Even if insurance companies were required by law to use the word coinsurance, which only 22% of Americans understand, couldn’t they also define the term for the customer? Some companies have figured out how to turn legal disclosure into an experience. For example, instead of starting a paragraph of legalese with the word “Disclaimer,” they might say something like, “A Word From Our Lawyers” and then try to “translate” the legalese into simple language.

In its Twitter profile, Network Health Wisconsin says: “Health insurance causes people stress. That’s beyond ironic. Network Health is determined to fix that. At Network Health, we do what’s right, even when it isn’t easy.” On a section of its website called “We Speak Your Language,” the company says that “When you call Network Health, you won’t be overwhelmed by health insurance language. We talk like people, not insurance dictionaries.”

It’s Not Just Healthcare

This phenomenon isn’t limited to the healthcare industry. Companies in all industries should look at their own contracts and other legal documents to see if the language can be simplified so it is more likely to be understood. Is it something that is so clear and so easily understood that a fifth grader could read and understand very clearly what is being expected, what is being promised and what is going to be delivered?

What are the jargon words in your industry? Every industry has them. They might be difficult, archaic, hard-to-understand words. They might be acronyms that everyone in your office building knows but no customer knows.

If you can, stop using these words and start using words that your customers understand. If not, make sure you find a way to translate these words into simpler language for your customers.

Because when they understand what you’re trying to communicate, you’re both achieving the initial goal of the legalese – communicating important information – and building trust with your customers because you’re speaking their language.

Related: Why The Healthcare System Is Failing Seniors and Digital Enhancements To Healthcare Improve Patient Experience

Image by Dwi Rizki Tirtasujana from Pixabay

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