Approximately 36% of U.S. adults have low health literacy, which means they have difficulty understanding, accessing, and utilizing the information and services they need to make informed decisions about their health.

As a health literate health care organization, The Cigna Group has established a culture, practices, policies, and systems that equip our customers, patients, and clients so they may understand and act upon health information to improve their vitality. We also believe that improving personal health literacy is a key strategy to achieving health equity. When individuals have a better understanding of their personal health and how to navigate the health care system, they are more likely to engage in healthy behaviors and to manage their health conditions more effectively, which helps reduce health disparities and enhance well-being. Research from the Evernorth Research Institute shows that higher health insurance literacy is associated with higher vitality, which helps individuals, families, and communities thrive.

However, even people with high health literacy may struggle to understand medical jargon or unfamiliar terminology. “Regardless of their level of education, all of our customers are counting on us to be clear and to help them understand our health care system,” said Brian Wilson (left), director of Medicare customer marketing at Cigna Healthcare. Wilson stressed that the use of plain language is critical to empowering people to make better health care decisions.

Wilson recently moderated an executive roundtable discussion with five leaders from The Cigna Group during the organization’s Plain Language Week. The discussion focused on the importance of plain language in the advancement of patient care and health equity.

Plain language is key to building patient trust 

Crystal Duran (right), a clinical program senior advisor specializing in health equity with The Cigna Group, highlighted the importance of culturally-responsive communication, including plain language, in breaking down the mistrust that has long been present in the health care system. “If people don’t understand what we’re trying to explain and why it’s important to them, especially the suggested action steps they should take, they can’t trust us,” she said.

“The ability to clearly explain how and where to access care, how coverage works, and the benefits of using network providers is vital,” Duran said. “It enables customer service agents, health coaches, case managers, marketing, and others involved in the patient care journey to become trusted sources of information. That trust is key to building strong patient connections that can make a significant difference in care outcomes”.

For the past 18 years, Duran and the Health Equity team have been committed to promoting plain language, a foundational ingredient in achieving health equity across The Cigna Group and with network clinicians. Their strong collaboration with Marketing, the Enterprise Clinical Health Organization, Care Solutions, Pharmacy, and other departments across the organization has led to the creation of learning modules, practices, and policies to simplify health care nomenclature while recognizing the cultural nuances of different languages to make the care experience relevant and easier to understand. These policies include evaluating health education and other customer and patient communications from within the business and from external vendors to ensure the communications are clear and culturally responsive. In addition, our extensive Language Service Governance model addresses multi-lingual and accessibility needs and ensures contracted vendors follow plain language guidelines.

Simplicity makes the complexities of health care easier to understand

Clear communications can help simplify complex health care information, such as the details of specialty pharmacy services. Regina Jones (left), vice president of Evernorth pharmacy operations, emphasized the importance of breaking down the complexities of specialty pharmacy care into simpler terms, which helps “make the process real” for everyone. “It truly adds clarity on how we can help patients get the drugs they need to their front door and in their medicine cabinet,” she said.

Jones explained the ways Evernorth’s Accredo specialty pharmacy partners with prescribing physicians to clearly communicate to their patients how to manage their medications and regimens with simple instructions and walkthroughs. For patients with more complex specialty treatments, Accredo’s field nurses visit patients in their homes to administer certain infused medications and otherwise assist with care. These nurses are trained to use plain language to explain every step of the treatment to patients as well as answer any patient questions during the visit.

Medical treatments continue to become more complex and navigating the health care system is a challenge for many, said Dr. Alla Zilbering (right), a Medicare Advantage national medical director for health equity at Cigna Healthcare. “Doctors are expected to communicate the information that they have in a way that their patients understand,” she said. “As a health benefits provider, we have an additional responsibility: to make the health care experience simpler and more accessible for our customers.”

Dr. Zilbering added that using plain language is especially important when customers are struggling with health inequities. “These individuals might not feel empowered to ask for help, or they might be embarrassed about lacking resources or not understanding the information being shared,” she said.

Finding ways to meet these customer’s basic needs, such as food and housing, and connect them directly to community resources that can help, instead of merely providing instructions on how to do so, is also important. “This strengthens our relationship with a population that tends to be at their most vulnerable,” Zilbering said.

Using clarity to advance health equity

Jen Roche (left), senior director of enterprise marketing for The Cigna Group, highlighted that health literacy is a crucial driver in combating health equity issues. “We know that the health care system is complex, and helping people understand the who, what, when, where, and why of that system is the first step to empowering them,” she said.

Roche’s team owns and maintains the clear communications policy and terminology guidelines for The Cigna Group. Her team also develops and provides ongoing plain language training across the enterprise. Helping customers understand their health information and how to navigate the health care system will ultimately improve their individual health and vitality, Roche said.

Roche also discussed The Cigna Group’s “each&every” campaign, which highlights the company’s focus on health equity and shares the ways the company is working in partnership with community stakeholders to close health disparity gaps. She noted that the campaign has seen a 78% increase in viewer engagement since its launch six months ago.

Nico Thom (right), health equity advisor for Cigna Healthcare’s Medicare Advantage business, added that plain language is crucial not only for improving customer understanding but also ensuring alignment with the Centers for Medicare and Medicaid Services’ (CMS) vision for health literacy. She referred to the health equity framework by CMS, which outlines key priority areas for the next 10 years. “CMS has released final regulations directly tied to those priority areas, including advancing health literacy,” Thom said, noting that her team is at the forefront of ensuring compliance with those regulations. “We’re excited that CMS is promoting the use of clear and more accessible communication materials for Medicare beneficiaries, and we’re working to be ready for future rulings,” she said.

Although The Cigna Group has made significant progress, considerable work to advance health equity remains. “We are elevating the conversation with the ‘each&every’ campaign, but we have much work to do at both Cigna Healthcare and Evernorth to keep that conversation going,” Roche said.

Some quotes in this article have been edited for brevity and clarity.