(Written by Susan Burris and Brandy Poiry)

The Challenge
Imagine trying to educate 45 million people on a complex subject.  Now imagine that those people have diverse literacy skills, education levels, technology access, and experience with the subject matter. They are located all across the U.S., from the farthest reaches of the Maine woods to the sandy desert border with Mexico.  Some speak English, some don’t. They have two things in common:  They are Americans,
and they are not enrolled in a healthcare plan.  This is the educational challenge created by the Affordable Care Act.

With open enrollment beginning in October 2013 and penalties starting in January 2014, uninsured Americans need education on health insurance and the changes coming in 2014.

C² is helping a large healthcare organization meet this challenge with content, tools, and a flexible, modular blended learning solution that can be used to:

• Reach uninsured Americans where they are
• Teach them enough about health insurance so they understand what they need and why
• Motivate them to make appropriate health insurance decisions

The Solution
As shown in the image below, our solution offers a flexible, multi-tiered approach to meeting the needs of three primary audiences:

• The Consumer—Uninsured Americans who need to know about changes brought about by the Affordable Care Act, including eligibility for tax credits and changing rules for coverage
• In-Person Assisters—People in the local community who facilitate enrollment for eligible consumers (some are professionals that have worked with Medicaid enrollment in the past; others are caring volunteers intent on improving the lives of people in their communities.)
• Partners—People in private and public organizations, whose mission is to ensure that consumers get the information they need to make good health insurance decisions

The information will be delivered through technology when possible, but many of the people in the consumer audience do not have access to the appropriate technology or do not like to receive information through technology. Therefore, non-technological options are also available, and the In-Person Assisters can walk consumers through the information they need.

Delivery is visually centered, starting with a graphic that tells the whole story. These graphics are designed to be culturally neutral to prevent the consumers from “identifying out” of the narrative and consequently, out of the need for health insurance or assistance. The graphics are supported with text or audio.  More in-depth content is then delivered in a variety of ways to allow each audience member to personalize the learning experience. Training components are short and discrete with reinforcements along the way. Through a series of questions, consumers are guided to options that give them just the information they need, and give it in the way that they prefer.

All of the products are interchangeable, so no matter how consumers are receiving information, they can switch to a different delivery method, if necessary, without losing continuity.

Similarly, we develop train-the-trainer materials for Assisters and Partners, which are broken into discrete topics that are customizable based on the audience’s level of knowledge and interest and the amount of time allocated for training.  The same content is available, with some modifications, in interactive computer-based training.  The ultimate focus is always on getting the required health insurance information to the consumer.

With this plentiful set of customizable products, C² is able to get the right level of health insurance information to the right people.

Beginning with the End in Mind
In developing these materials, C² has applied an alternative design perspective that begins with the end in mind.  We start by considering the needs of the end-user—the consumer, an approach that helps to determine the training required for Assisters, which in turn determines the training for Partners, who are our clients.

Only after the graphics have been constructed to tell the complete story in a culturally neutral way do we add minimal text to guide Assisters through the process of reaching consumers.  We include additional teaching and vocabulary strategies to improve this process.  Lastly, we incorporate the graphics, minimal text, and in-depth information about health insurance literacy and the Affordable Care Act for the train-the-trainer (Partner) materials.  Partners will in turn train Assisters with the skills and knowledge attained in the train-the-trainer materials.

The ultimate result is a product that has delighted our client because it will ensure that uninsured Americans get the information they need to make good health insurance decisions.