The Basics

The standard requires that your organization have a process to provide information to consumers that complies with certain minimum requirements:

• the information must conform to the literacy skills of the consumer (within reason);
• information must help each consumer have an understanding of the effect a healthcare decision might have on his or her daily life (e.g., information about drug/food interactions, the ramifications of non-adherence to prescribed medication);
• the information should be displayed so as to highlight important information (e.g., boldface, use of color);
• the information should be responsive to the PBM's diverse enrollment, including such factors as:
  • literacy level;
  • language differences;
  • cultural differences; and
  • and mental or physical impairment (including hearing and vision impairment)..

Management Tips

Your policy and procedure needs to provide clear guidance to your staff on how to identify consumer-specific needs and access the appropriate resources needed for clear communication across the full spectrum of consumers served by the PBM.  This may involve the development of literacy assessment tools with which you can assess the clarity of your communications.

As you address your organization's consumers' diversity, be sure to make sure you have assessed the reading level of both your print and website communications.  In addition, you should at least consider whether interpreter services for live callers is an important component of your offering.  Consider the extent to which you should translate written consumer materials they disseminate.  In addition, your communications materials should be responsive to diverse cultures, particularly as they impact issues of appropriate medication and dietary restrictions.  Finally, make sure your policies and procedures include the full array of necessary alternatives, including a TDD line, the use of braille, and any other options that are a part of your array of responses to diverse consumer needs.

URAC Accreditation Tips

The seven elements of this standard vary in weight from two to four.

For the desktop review, submit your policies and procedures, a communication plan that addresses these issues, and an example of the literacy assessment tools you use.

During the on-site review, the reviewer is likely to interview members of your staff to make sure that they have a working understanding of how these policies and procedures affect how they do their job.  In addition, employee training records dealing with cultural and literacy diversity will be examined.  The reviewer also is likely to want to see at least three examples of health information materials that demonstrate compliance with the standard.  Finally, keep handy for the reviewer your most recent literacy analysis of consumer materials.