If you’ve ever found your head spinning when the paperwork arrives in the mail after a trip to the doctor or hospital, you’re not alone. Scores of surveys show that many Americans don’t understand key health insurance terms, such as copays, cost sharing, deductibles and networks.

Since 1998, the Center for Plain Language, a nonprofit based in Washington, D.C., has worked to help government, corporations and nonprofits write more clearly.

Last month, UnitedHealthcare brought home one of the organization’s ClearMark Awards, dubbed the Oscars for paperwork, for its “Happiness Counts” kit. The brightly colored kit includes daily journals, postcards and other information to help seniors take actions and create a stronger mind-set for staying upbeat even in the face of illness.

The kit is part of a larger push across the nation’s largest insurance company to simplify language, an effort championed by Chief Marketing Officer Terry Clark when he joined United­Healthcare in 2006.


Q: Tell me about the “Happiness Counts” kit that won the award.

A: This is based on a lot of work we’re doing in our Medicare business. Older adults are often dealing with multiple chronic conditions and advanced health issues, and they’re engaging in the health system in a very different way than when they were 35 years old or 18. We wanted to focus on the impact of happiness on one’s health. You aren’t going to cure everything by making someone smile. But we know there’s a difference in how you take on adversity and embrace life when you have the right attitude and approach. So the kit was a way to help people facilitate that — encouraging our members to smile more, engage with loved ones, show appreciation. We designed the kit around simple, plain language and iconography that really works. When someone picks up something from us, it shouldn’t take a big effort to figure out what they’re supposed to do.


Q: Health care is full of lingo, mounds of paperwork and confusing terms. What is UnitedHealthcare doing to help explain it for members?

A: The “Happiness Counts” kit is at the heart of a broader effort to drive complexity out of the system through an initiative we call Just Plain Clear. Just Plain Clear spans across everything we do and says, “How can we simplify the way we engage with consumers? How can we look at the design standards we put in place, the language we use?” We’ve created a “blue book” as an evolving set of standards. Whether a letter comes from our operations group or whether it comes through our marketing team, we’re trying to put a lens on what’s best for the consumer. It has also led to some great innovation here.


Q: Such as?

A: Our team developed this very cool tool last year called Doc Scrub — document scrub. It allows us to take letters and other printed materials and scrips for our customer service agents, and run them through a document scrub that scores the piece based on health literacy levels and suggests ways to make it better. The goal is to use real, understandable words instead of jargon. Our Just Plain Clear glossary has 2,200 words in it. Maybe we’re always using the word “provider” but we should be using “doctor,” for example. We’ve seen that have a dramatic impact on the way we think and develop content and measure it.


Q: When did the Just Plain Clear initiative start?

A: About five years ago, as a way to improve our marketing and communications. But the reality is, our organization touches members and the marketplace in so many different ways — whether it’s operations, clinical, all the different parts of our business. So, for example, the explanation of benefits: People get those on a monthly basis, [but] do they understand what they should do with them?


Q: How does that work in practice?

A: We have embedded resources in operations and in clinical and we have champions across the organization. We train people to be certified in health literacy and our Just Plain Clear principles. This includes call center reps in our Medicare business, all of our marketing and operations people, and even our outside agencies to ensure they’re designing our communications with an understanding of the unique needs of the populations we serve. It’s not just, “oh this looks pretty.” It really means someone now can understand it better and they can take action upon it.


Q: How is using clear language a good business strategy?

A: Health literacy is a strong predictor of health and health outcomes, so we think that giving it focus and attention will help us to be a better organization as a whole. With more decisions being put in hands of consumers, it’s more and more important for us to drive a new way to engage with them that’s very focused on simplification. There are challenges. There are regulated ways you have to do things and boilerplate language. But I believe if we’re the simplest insurance company to do business with, that’s a distinct advantage.