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HCPF trainer urges plain-language writing to make Medicaid notices clearer for members
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Summary
Michelle Adams, HCPFsenior health literacy specialist, told a TSAC training that identifying audience and purpose, consumer testing and removing unnecessary legalese make member correspondence easier to understand and reduce missed deadlines and anxiety.
Michelle Adams, the senior health literacy specialist at the Colorado Department of Health Care Policy & Financing (HCPF), told attendees at a TSAC virtual training that clear, plain-language member communications are essential to prevent confusion and to meet legal requirements.
"Simplicity is the ultimate sophistication," Adams said during the training, adding that "it's our job to be understandable, and it's literally required in state statute." She reviewed why audience and purpose should drive every communication and recommended consumer testing and iterative editing instead of relying on automated reading-level scores.
Adams said members often react to dense or conflicting letters with fear, anxiety or anger and may put correspondence aside, which can cause missed deadlines. She described feedback from the Member Experience Advisory Council (MEAC), which repeatedly reported that members receive contradictory or duplicative letters and sometimes assume they lost coverage when a letter denied only a specific request.
To illustrate, Adams showed a before-and-after rewrite of a notice about appeals: the original legal phrasing was rewritten as direct, active-language items such as "If you disagree with our decision, you may appeal it" and "You must file your appeal within 30 days of the date of this letter." She also presented an example where a long legal paragraph about filing civil-rights complaints was shortened to a single clear instruction: "If you think your civil rights have been violated, you can file a complaint online."
Adams cautioned against relying on grade-level calculators (Flesch, Gunning Fog, ARI) because they count syllables and sentence length rather than testing comprehension. She said those tools can give inconsistent results and that layout, design, and consumer testing are more useful measures of whether a communication will be understood.
She walked through practical layout and wording suggestions: front-load calls to action, use bullets and white space, prefer bold to italics for emphasis, employ familiar words (avoid idioms), keep font sizes legible, and use one consistent term for a concept across a document. Adams emphasized active voice, short sentences and clear pronoun antecedents.
Adams noted state-level requirements and audits: she said HCPF has had two audits of member correspondence and that the agency recently formed a member communications team to improve compliance and readability. "We've had two audits ... the results were not good," she said, adding that the new team aims to accelerate improvements.
The presentation included several program-specific examples (such as CES descriptions and a letter about benefits denials) that Adams revised on-screen to show how much of the original language could be removed without losing legal effect. She invited attendees to email materials for review and said training slides and the recording will be posted on the TSAC/HCPF site.
Adams' claims about literacy and dyslexia (she said a high proportion of low-literacy readers are likely dyslexic) were presented as examples of why accessible formatting and plain phrasing matter; those statements were characterizations made by the presenter rather than independent findings shown in the session.
The session closed with thanks from attendees and an offer of follow-up consultations and trainings from the HCPF member communications team.
