Health Care and Consumer Confusion

There is some consumer confusion in the market place today about certain medical treatments, cost control, and health plans and how they work. Much of it relates to sourcing accurate information related to pricing and transparency. Health care information blog Health Populi has recently stated that consumers are interested in a variety of financial instruments to help them purchase health care. However, even when given a choice to shop for and eventual purchase insurance, millions of people don't. And, consumers are confused about health plan choices and need help in financial decision making.

Health Populi goes on to state that beyond insurance products, for example, some consumers like the idea of discount cards and annuities. There are options for Long Term Care, High Deductible Health Plans and HSAs, PPOs and HMOs, and even traditional insurance. Some vendors are even pushing some exotic plans that offer FSAs and HRAs through employer-based insurance. Companies are into wellness programs and more to help save money and get workers involved in the process.

According to the Blog's author, there isn't a great deal of variance in consumers' minds between the uses of these mechanisms based on whether the funds would go to long-term care, catastrophic expenses, or medical cost increases. The biggest differentiator is for catastrophic expenses, where consumers seem to understand the application of a savings vehicle. Many consumers like the idea of paying for support and advice for guidance. However, while about 70% of consumers want such support when shopping for new coverage, only 41% of those who had access to it found it "satisfactory." You know you have a problem with your health system when you're more concerned about the cost of your care than fighting your disease.

According to the Commonwealth Fund, on one hand, John and Joan Q. Public know exactly what they want: high-quality care at discount prices. They want it fast, they want it convenient, they want it cheap and--of course--they want the best health care system in the world. On the other hand, they don't know how the system works, what it costs or what their role is. They are still happy to use word-of-mouth to select doctors and hospitals. They tend to ignore data on quality, and 89% of people surveyed by the Fund said they were either very or somewhat satisfied with their physician. Just over 50% ranked the care they receive from their physician as excellent. Yet, two-thirds of Americans do not see the same physician for more than five years, and 23% don't even have a regular doctor. Consumers like their doctors, but don't establish long-term relationships with them.

However, the reasons that people doctor-hop have little to do with whether they're satisfied with the care they receive--it is usually for external reasons. According to a Harris poll, 50% of respondents say they changed doctors in the past five years because the medical provider was not covered by their health plan, they moved, or the doctor moved or retired. As reported in the San Francisco Business Times, consumers and employers are pushing for more standardized, easy-to-use tools that approximate what Consumer Reports does for car shopping and similar examples of comparison purchasing; and greater transparency is an important goal. Americans are hoping ways will be found to make quality and cost data more easily accessible and relevant to consumers.

The array of options, often contradictory data, and questions about the credibility and ease of use of some sites appear to have combined to make them less influential than many proponents expected. Such tools are irrelevant to patients unless the information they provide is germane to patients' particular treatment context, coverage situation, and personal preferences or values, according to the SF news article. The ongoing proliferation of quality "report cards" and rankings by hospital groups, medical providers, and health plans appears to be confusing consumers as much as enlightening them, some experts say, which may help explain why they're having limited impact on consumer behavior.

Health care price transparency is a good idea - it allows people to make informed decisions about where and when to seek non-emergency health care. In some cases, health care price transparency has not been proven to reduce health care costs. Some people may postpone or forgo preventative care which would prevent more expensive health conditions. Also, the information does not help people who require costly emergency care, such as treatment for a heart attack. This may be due to a certain lack of incentive on the part of consumers to do homework to find the information they need, or the information is just not available or displayed in a consumer friendly format. In order for consumers and purchasers to get better care at a lower cost, they need and want useful information according to the Robert Wood Johnson Foundation. There have been a number of significant advances in the effort to improve health care quality. Information on the quality and cost of health care will empower consumers to make informed decisions about their health care. Therefore, it is imperative that the information patients, consumers and their families receive is accurate, clear and relevant to them.

The Foundation also suggests that many different private- and public-sector groups have designed models for assessing performance and reporting data. However, the proliferation of multiple, uncoordinated and sometimes conflicting initiatives has significant unintended consequences for different stakeholders—unnecessarily burdening physicians, nurses, clinics and hospitals; creating confusion among consumers; and detracting from efforts by employers to design programs that meet the needs of their employees.

Americans like the power of personal choice. Unfortunately, most consumers have lulled themselves into a dream-like state with the easy availability of insurance co-pays. If you don't take charge of your own health care needs, then you will suffer the consequences of ignoring the best options for controlling costs and getting the quality of care you desire. Take the initiative to investigate various medical providers, costs for health care treatment, and available options to get the best care for the best price. It's your health, and it's up to you to keep it. Don't pass the buck, or you'll be paying big bucks for health care that is not the best for you, your family, or your employees.

Until next time. Let me know what you think.