How Employers Can Encourage Healthcare Consumerism

The healthcare system often confuses patients, leaving them unsure of where to go or whom to trust. In fact, 3 in 4 American patients leave the doctor’s office confused, and do more research, according to a survey of 1,000 U.S. adults.  So, if they’re willing to do more research after leaving the doctor, how do we encourage them to do more research beforehand?  That’s the question we’re asking when it comes to engaging employees in healthcare consumerism.

What is Healthcare Consumerism?

Different organizations define healthcare consumerism in various ways. At The Alliance, we like to think of it in this way: Healthcare consumerism is getting patients to act like consumers of their healthcare, making choices based not on just word of mouth but on information related to cost, quality, and reviews.  In an era where consumers can search for all the information, they need to buy a new appliance, including reading product reviews, watching videos, and searching for deals, how can employers get their employees to do the same when it comes to healthcare?  Give them the same type of tools consumers are used to researching and purchasing anything else.  And help them use them.

Digital First

The future of healthcare consumerism needs to start with an investment in digital solutions to help support patients in their journey.  A good provider directory, like our Find a Doctor tool, is key in ensuring patients know which doctors and hospitals are in-network and which aren’t.  That can help patients avoid surprise bills, which happen to more than half of U.S. Consumers, and help keep plan costs down.

In addition to provider directories, information on cost and quality, where it is available, can be helpful.  While the recent CMS Price Transparency Rule states that hospitals operating in the United States must provide clear, accessible pricing information online, hospital compliance is less than stellar, at around 14%.  And this assumes patients will go to individual hospital websites to compare prices.  That’s a lot of work when consumers are used to doing a quick Google search for an item and seeing how much it retails for at multiple locations.  That’s why The Alliance developed Smarter Care Advisor^SM to help employers, employees, and families.  While it is just a starting point, this new tool is designed to help patients make smarter healthcare decisions that save them – and their employer – money.  They can sort surgeries and other procedures by network, cost-range estimate based on The Alliance’s claims data (low, average, or high), location, and distance in miles away from their home or location.  And if patients need more specific cost information, they can submit a cost estimate form to our customer service team.

Employers may be worried their employees will think low-cost providers and hospitals must mean that they’re lower quality.  According to RAND corporation’s Hospital Price Transparency study, that isn’t true.  Sixty percent of medium-priced hospitals received four or five star, so employees have options for high-value facilities that offer high quality at lower prices.

Incentives Next

Often, patients rely on their doctors, friends, and family to provide recommendations on where to go for care. While anecdotal information is nice, incenting employees to go where care is good and costs are low is critical.  This is called steerage, and there are different ways this can be done. 

• Employers can pay employees to go to a particular provider for shoppable procedures.  For example, using a low-cost imaging center for a CT rather than a hospital often saves so much money they can pass those savings along to employees in their paycheck.
• Employers can provide employees with no-cost care, like an independent primary care facility.
• Employers can design their benefits to tier different providers, steering employees to the best cost options. The Alliance’s Premier Networks are customizable up to four tiers. 

These options offer flexibility while encouraging employees to manage healthcare wisely and enjoy financial benefits.

Finally – Communication, Communication, Communication

Finally, to encourage healthcare consumerism in their employees, employers must communicate multiple times and in multiple ways.  One employee benefits fair around open enrollment time isn’t enough.  Employees aren’t good shoppers until they need the services. Employers must ensure employees know where and how to find information when they need it. Employers should consider:

• Regular newsletters to employees with vital information about their benefits
• A subject matter expert within the organization so that employees can ask questions confidentially
• An intranet or other employee resource hub with employee educational matters, with links to important sites, etc.
• Care navigation partners or direct primary care clinics to guide employees to high-value care through timely, relevant communication.

The Alliance Can Help with Healthcare Consumerism

While all this may seem overwhelming, remember to rely on our health benefits partners in executing the above strategies.  You don’t have to do it alone.  If you’re a client of The Alliance, you have access to your data to assist you in making decisions on shoppable procedures through our Smarter Health analysis and steerage. The Alliance offers employee flyers on finding in-network doctors, choosing care sites, and using the Smarter Care Advisor tool. Please reach out to your Account Executive, who would be happy to get you the information you need.