Patients in healthcare are often confused by the healthcare system, unsure where to go or who 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 Health Consumerism?
Healthcare consumerism has been defined differently by different organizations. 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.
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 AdvisorSM to help employers, employees, and families. While it is just a starting point, this new tool is designed to help patients make smarter health care 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.
One thing employers may be worried about hearing from their employees is that 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.
But often, patients rely on their doctors, or friends and family, to provide recommendations on where to go because “so and so had a good experience.” 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. An example of this can be seen related to our Premier Network.
All these options still allow employees and their families the flexibility to go where they want but encourage them to be better stewards of their healthcare to reap the 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, so making sure they know where and how to find the information when it’s needed is key. 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.
- A care navigation partner or direct primary care clinic (if budget allows) to communicate with patients when it’s most relevant, directing employees to high-value care
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 also has a variety of employee flyers to explain how to find a doctor in-network, what the appropriate site of care is, and how to use the Smarter Care Advisor tool. Please reach out to your Account Executive, who would be happy to get you the information you need.