Does Consumerism in Health Care Really Exist?

An article from Better Business Bureau

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Vice President
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January 22, 2020

Note: This article was originally published by Better Business Bureau.

As healthcare consumers, we have access to a number of resources regarding the cost of services provided to ourselves and our families. The rise in high-deductible health plans created more transparency. However, many people are unaware of how to access these tools and how to discuss their options with providers. Healthcare providers negotiate contracts on an individual basis with their interests in mind - not those of the consumer. Providers want to be accessible to individuals and families, but they also want to direct care internally, which may not be the lowest cost option for the patient depending on their health plan.

The question still remains: does consumerism really exist? The short answer is yes, but our local employers have the ability to continue moving the needle forward. Without their willingness to sponsor health and welfare plans, providers would be significantly impacted. Employers are concerned with retaining employees in a competitive job market, and many are hesitant to make decisions on benefit offerings centering around higher quality, value and lower costs. It is a question the health insurance carriers and consultants attempt to relay to employers on a very regular basis. A large number of consumers are concerned only with the deductible not the overall pricing of a particular service. This leads to employees going where they feel comfortable for healthcare services and not pursuing additional cost saving opportunities that do not sacrifice their quality of care.

Employers have found themselves at a crossroads. Do they continue to maintain the status quo or encourage and/or incentivize employees to make better healthcare decisions? This question will force employers to jump out of a comfort zone, but it is a necessary decision to make a positive impact moving forward. 

There are a number of resources available. Here are a few examples based on best practices:

  • Promote Carrier Resources: All major health insurance carriers have tools to help employees access pricing for healthcare. Education helps both the employee and employer save money on planned procedures.
  • Consider Narrow Networks as a Dual Option: For those employees who know where they want to access care and are averse to change, this allows employers to access better pricing without eliminating choice for the entire workforce.
  • Promote Centers of Excellence: Orthopedics and cardiology are a couple of examples in which services are bundled and pricing is reduced based on the volume of procedures these providers perform.
  • Consider a New Approach to the Health Plan: Whether exploring a reference-based pricing arrangement or on-demand style offerings, these solutions place healthcare decisions directly in the hands of consumers.

The opportunity is there. We have the responsibility as trusted advisors to educate employers of what is available and provide a roadmap to obtain better outcomes. We should encourage employees to ask questions regarding their healthcare and provide them with the resources to act on those inquiries.

This idea may appear uncomfortable at first, but with buy-in from HR leadership and executives of our local employers, we can make consumerism in healthcare a reality for all.

If you need insurance advice or are looking for insurance coverage, turn to a BBB Accredited insurance company, like Marsh & McLennan Agency, LLC.