High-deductible health plans were intended to make workers more responsible healthcare consumers by switching more of the costs to them, but getting accurate pricing information to consumers — or even agreeing on what “price” means — has been difficult. When it is available, roughly one in 10 patients take advantage of it, the New England Journal of Medicine found, and usually after they received care.
With these two challenges in mind — getting accurate information to plan members and then getting them to use it — how can employers get their employees to care about health costs?
You Can’t Impact The Past: ↑ Advocacy + ↑ Quality = ↓ Cost
Thursday, May 20, 2021, 2:00 PM ET / 11 AM PT
Unlike most things, healthcare services have an inverse relationship between cost and quality: the better the quality, the lower the cost. Unfortunately, the current health benefits market is completely opaque and lacking any meaningful, realistic transparency. Additionally, we have always been taught that easy = better when designing health benefits programs for employers and their employees. However, the cost and quality of healthcare can vary dramatically within the same city. Utilization Management for example, where your members access healthcare, is one of the single most important additions to your health plan design.
Teach employees what questions to ask. NJEM found the complexity of the billing system can undermine any price shopping that patients might do. They don’t know if the prices they’re looking at are for the same services, or if they cover the total cost to the plan or just the out-of-pocket cost to the employee. Without this information, employees’ decisions are only slightly better than picking a provider at random. Teaching plan members what to ask, and even providing scripts for them to start the conversation, can make it easier for them to be proactive about price shopping.
Create layers of educational interventions based on how and when plan members will access them. A simple price list may suffice for a plan member who’s just scheduling a routine appointment, but judgement and decision making can be impaired by stress; someone facing a catastrophic diagnosis will take the easiest route unless they have more interactive or personalized guidance showing them the way to better quality or less expensive care. Willis Towers Watson found that almost half of employers were considering introducing care advocacy or navigation services to help their employees make better choices.
Design communication strategies for your current workforce. Many employers are relying on old-fashioned methods of communicating benefits to their members like benefits booklets and presentations, a study by HealthJoy found. That’s a problem, as 80% of employers surveyed by the International Foundation for Employee Benefit Plans said their workers don’t read the benefit materials they provide them. Employers should revisit their education strategies whenever they have turnover to keep up with their changing workforce’s evolving needs.
Look for gamification opportunities. There’s a lot of hype around gamification, and behavioral research shows that it can have some impact on users. Be careful, though — poorly designed games may not create long-term changes in behavior, and may even annoy users.
Communicating the importance of smart healthcare shopping is clearly a challenge for many employers.
Controlling costs is important, but benefits leaders’ top priorities center on employees’ experiences, and finding ways to make them more productive, more satisfied, and generally healthier and better off. By developing enhanced communication and education strategies to help their employees navigate the complex and often overwhelming world of healthcare, they can do just that.