Pressure is mounting on consumers to rise as active managers of their health. Consumers are not only willing, but eager, to take on that role.

90% of consumers want to be in full control of their medical care or collaborate with their physicians in shared decision-making, according to the 2014 Altarum Institute Survey of Consumer Health Care Opinions1. Further, almost two-thirds of these polled consumers actively sought information about their health conditions beyond the knowledge provided by their physicians. However, less than half of the polled consumers had actively researched information about quality and cost of the care that they received in the previous year1.

PH_OTH_figure_for_blog_post_v1

In a Consumer Reports write-up on electronic products, for example, three categories of information would be provided to help drive consumer decision-making: a description of features; a rating of product quality; and the product’s cost.  Although consumer are concerned about their health and want to be involved in decision-making, assessing features, quality and cost of different health care alternatives is very different than doing the same thing for a TV. This is partially due to the lack of availability of this information, and partially due to consumers’ differing levels of health literacy. Until consumers can access and understand information, they will be unable to make well-informed choices about their care. The first part of the problem can be solved by engaging consumers and providing more information to them. A number of healthcare stakeholders are stepping in to improve consumers’ access to healthcare information:

      What do consumers need from other healthcare stakeholders to make smart decisions?

  • Information about diseases and conditions
    • Payers, providers, manufacturers, and third-party sources all provide information about diseases and conditions to consumers
  • Explanation of features & benefits of insurance plans, providers, and treatment options 
    • Thanks, in part, to mandates of the ACA, insurance plan benefits and treatment options have become easier for consumers to internalize than in the past:
      • Examples:
        • All insurers must provide a four-page overview of plan benefits, cost-sharing, and limitations in layman’s terms, as well as examples to demonstrate how the plan works3
        • Private insurance plans offered on the federal health insurance exchange (HIX) or state-based insurance exchanges are assigned a ranking of Bronze, Silver, Gold, or Platinum based on benefits and total costs to the consumer4
  • Price Transparency2
    • Resources are starting to emerge that are dedicated to providing information about pricing of provider and treatment options, but consumer uptake is slow (many consumers are unaware of these options, and others struggle to make sense of the information provided)1,5, 6
      • Examples:
        • Apps / startups: 
          • Castlight Health
          • Pokitdok
        • Providers:
          • Some providers are targeting price-conscious consumers. For example, the Surgery Center of Oklahoma developed transparent pricing website for specific procedures.
  • Quality scores of providers or treatment options
    • Quality scores are becoming more readily available, but the majority of resources are not distilled into usable information for the average consumer. The value of quality information for consumer decision-making is also reduced by issues such as the lack of standardization in quality reporting across providers and a focus on metrics that don’t resonate with consumers’ top concerns6
      • Examples: ZocDoc  

However, even when all of this information becomes readily available, not all consumers will be equipped to make sense of it. In upcoming articles, we will explore how average consumers are transforming into healthcare literate consumers, and how other stakeholders are collaborating to help consumers get there.

 

1 http://altarum.org/sites/default/files/uploaded-related-files/Spring_2014_Survey_of_Consumer_Health_Care_Opinions.pdf

2 http://www.uhc.com/live/uhc_com/Assets/Documents/myHCEwhitepaper.pdf

3. http://www.cigna.com/health-care-reform/summary-of-benefits-and-coverage

4. https://www.healthcare.gov/choose-a-plan/plans-categories/

5. 1 http://nnlm.gov/outreach/consumer/hlthlit.html

6. http://healthaffairs.org/blog/2011/10/04/the-credible-threat-of-consumer-engagement/

Topics: Hensley Evans, Consumer health