High-deductible health plans were supposed to spur price shopping and consumerism, but that has not entirely been the case.
Better support from providers and health plans could motivate high-deductible health plan enrollees to engage in consumer behaviors, such a price shopping for the best value care, according to survey data published in the journal Health Affairs.
HDHPs were supposed to spur consumer behaviors, according to the research team hailing from the University of Michigan. These plans leave patients liable for much of their medical expenses. To mitigate those costs, industry experts have encouraged patients to engage in more consumer behaviors and identify the best value treatment or provider possible.
“In theory, such consumerism would take the form of behaviors that could help patients in HDHPs get the most value for their out-of-pocket spending,” the researchers wrote.
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But despite those efforts, patients haven’t entirely assumed their role as consumer. Few patients are actually shopping around for their care, and price transparency tools are being met with a lukewarm response, previous research has shown.
The researchers set out to better understand patients’ relationship with consumerism, specifically the factors motivating them and keeping them from engaging in price comparisons. A survey of 1,637 patients examined their habits surrounding price comparisons, their health literacy levels, and their maintenance of a health savings account.
On the whole, saving for future health events was the most common consumer behavior, with about 40 percent of respondents saying they are using their HSA for this purpose.
Far fewer patients are shopping around for their care, with only 14 percent of patients saying they have done so in the past 12 months. Patients with high financial literacy were more likely to engage in price shopping than those with lower literacy.
One-quarter of respondents had discussed healthcare costs with their providers, a finding the researchers also considered suboptimal. Patients who reported a positive rapport with their providers were more likely to have engaged in conversations about price than those with weaker provider relationships.
Forty-four percent of patients said they had not price shopped because they had not considered it an option, while 38 percent said it was because they did not believe price comparisons would actually lower their out-of-pocket spending.
“These results raise important questions about the extent to which patients in HDHPs are willing and able to function as consumers in the health care marketplace,” the researchers said. “Yet our results also highlight opportunities for new strategies that employers, health plans, and health systems could explore to promote greater engagement in consumer behaviors among patients in HDHPs.”
Employers, for example, should play a bigger role in helping patients with their HSAs. The survey revealed that the largest income source for HSAs were employer contributions. Employers to continue to contribute to these accounts will help patients engage with them more.
Additionally, employers can set up programs to improve patient financial and health literacy.
Health plans can create programs to empower patients and help them communicate with their providers more effectively. This could result in more conversations about price and price negotiations, a true benefit for all patients but especially those with chronic illness.
Finally, health systems can make price transparency information available at the point of care, prompting more patient communication on the subject.
Industry experts must also draw patient focus to the benefits of price comparisons, the researchers added. Research indicates that price shopping can reduce patient costs, they stated. Emphasizing those financial benefits could motivate more patients to engage in consumer behaviors.
“Employers, health plans, and health systems must work together to ensure that engagement in consumer behaviors translates into meaningful benefits for patients,” the researchers concluded. “As these benefits are realized, employers, plans, and systems could implement communication strategies to help patients feel confident in what they might gain from engaging in consumer behaviors.”
Date: March 8, 2019