According to a briefing on consumerism in healthcare, hosted by Health Affairs, one panel agreed that healthcare as an industry has been defined by an imbalance of power between consumers and everyone else, which means that patients aren’t “consumers” in the same sense as in other industries, mostly because consumerism is based on choice and information. Physicians hold the knowledge about illness and diagnosis, payers hold the knowledge about what treatments and medicines cost and how much they are willing to pay, and consumers haven’t historically had enough information or ability to push back. In an effort to democratize the health care system and empower consumers, there has been a significant push to give people easier access to data, information, and tools, however there is still a lack of perceived choice when it comes to everything from the health plan to the treatment.
To truly make a choice, one must feel equally well-informed and empowered to make that choice. However, when one’s financial and economic situation obstructs one’s ability to truly absorb information and weigh complicated options, it cannot be said that they are free to choose. In order to truly empower consumers to choose a health plan or make other health decisions, plan sponsors and payers need to actively tailor education and access to information to their audience, not simply make it available for passive consumption.
This is especially important for financially vulnerable consumers. According to Greenwald & Associates’ and EBRI’s 2018 Consumer Engagement in Healthcare survey, only half of consumers are extremely or very satisfied with the information available for them to understand their health plan choices. However, the gap widens when financial security comes into play. Merely having access to information might not be enough to get to some of your most vulnerable employees. While nearly 57% of consumers who feel financially secure were extremely or very satisfied with the information available to them, only 39% of those who feel financially insecure felt that way. Furthermore, of the individuals who indicated that they were offered a high deductible health plan or health savings account but chose not to take it, financially insecure consumers were almost twice as likely as financially secure consumers to indicate that they didn’t select it in part because they didn’t understand it.
Simply put, access to information does not equal informed decision-making, especially for individuals whose mental space is occupied with a host of other concerns, such as falling behind on monthly bills, paying off high-interest debt, and paying off student loans. In fact, the increased financial risk associated with a high deductible plan and fear of the unknown medical emergency, means that this vulnerable population needs a different kind of education that is personalized to their economic and financial situation. It cannot be a once-a-year, generic, water-hose of information, within weeks of their online enrollment. Vulnerable consumers need extra time to digest and understand their offerings. They also need in-person or robust online resources to allow them to test different scenarios to make sure that they truly understand their exposure. Employers, payers, and brokers need to work together to develop more effective education campaigns and safe spaces that allow consumers to voice their concerns, evaluate their options, and be true partners in the decision-making process regarding their health plan.