Recent survey findings suggest the majority of those using employee health benefits are ignoring cost as a factor in their healthcare choices. That leaves employers and insurers to consider why, and what they can do to impact member behavior.
A national survey of more than 2,000 employees finds that these consumers—especially those who are more affluent—typically fail to ask healthcare providers the question, "How much will it cost?"
Of the respondents, 69% said they have enough information to get the right healthcare for themselves and their family, yet only 48% said they always ask how much their care will cost. Among those with household incomes of $125,000 to $149,999, only 31% always ask their doctor how much a procedure will cost.
"That question could mean the difference in thousands of dollars for consumers, and millions for US companies," according to Benz Communications, a marketing firm specializing in employee benefits. The company led the research along with Quantum Workplace, a technology firm that provides employee satisfaction and engagement surveys.
Implications for employers and insurers
"I think the biggest insight there is that we have a really long way to go to create the consumer mindset that the industry has been trying to create now for 10 or 15 years," Jennifer Benz, founder and CEO of Benz Communications, tells Healthcare Dive.
Even though there's high awareness of increasing US healthcare costs, people aren't asking the basic questions about cost when they visit their doctor, Benz says—and they often don't think they need that information to get the right care.
"I think very few people have access to good tools to evaluate costs," Benz says. She suggests that even though price transparency tools are becoming prevalent, many people remain unaware of them, or haven't internalized the idea of utilizing them to "shop" for healthcare.
"I think the biggest issue is that we have a cultural norm of doing what the doctor tells you, and so very few people are going to question the cost of a medical service unless they really can't afford it," Benz says.
She looks at this as a big opportunity to change the cultural norm by teaching healthcare consumers to question their doctor about costs and necessities.
What can employers and insurers do?
"Just educating people year-round is a good start," Benz suggests, rather than engaging with members only during enrollment or a few times per year.
One of the survey's additional findings was that communication correlates to more trust, and that among employees who trust their company leaders, 49% say they receive frequent health and wellness communications. Of those who do not trust their company leaders, only 28% receive frequent communications. Therefore, ongoing education about how to best utilize health benefits appears welcome.
Aside from that, Benz sees two main ways to impact members' behavior.
One is through the Choosing Wisely campaign, an initiative to eliminate unnecessary medical care. It includes an employer toolkit and information for any consumer, Benz says.
The next is to aggressively promote the price transparency tools that are available.
"A lot of employers work with third-party price transparency companies, and the ones that are very aggressive about promoting those tools and make that part of the way they do ongoing education start to get good results," Benz says.
However, a lot of health plans have price transparency tools buried within their member-facing applications, she says, and they need to be promoted so they are top of mind for people when they're getting care, not just in a once-a-year communication.
She adds that leading with a cost message is not necessarily the most effective approach, however. Customers can be suspicious of just being told they need to spend less money.
"What is really effective with employees is to help them understand how being more engaged is going to help them get better quality of care," she says. She suggests that employers and insurers balance a message of finding quality of care, along with what’s necessary, as in the Choosing Wisely campaign.
"It's about getting the right care at the right place, not about getting the cheapest care possible," Benz says.
Her thoughts are echoed by Burt Rosen, VP of Marketing and CMO at HealthSparq, which provides transparency tools to health plans.
"My theory is that it's a lack of education," Rosen says, based on studies showing low general understanding of healthcare and its terminology, such as the study "Consumers' Misunderstanding of Health Insurance" in the Journal of Health Economics. It suggests that many consumers don't even know what a deductible is.
"I think that people asking about costs in healthcare is a little bit of an advanced concept," Rosen says, because to really make use of price transparency tools, people need to understand the context.
"You need to understand the ins and outs of your insurance before you even start thinking about, should I be comparing prices on my healthcare," he says. "I think people don't understand all the steps that have to happen before even understanding that there's cost variance and how that applies to their benefits specifically."