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Smart Benefits: Consumer Engagement is Key to Better Healthcare

Monday, December 16, 2013


For years, industry experts and employers have debated whether arming individuals with more information would make for smarter consumers – or more confused ones. But today, whether it’s choosing a plan on a state healthcare exchange, or participating in an employer-sponsored Health Savings Account (HSA), consumer engagement is now the name of the game.

A new survey from Buck Consultants suggests that those who regularly contribute to their HSAs are more involved with their own healthcare decisions. Additionally, 29% of respondents said they had better dialogue with their doctors about the cost of care and another 13% said they were involved with actively managing their own chronic diseases.

Travis Klavohn, Director of Consumer Health Solutions, BenefitWallet, agrees with the increasing interest of consumers in their own care. “They are evaluating costs more closely before receiving care, shopping for lower price drugs and choosing less costly services.”

Carriers Contributing with Technology

To be better consumers, employees are seeking out tools and technology, and the carriers are stepping up with solutions to help. UnitedHealthcare of New England and BCBSRI both offer cost estimators based on actual claims that let individuals know up front what the costs will be for a particular type of service based on the care setting.

For example, costs for MRIs vary widely based on whether the imaging is provided in a hospital, doctor’s office, or stand-alone facility. If an individual has a deductible to satisfy out of their own pocket before the insurance carrier pays, these calculators help them find the best price so they can keep more money remains in their HSA for future care or savings.

HSAs Hit Exchanges

Recognizing the drive toward consumer engagement and the high cost of care, state healthcare exchanges are offering HSA options. That way, if a person has to have a deductible on a plan, at least the money saved in the HSA to offset the deductible expense is pre-tax, which is not the case with a regular deductible plan. For this reason, HSAs are a sustainable option, regardless of income level.

It Pays to Compare

As healthcare costs continue to rise, consumers’ interest in what they’re paying is also increasing. And that has led to value-shopping. With access to consumer-driven plans and even tiered provider networks, consumers are researching cost drivers. In Rhode Island, consumers who are enrolled in BCBSRI’s SelectRI can choose physicians who are part of patient-centered medical homes and, in turn, pay lower copays and deductibles that for care provided by doctors who are not.

In Massachusetts and Rhode Island, Tufts Health Plan, through their new product, RightChoice, offers a defined contribution model with four to five different plan designs with varying deductibles, some of which include HSA options.

While the Affordable Care Act means higher costs, it also means more choices to help consumers manage their own costs. From public and private exchanges to plenty of options in the private market, there’s more selection than ever before. The key is for the consumer to make the most of the options by getting engaged.

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.

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Jim D

I've never read this much shite before.

The RI HealthExchange is already talking about being unsustainable.

Building a 'headquarters' when 10 of 12 plans are from BCBSRI seems more than a bit extravagant. Why not just send people to BCBSRI and if they qualify send them to RIteCare?

Perhaps Ms Gallagher can explain how 10 of 12 plans and 100% of the plans for individuals & families not on relief being from BCBSRI means more choice? The cheaper plans have deductibles from $5,000 to $5,800 plus the monthly premiums. No one else is offering plans directly to consumers.

Why can't individuals get an HSA from Tufts or United? Oh yeah that would mean real choice.

The State and the Feds will be buckling under the weight of Medicaid costs soon enough while consumer healthcare costs continue to rise 100's of times faster than the rigged inflation rates.

The ACA is a disaster in the making.

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