Consumer Directed...or Consumer Dejected
In today’s healthcare marketplace, consumerism is a dominant force. America is witnessing the emergence of a generation of price sensitive healthcare buyers. Cost shifting by employers has led to higher deductibles and increased out-of-pocket expenses for employees. Plan designs are exposing consumers to price and quality differences among providers. The result is a healthcare consumer equipped with information, empowered with choice and motivated by accountability.
Consumer Directed Healthcare (CDH) promotes increased awareness and consciousness about choice, cost and quality of care. Rather than shielding consumers from the actual costs of healthcare services, these plans involve consumers directly. The customer takes the lead in deciding where, when, and from whom they receive care. CDH has arrived, nationally and locally.
Over the years managed care helped stem the increase in healthcare costs. But dependence on rules-based cost controls is no longer effective. Nagging double-digit premium increases demand a new approach. And, with most HMO and PPO plan designs problems are exacerbated by dependence on a payment system grounded in co-pays that isolate consumers from the actual cost of care. Low co-payments for office visits, tests and medical procedures have given people a false impression of how much healthcare really costs.
Health insurance customers are clamoring for more choice, lower rates and less intervention in personal healthcare decisions. Employers are looking for health insurance options that deliver quality care to their employees while reducing premium inflation. The result is healthcare consumerism — benefit plans and support tools that put consumers and their physician at the hub of healthcare decision-making, giving them greater discretion and control over their benefit dollars and medical care choices.
Consumer Directed Healthcare plans introduce incentives to increase member involvement in the healthcare decision-making process. Plans meld prevention, wellness and major medical coverage with a savings or spending account feature while providing access to negotiated rates from physicians, hospitals and other providers.
It appears CDH has reached the tipping point as the future direction of employer-sponsored health insurance. Three persuasive business drivers are fueling its growth:
- Alternative to managed care
- Return control and choice to the customer and their providers
- Employer premium stability and price predictability
Patients are the new healthcare consumer. They want to know what they are buying and why it costs what it does. Every healthcare company reaching-out to today’s consumer has to communicate value – including quality measures – in meaningful terms. In the end, don’t underestimate a patient’s willingness to comparison shop when it means saving money out of their pocketbook.
NOTE For more information see the article CDH Success: What's it going to take?
© Lindsay Resnick