A Publication of WTVP

Trend in healthcare transforms employees into consumers.

There is no single cure for America’s ailing healthcare system. Healing the system will require solutions from multiple sources, including healthcare providers, insurers and employers. Employers are particularly vital to the cure, because they are in a unique position to empower and engage their employees as individual healthcare consumers.

As consumers of healthcare, employees have the power to influence the system and potentially contain rising costs. In fact, studies show that many employer groups may see their health benefit costs begin to stabilize when their employees become engaged consumers. Plus, employees themselves experience better health, both financially and physically.

The trend toward individuals gaining more control over managing their healthcare is known as “consumerism.” This means giving people information about products and services and the tools they need to turn that information into educated decisions. Consumerism can also create demand for higher quality, more choices and added value for the healthcare dollar—all factors that could benefit the employers’ bottom line and their employees’ health.

Employees Need Guidance as Healthcare Consumers
A recent ethnography study from Humana found that employees want to be—and can be—more knowledgeable healthcare consumers. The study also reports they already understand the benefits of informed decision making, in large part due to their experience with using research methods when buying big-ticket items, such as cars and high-definition televisions.

However, unlike such traditional consumer purchases, in the case of healthcare, employees do require some assistance from employers and insurers to become knowledgeable healthcare consumers. Employers can offer guidance to employees in learning about their options and how to use available resources, and insurers can provide comparison tools and other “transparency” data to help employees make more informed healthcare decisions.

Transparency Tools Simplify Decision-Making
Transparency is a consumer-driven approach to healthcare that emphasizes the importance of clear, accurate, relevant information. It is designed to improve consumers’ healthcare experiences and lower healthcare costs by making comparison information readily accessible, primarily via the Internet.

Healthcare companies like Humana are beginning to work with industry organizations, consumer advocacy groups, and doctors and hospitals to develop a wide and growing array of transparent comparison tools. The tools make it simpler for consumers by placing all of the decision-making data together using easy-to-understand numbers and graphics, including:

Putting Consumerism Tools to Good Use
Once employees understand the value of transparent healthcare data, they gain much greater confidence in their ability to be informed, knowledgeable consumers. By using consumer-driven resource tools, employees can compare estimated costs and provider effectiveness to choose specifically what’s right for them. This gives them greater control over their costs, and could potentially impact their employer’s costs. It also makes it easier for employees to actively engage in making wise healthcare decisions.

For example, if employees learn from using the tools that the actual cost of a prescription drug is several hundred dollars, they gain a better understanding of the true cost of their medication. They also see how their employer may struggle to manage healthcare costs. Learning this information can change employees’ perspectives and most likely prompt them to use their healthcare benefits more cost effectively—for themselves and their employers.

As another example, if an employee has a knee condition that needs attention, by using the web-based research resources available, the employee can find the best doctor, hospital and price for remedying the condition.

Beyond these and many other web-based resources, insurers are working together with employers on several additional initiatives to help manage healthcare costs. Perhaps most importantly, together they are promoting healthier lifestyle choice initiatives, such as wellness programs, designed to keep employees healthier and happier—and, as a bonus, prevent costly medical services, procedures and medications.

Employers Must Proactively Promote Consumerism
Of course, none of the consumer-driven tools or initiatives provided by insurers will help reduce healthcare costs if employers neglect to inform their employees about the tools available to them. Employees also need to understand how to use the tools effectively, so employers should offer training and even consider using “coaching” specialists to actively engage employees in managing their individual healthcare from a consumer perspective.

Healthcare Shifts to Consumer-Driven Future
It took a while for consumerism to reach healthcare. But today, healthcare companies are transforming themselves and their products and services to become far more consumer-driven.

The rationale for the transition is simple: By engaging employees in managing their own health, employers can help improve the medical outcomes for employees while helping to control one aspect of skyrocketing costs. As a result, taking a consumerism approach to healthcare can be a win-win situation for both employers
and employees. iBi