In the case of health care decisions, Americans are seemingly hypocritical.

Though most U.S. consumers say affordability is the top driver of their health care decisions, only a small portion are willing to change doctors or health care settings to reduce costs, according to a new survey of some 3,200 people by Accenture.

The consulting firm found less than half of consumers are willing to change to generic prescriptions (43 percent), use a nurse practitioner instead of a doctor for routine visits (41 percent) or change their primary care doctor (23 percent).

“Under most health plans today, however, the benefit from consumers making cost-saving changes goes primarily to the insurer or employer,” says Mark Knickrehm, who leads Accenture's global health business. “To help consumers make smart, cost-effective care decisions, insurers must incent consumers and clearly communicate the direct benefits by engaging them in ways that are relevant to them.”

As the post-reform marketplace expands to 51 million individually insured consumers, Accenture found that health insurers will need to further differentiate their services and engage new customers—a task that could prove quite challenging considering consumer preferences for lower health care costs with little tradeoffs.

Only one out of the four consumers surveyed trust insurers to provide guidance on improving their health.

While health care consumers seek low out-of-pocket health costs, fewer than 20 percent of those surveyed understand the cost of their care in advance or feel they should track and budget health care expenses.

Accenture also found that Americans aren't prioritizing health checkups. Although 81 percent of subsidy eligible health care consumers report they want guidance to improve their health, 40 percent of these same consumers don't identify going to the doctor for regular checkups as a priority.

Instant Insights /

Americans aren&rsquo;t willing to make tradeoffs that impact health costs

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Americans aren’t willing to make tradeoffs that impact health costs