While many in the health care industry continue to look for ways to reduce patient costs, the stats still tell a different story. Health care consumers are forced to deal with cost ranges unlike anything they encounter when purchasing other goods and services. And most often, they're making decisions without adequate information.
Take mammograms or vasectomies, for example. These services can be charged at a wide array of price points, which depend upon whether the service is performed at a hospital or specialty center, what medical team is needed, and even where a consumer resides.
But if a consumer knew ahead of time that prices for the same treatment can vary by thousands of dollars depending on who's providing the service, what would that enable them to do?
A push for health care price transparency
President Trump's June 2019 executive order aimed to improve patients' awareness of price and quality of service in advance of receiving services. The executive order highlights the need to distinguish between (and disclose) what hospitals charge and the rate negotiated between payers and providers, as well as encourage consumers to use price comparison for common, shoppable items. What's more, the Executive Office's initiative is reflective of rare bipartisan efforts in Congress toward cost transparency, with the Senate Health Committee proposing that insurers and hospitals tell patients ahead of time what they would pay for scheduled treatments, and the House moving toward a proposal that would prevent patients from receiving substantial bills after receiving care from an out-of-network provider.
Politics aside, our nation is clearly in the mood to increase health care price transparency and enable consumers to make the best choices to optimize their health care spending and enjoy positive health outcomes.
This consumer-driven health care concept isn't new. It's been around for at least two decades, dating back to when a handful of businesses started offering their employees' health plans with low premiums, high deductibles and tax-exempt savings accounts. One of the ideas behind the initiative was — and still is — to encourage employees to make educated decisions when seeking health care.
Admittedly, we haven't achieved true health care consumerism yet. To make smart decisions, consumers need information about how much a particular provider charges for treatment, equipment, pharmaceuticals, etc., and price information continues to be difficult to obtain in many circumstances.
But our industry is moving in the right direction. The recent activity in Washington D.C. is a promising step forward. If consumers can access the information they need about cost and quality of care available where they live, the advantages can be enormous. Educated consumers are more likely to ask their doctors about various available treatment options and to request generic medications, both of which can drive down the ultimate cost of care for the individual patient.
According to an article published in the AMA Journal of Ethics, once patients are knowledgeable about their options and health issues, they become powerful advocates for their own care, which leads to far better patient outcomes. Additionally, when consumers apply pressure on any industry — from banking to retailing — "it invariably produces a surge of innovation that increases productivity, reduces prices, improves quality and expands choices."
Health care will be no exception. Educated, engaged consumers, who shop for the best price and demand the highest value in their health care, can drive market competition and, ultimately, push industry costs lower. Consumers now directly control $330 billion annually in out-of-pocket health care expenses, and the choices they make have the potential to affect 61 percent of all health care spending. This is consumer empowerment.
Change is inevitable and there is opportunity for benefits advisors to continue the conversation with clients on changes that can be made today, including:
- Leveraging the power of consumer financial accounts that give equal weight and presence to spending, as well as saving health care dollars. For example, health savings accounts provide consumer-friendly product features like multiple reimbursement methods to simplify the payment process, and point-of-purchase tools that give spenders confidence they're using their dollars wisely.
- Become familiar with consumer-friendly plans that offer support tools that help groups guide their employees to finding the best care. Many health care providers have resources to compare services, which will become more of a prevalent demand as the executive order unfolds.
- Offer to hold lunch-and-learns or employee meetings at your clients' workplace to share tips on navigating the health care changes as they unfold.
This is only the beginning. As the executive order continues to take shape, consumers will become more confident in their health care decision. We're continuing to develop consumer education resources to empower people to take ownership of their health care, seek out the best options and, ultimately, realize the promise of consumer directed health care.
Matt Marek is Chief Executive Officer and President of Further, a national leader in health spending and savings account administration dedicated to guiding account holders across the U.S. in saving and spending wisely on their health care. Further serves large corporations, small businesses, labor unions, retirees, and groups in the public sector by providing health savings accounts (HSAs), flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), voluntary employee beneficiary association (VEBA) accounts and commuter benefit services. Visit hellofurther.com for more information.
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