What tools are available to consumers who want to know more?
Many insurers offer Web-based tools that provide prices for specific services that can enhance consumer awareness. Members can look up cost differences between providers, care centers and medications.
In addition, almost every insurer offers a nurse line that’s available 24/7. Members can get help with determining the next steps for symptoms and whether self-care might be appropriate. Or, the nurse might recommend an urgent care center, or a retail clinic in a local drug store, or help the member decide that an emergency room visit is needed. Good, quality care does not have to be the most expensive care.
Are patients better consumers now than when employers paid for all benefits?
Consumers have become better in certain areas, typically with pharmacy programs and some physician office visits. As individuals share in a greater portion of the cost for their pharmacy benefits, they have been more willing to consider using generic drugs. And more patients are realizing the value of a good relationship with a primary care doctor.
In addition, more people are realizing that when they visit the emergency room for routine services, the wait time is long. Emergency room doctors and nurses must focus first on situations where life and limb are in danger. That can mean that a sore throat or sprain is going to have to wait.
How can employers help employees become informed customers?
First, help them recognize that health insurance premium increases are directly due to underlying increases in health care costs and utilization. Explain the factors driving health care costs, which include increased use of services, new and experimental services, and duplication of services. Promote the use of in-network providers, as there is usually a financial incentive to use one.
But most important, don’t forget that the best and cheapest way to treat any illness is to prevent it in the first place. Communicate health and wellness tips, such as exercise, preventive visits and others available on many reputable health education Web sites.
What other information should employers provide?
Tell employees how much you pay for health insurance premiums. Many will be shocked to learn what you pay on their behalf. Communicating this is especially important during times of open enrollment or benefit changes. But it’s never too early to start.
An employer needs to spotlight the per-employee average or highlight the cost of individual and family packages. This compensation doesn’t show up on paychecks, and employees don’t really understand its value.
Howard Cutler is vice president and executive director of HealthAmerica’s eastern region. Reach him at [email protected].