Helping Employees to Be Smarter Health Care Consumers


Fifty-five % of staff do not know that they’ll examine the price of well being care therapies or providers earlier than selecting the place to get care, whereas 57 % test if a supplier is in community solely after they plan to go to a brand new supplier or facility, although suppliers’ community standing can change from yr to yr.

These are among the many findings in a September 2021
report on well being care literacy by Birmingham, Ala.-based DirectPath, a advantages training, enrollment and well being care transparency agency. DirectPath carried out a survey earlier this yr of greater than 1,000 respondents with employer-sponsored insurance coverage.

Kim Buckey, vp of shopper providers at DirectPath, just lately answered questions from
SHRM On-line in regards to the steps employers can take to enhance staff’ understanding of well being care prices and the way to buy nonemergency well being care providers.

SHRM On-line
: How is well being care literacy and consumerism vital for employers and staff?

Kim Buckey: If staff do not perceive the essential phrases and ideas of medical insurance, it may be troublesome for them to understand how their choices can have an effect on the price of their care. As a result of they do not store for care, they usually find yourself paying greater than they should for well being protection and well being providers. Once they pay greater than they should, it hits them—and their employers—within the pockets.

Assume staff are advised to get a take a look at at their native hospital, which costs $1,000. If staff have not met their deductible, they need to pay that quantity out of pocket. If they’ve met their deductible, they will nonetheless need to pay a share of that value—usually 20 % or 30 %.

By procuring round, they could uncover they’ll get the identical take a look at completed at a stand-alone testing middle for $500. Would not they reasonably pay 20 % of $500 as an alternative of $1,000? And bear in mind, the employer usually pays a proportion—usually 70 or 80 %—of that very same $1,000 or $500.

For self-insured plans, that is a direct hit to their backside line. For absolutely insured plans with premiums based mostly on participant expertise, the selection of the $1,000 take a look at—and related selections made by different staff—will finally drive up premiums.

Worse, staff could grow to be petrified of prices, particularly in the event that they have not met their deductible and postpone and even neglect getting the care they want—lacking the chance to establish and attend to potential well being points early, earlier than they grow to be persistent or acute and much more costly.

SHRM On-line
: Is the state of affairs round well being care consumerism enhancing?

Buckey: Lately enacted laws requiring transparency in well being care pricing and
associated company steerage has been an enormous driver for employers—if they have to put money into the instruments mandated by the federal government to supply cost-comparison data from well being care suppliers, they’re actually going to need to ensure their staff know that these instruments can be found and the best way to use them. That requires some pre-education about what’s coming and why it is vital.

Info on Comparative Prices

When enrollees in group plan protection have been requested what assets they’ve used to match the price of well being care providers, right here have been their solutions, with the share of respondents citing every useful resource.

  • On-line assets evaluating approximate service prices (45 %).
  • On-line assets evaluating approximate prescription prices (34 %).
  • Price-comparison options provided by their employer (24 %).
  • Financial savings applications that present free prescription financial savings (23 %).
  • Price-comparison options provided by their well being care service (23 %).
  • Hospital or facility web sites (17 %).
  • “I known as round myself” (15 %).
  • Advocacy providers provided by their employer (8 %).

2021 Client Report: All Eyes on Well being CareHowever Not Sufficient on Well being Care Literacy Initiatives, September 2021

SHRM On-line:
What are the very best steps staff can take?

Buckey: For workers, make it your corporation to get accustomed to the instruments your employer and your plan supply. Examine the advantages web page in your employer’s web site, your native hospital’s webpage and your service’s member web page for data and instruments that can assist you analysis pricing. Taking the time to research client websites akin to GoodRx and FairHealth, to call simply two, will help you get comfy with the method. Ask your employer if they provide transparency and advocacy providers—they’ll do the give you the results you want and allow you to with the decision-making course of.

For employers, make it straightforward for workers to get assist. Along with a fundamental training marketing campaign emphasizing that staff
can store for well being care with out risking high quality, it is vital to clarify precisely the best way to do it and what assets can be found to assist. Work together with your carriers, your brokers, your consultants and different companions to ensure there are instruments out there—and assets to assist staff to make use of and make sense of those instruments.

Emphasize the “what’s in it for me”: Present examples to indicate how staff and their households can receive high quality care whereas managing their prices.