The pandemic is actually generating something positive: an escalation of healthcare consumerism.
At the end of last year, employee benefits consultants were putting the finishing touches on carefully researched “decade in review” presentations. I should know—I was one of those people. At the time, we believed data found in those reports, like the healthcare consumerism trend, could help build a strategy for the next few years while we enjoyed a steadily growing economy.
But, not long after we gave those presentations, everything changed. As we continue to battle the COVID-19 pandemic and the uncertainty that comes along with it, some of the strategy recommendations in those presentations feel like ancient relics.
However, the healthcare consumerism trend that continues to gain momentum. Especially when aided by new technology and regulatory reform, this push to create a more informed, empowered consumer is one thing COVID-19 can’t stop.
Defining Healthcare Consumerism
In a nutshell, “healthcare consumerism” is the appetite for and ability of members to make informed, personal decisions about care based on details like quality, price and convenience. We encourage consumerism because informed members make better investments in their long-term health, saving themselves and their employers money in the process.
For example, a member who has access to physician reviews can whittle the field to someone whose style of practice fits their needs. With pricing information, they can further eliminate providers who charge above-average prices for similar services. Finally, with accountable care organizations (ACOs) and other provider arrangements, a member can trust that a diagnosis is coming from the most-qualified provider, eliminating uncertainty.
Through careful analysis, there were recommendations, regulations and strategies implemented over the last decade to get the ball rolling. Fortunately, it’s clear that the pandemic hasn’t slowed it down.
The Decade in Review, Revisited
The groundwork for our current healthcare consumerism trend was laid when the Affordable Care Act passed. Its Medicaid expansion strategy allowed the Centers for Medicare and Medicaid Services (CMS) to enact a Medicare-shared services program that paid providers based on performance, which led providers to establish ACOs.
These programs made it easier for members to get high-quality care at a lower price. But they also had an added benefit: an electronic reporting mandate that provided the government access to large swaths of usage data, making it easier to assess which parts of the programs were most effective in promoting improved outcomes and responsible consumerism. One of those highly-effective products was the health savings account (HSA), a long-standing tax-advantaged savings account dedicated to approved healthcare costs and funded by the employee, employer or a combination of both. Though HSAs were available before the Affordable Care Act, they captured the attention of experts who noticed how well ACOs and HSAs work together.
In fact, in December 2018, the United States Joint Economic Committee found that HSA enrollment would improve industry performance because consumers would be managing their own healthcare dollars, motivating them to shop around for the best value and to demand more transparency.
What Happened—or Didn’t—in 2020
When the COVID-19 outbreak hit, we were concerned that progression would slow as the federal government tried to “triage” issues in an overburdened healthcare system. Though some things have slowed down, others are rapidly accelerating.
Consumer-facing telehealth products are now the main drivers of consumerism, thanks to a strong pool of startups enjoying large venture capital infusions and merger offers, even as the outbreak stalls other investment categories.
The federal government and insurance carriers also evolved rapidly by making telehealth adoption one of their key strategies.
Suddenly, telehealth saw a massive turnaround complete with member education and improved user experience. There’s also necessity driving adoption rates—after all, patients are rightfully nervous to visit the doctor about an ear infection during a global health crisis.
Today’s telehealth is such a boon to healthcare consumerism because qualified providers are able to see more patients within a smaller window, and often at a lower service price. Patients also aren’t limited by region and can “see” a specialist for their condition virtually, eliminating the need for multiple opinions from less experienced providers.
All of these factors are having a big positive impact on consumer experience, as well as the bottom line.
For HR teams, encouraging healthcare consumerism requires a second look at plan design, strong healthcare education and constant communication. In practice, consider adding an HSA to your offering, organize regular meetings between employees and benefits consultants, send frequent reminders about ways to get the most of their plan (even outside of enrollment season), and encourage them to build on their benefits intelligence.
From physicians to health plan administrators, if you’re in the healthcare business, you’re in the behavior-changing business. In spite of COVID, we’re still changing for the better.
- Shopping for Benefits: What the Future Holds for Employers and Employees
- Employers: Help Your Employees Avoid HSA Challenges
- Creating the “Urgent Care First” Mindset for Employee Benefits
© 2020 Corporate Synergies Group, LLC. No part of this material may be republished or distributed without prior written consent.