Wednesday, November 29, 2006

Who Pays?

The HDHP debate will probably continue for some time. Who really benefits from these plans?

Our contention at InsureBlog is that (almost) everyone can benefit in some way from the HDHP coupled with the HSA. A recent Kaiser Foundation survey would seem to bear that out.

For example, compared to people with traditional health insurance, those in consumer-directed plans are more likely to say that they always or sometimes ask about the cost of a doctor’s visit before making an appointment (39% vs. 23%) or that they always or sometimes ask about less costly alternatives (57% vs. 38%). And, over half of consumer-directed plan enrollees who have used any services under their plans say that being in such a plan has changed their approach to using health care. Of those, 57% say they changed due to cost considerations.

The observation here supports our contention that those who pay the bills are more concerned about cost containment than those who are simply beneficiaries.

If you pay, chances are you are going to ask how much it costs before making a decision on treatment. If you pay, you may also ask for alternatives that may be lower in cost but just as effective.

If someone else is paying, then price is rarely a consideration.

And there is this.

However, based on these early experiences, it appears to be that consumer-directed plan enrollees are not yet becoming the kind of savvy shoppers that advocates for these plans envision. Relatively few say they have used their plan’s Web site to compare prices across providers (5%) or to compare quality across providers (7%) – essentially the same low rates of comparison shopping reported by those in traditional plans. A small exception may be shopping for prescription drugs, with people in consumer-directed plans somewhat more likely to say they used the Internet to shop for drugs (19% vs. 10%).

Disconnected consumers.

Only 5% use the resources available to compare provider prices. Only 19% compare prices for Rx.

If consumers are this apathetic when spending their own money, how much more so are they when spending the carriers money?


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