Through blogs and comments, patients and experts explore what it takes to find good health care and make the most of it.

Health Care Consumers Are Compromised By Complex Information


article image
Follow us on Facebook

The U.S. economy is largely built on consumer purchasing (the big “C” in the GDP* – see note, below Hot Points). Americans have universally embraced their role as consumers in virtually every aspect of life — learning to self-rely in making travel plans, stock trades, photo development, and purchasing big-dollar hard goods (like cars and washing machines). Consumers transact these activities thanks to usable tools and information that empower them to learn, compare, and execute smarter decisions. That is, in every aspect of life but in health care.

While the banner of “consumerism” in health care has been flown for much of the past decade, it’s been heavy-lifting for those U.S. health citizens who’ve been covered by insurance plans – and even heavier for those without health insurance coverage. The U.S. News & World Report magazine cover shown here is from 2004 – an image that clearly resonates nine years later when we’re all still trying to be “a smart patient.”

Nine in ten American adults still find the health care information that’s available to be confusing and complicated, and eight in ten say they don’t know which information and sources to believe. Seven in ten say it’s difficult to know the costs of different health plans, and seven also say there’s too much information to sort through.

Aetna‘s survey of consumer views is summarized in their report, The State of Consumer Health Care Empowerment. In three words, this state can be summed up as, “Not So Empowered.” 41% of U.S. adults have either skipped/stopped taking prescribed medications or skipped/delayed a recommended medical procedure.

Aetna quantifies that only 14% of U.S. adults are truly empowered in health care based on their perceptions of making health care related choices including comparing costs of health procedures beforehand, tracking out-of-pocket costs, and using mobile phone apps to manage health and wellness.

At the lowest rung of health empowerment, 41% of U.S. adults tend to be in fair or poor health, unemployed, with household incomes of less than $50,000, and unsurprisingly, the uninsured.

Aetna calculated an “empowerment gap” in several specific areas:

  • Getting a second opinion: 73% do so when they want one, but only 40% find it easy to do, leaving a 33% empowerment gap
  • Comparing costs of health procedures: 53% do so, 22% find it easy to do, leaving a 31% gap
  • Getting an appointment with the doctor of your choice: 82% do so, 53% find it easy to, leaving a 29% gap
  • Finding a doctor that takes your insurance: 84% do so, 56% find it easy to do, and 28% don’t

Aetna’s survey was conducted in July 2012 among 1,500 U.S. consumers 18 and over via a 20-minute phone survey (landline and cell phones).

Health Populi’s Hot Points: While the present state of health empowerment shows many gaps, consumers polled by Aetna say they’re keen to access tools that help them embrace their consumerism in health care. 71% of people told Aetna they’re interested in a website to help manage health care expenses, 65% would like a mobile phone app to provide reminders for doctors’ appointments and medication adherence assistance, and 52% would like a mobile phone app to help manage health expenses. Aetna offers digital tools through its iTriage platform.

The data chart tells the story about consumers who desire health empowerment but face complex information that’s inaccessible, opaque, potentially untrustworthy and daunting to sort through. The tools people are looking for must do that sorting and triaging to personalize the information so people can make as good a decision about their health care plan, provider, procedure or pill, as they do for their next washing machine.

The start-ups being funded in record dollar-numbers (see Rock Health’s 2012 report on the subject to get up to speed), the most successful of these ventures will be informed by what users want. Since 2004 and well before, the consumer has been waiting in the exam room in her white gown to become a smarter health purchaser. With newly insured people entering the health insurance marketplace in a matter of months — that would be about three fiscal quarters remaining in 2013 — it will be hard to fill those empowerment gaps noted by Aetna in time.

*From your Econ 101 course, remember that GDP = C + I + G + (X-M), where C=consumer spending, I=investment, G=government spending, and (X-M) is the net trade surplus of deficit of exports less imports.

This post was originally published on Jane's HEALTHPopuli blog on February 27, 2013.

More Blog Posts by Jane Sarasohn Kahn

author bio

Jane Sarasohn-Kahn is a health economist and management consultant serving clients at the intersection of health and technology. Her clients are stakeholders in health, including providers, payors and plans; companies in biopharma, medical devices, financial services, technology and consumer goods, non-profits and NGOs.  She blogs on HEALTHPopuli , where this blog originally appeared, and you can follow her on twitter at @healthpopuli.

Tags for this article:
Inside Healthcare   Health Insurance   Patient Engagement   Health Care Cost   Find Good Health Care   Pay for your Health Care   Participate in your Treatment  

Comments on this post
Please note: CFAH reserves the right to moderate all comments posted to the Prepared Patient® Blog. Any inappropriate postings will be removed.

Anne Thomas www, says
April 5, 2013 at 12:37 PM

Price comparisons are difficult given the elaborate system of discounts negotiated by insurance companies with some hospitals, labs, etc. In plan versus out of plan cost variables further complicate it. And pricing all depends on what codes are used which the consumer has no access too. Even if you find the best price, insurance can still refuse to pay for it, thus triggering the appeal process which rarely goes in favor of the patient. This is an incredibly complex problem.