Health Care Consumerism —What You Need to Know
Health care costs in the United States continue to rise after a decade of unexpected growth. Hoping to encourage a turnaround, many employers have been turning to a recent trend in employee health care benefits: consumer-driven health plans. The purpose of these plans is to educate employees concerning the true costs of medical services and to hold employees more responsible for their medical care purchase decisions. Though the employee takes the reins with these plans, consumerdriven health care is still sponsored by the employer.
Consumer-driven health plans require patients to be more informed and eventually more financially responsible for the real costs of health care services. Employers offering these plans hope that employees will use health care services more efficiently, which should eventually lessen the demand and cost of health care over time.
Ultimately, consumer-driven health plans are more than just a few specific types of health plan “models.” Instead, these plans rely on the idea of “consumerism,” coupled with a formal employer-sponsored health plan. Consumerism, as it relates to health care, can range from simply offering employees the ability to choose among a few different health plans to providing vouchers for employees to purchase their own individual health plans on the open market.
Advocates believe this will encourage employees to assume a greater role in managing their own health and the associated costs. Whatever the case, consumerdriven health plans can only work when a variety of additional financial incentives and informational programs are introduced, such as preventive care services, wellness and disease management programs and provider cost and quality information. These tools provide employees with the information they need to make the most valuedriven choices.
One of the most common consumer-driven health plans pairs a health reimbursement arrangement (HRA) with a high-deductible insurance plan. HRAs are employersponsored health spending accounts that allow employees to accumulate funds for health-related expenses. Employers fund these accounts for their employees to pay for routine and preventive medical care, and the insurance portion provides coverage for traumatic or high-cost events. Typically, any unused funds in the account can be rolled over and used in the following year(s).
The key component of any consumer-driven health plan is that employees are provided with a set of tools to help them understand the complex health care system.