Home / Archived Articles / Tools Help Consumers Choose Quality Health Care at the Best Price

Articles

Tools Help Consumers Choose Quality Health Care at the Best Price

The cost control promise of consumer-directed health plans depends on plan members making medically appropriate, yet cost-conscious, decisions when seeking health care services. Though resources to enable this kind of decision making have been lacking, some tools are being developed that help consumers to find and choose quality providers, and compare costs before receiving services.

As stated in a release from the Employee Benefit Research Institute in conjunction with its 2008 EBRI Consumer Engagement in Health Care Survey, the premise of consumer-directed health plans is that by transferring more costs to plan members, they will become more savvy health care consumers, and have more incentive to take better care of themselves. In support of this, the survey found that consumer-directed health plan members ranked high in cost-conscious behaviors, including seeking information on the cost and quality of doctors from sources other than their health plan, considering cost information when making health care decisions, and asking a doctor to recommend a less costly prescription drug.

But just where can consumers find cost and quality information to enable informed health care consumerism?

One such place to obtain information on the cost of specific health care services is from the firm change:healthcare (http://www.changehealthcare.com/) which issues a quarterly Healthcare Transparency Index that analyzes medical claims to determine opportunities for cost savings in different medical categories. The index, for example, looks at the cost of prescription drugs in different pharmacies to isolate opportunities for savings that consumers could take advantage of by shopping around when filling their prescriptions.

According to the 2010 index, prescription drugs are the health care services category that offers the highest opportunity for savings, followed by dental, psychotherapy, primary care physician office visits, physical therapy and chiropractic care. Both generic and brand-name prices varied by dispensing pharmacy. For example, a user of Abilify, a brand-name drug to treat depression, could save nearly $2,500 a year by making a pharmacy change; for omeprazole, a generic for Prilosec (to treat acid reflux), a pharmacy switch could mean close to $900 in annual savings. Switching from one name pharmacy to another was not the only way for a consumer to save money on prescription drugs, because within pharmacy chains, costs could vary widely location to location, with Wal-Mart, Target, CVS and Walgreen topping the list of pharmacy chains with the largest cost discrepancies for a one-month supply.

Consumers need and deserve more information than has been traditionally available about health care providers and services, including the costs of various treatment options, results of patient experience surveys, and data on quality. The Consumer-Purchaser Disclosure Project, an employer/consumer/labor organization collaboration, suggests that such information should be provided through simple printed materials, including comparison charts and worksheets, as well as through interactive computer programs. These types of tools will help consumers choose the right health care, at the right price. Only then will consumer-directed health plans live up to their cost-savings potential.