Too Confused to Use?

A study by GfK Custom Research of 502 private-sector employers painted a picture of where employers stand today regarding the Affordable Care Act and offering health insurance benefits to employees. Not surprisingly, most still don’t believe the Affordable Care Act will have much impact on the future costs of health care, and many believe it will actually increase the costs in the future. However, the majority of employers still don’t understand what is in the law and how it is supposed to work- so, the comments are based more on perception than fact.

Over 55% of the employers indicated they would continue to offer health insurance to their employees even after the major components of the “insurance reforms” of the Affordable Care Act are put in place. However, the responses were dependent on the size of the company. Most large companies plan to continue to provide health insurance- while smaller companies aren’t so sure. Over 30% of the companies (both large and small) are unsure whether they will continue to offer health insurance as a benefit to the employees in the future. Not surprisingly, the majority not offering health insurance now base their decision on cost (not on the Affordable Care Act).

In 2004, about 68% of the employers offered health insurance to their employees. The number stands at 60% today. By 2014 (when the theoretical “health insurance exchanges” are supposed to be operational) the number will likely be somewhere between 50-60%.

If the numbers hold, consumers are going to need to purchase health insurance different than they have in the past. They are going to need more education, more guidance, and more “transparency” than ever before. Transparency has never been a core competency of Health Care.

So, while Health Care focuses on all of the other transactional details to establish exchanges, develop new delivery models (Accountable Care Organizations), collect data, and all the rest let’s hope it doesn’t forget about the needs of those who can really have an impact on changing the trajectory we are on today- the individual/the patient.

All the new ideas won’t make much of a difference if the individual doesn’t understand how they work- or are too confused to be engaged to use them.

Transparency- Getting People To Use Information Is The Real Key

The November, 2011 publication of the American Journal of Medical Quality found 80% of the “highly findable” health care rating sites (rating doctors and hospitals) draw on anecdotal patient reports (the patient opinion and experience) more than anything else. According to the article, the sites many are using to research care providers and show highly ranked in the search engines don’t use some of the measurements Health Care would like them to use to help make informed health care decision. Only half of the highly findable sites include quality information and a third feature cost data. Forty-four percent featured performance results based on claims data or board-certification information.

Despite the effort Health Care is making to increase the amount of data and information available to the general population, a large segment remains frustrated with their inability to find what they need when they need it. Their frustration lies in three key areas: A lack of awareness of what is available, not knowing what questions they need to ask, and then finding the information once they know what they need. Individuals will likely continue to rely on family, friends, and their social networks as a more reliable source until Health Care packages and markets the information in a way that is relevant to the individual.

As Health Care continues to improve the "transparency" of how with works with the general public it will need to continue to acknowledge the “trust barrier” that exists with many individuals. Individuals will gravitate to the sources they feel they trust and provides information that is relevant to them. Collecting information is the first step, analyzing the information is the second step, packaging and communicating the information is the third step. And, it seems as if “experiential rating sites” have done a better job packaging and communicating their relevance to the general population than those that use the metrics Health Care prefers.

Maybe Health Care can learn from them.