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Economic Disruption in Healthcare Symposium - Part II
H. Stuart Elway, PhD
Will Consumers Shop
For Health Care?
Health Care Moving to Consumer Choice Models
• Will health care consumers price shop?
• Do consumers exercise choice now?
• Do consumers want more choice?
• Is it even possible for consumers to shop?
Health Care System Through the Eyes of the
ConsumerPublic Agenda Foundation• Most unaware of how HCS really works
• Concerned about personal HC spending– Only 30% confident they can afford
care they need
• Concerned about national spending trends
• Support cost-saving concepts, but no consensus
Our Research
• Focus Groups
• Survey of WA residents – 500 heads of household 18-64– March 13-18
Respondent Profile
42% over age 5016% under 35
68% Couple41% Children at Home
60% Employed Full Time14% Employed Part Time
53% College Degree
System Usage
82% have regular physician37% did own research
20% visited Doctor 0-1 times last year
21% visited 12+ times last year
52% saw specialist in last year
Health Insurance Coverage
2215
11
48
5
Self-PayPartial PayEmployer PayOtherNo Insurance
60% Chose from among plans offered by employer
Reason for Choosing Insurance Plan
53% Do not know their Maximum Out-of-Pocket Limit
Why is Health Care So Expensive?
26
20
20
15
10
6
13
12
Medical providers
Consumers
Government
General costpressures
Insurancecompanies
Attorneys/lobbyists
Other
None/DKNA
Potential Impact of Comparison Shopping on The Health Care
System
Advantages / Disadvantages of Shopping for Medical
Treatments
Advantages
48% Lower Cost
37% Choice
14% Better Quality
2% No Advantages
Disadvantages
33% Quality Concerns
27% Consumer Burden
6% Higher Costs
2% Less Choice
18% No Disadvantages
Consumers Able / Want to Price Shop?
Why Shopping Would be Personally Desirable / Undesirable
Desirable
30% Choice/Control
30% Lower cost
18% Better value
14% Better quality
Undesirable
40% Not Needed
26% Consumer burden
18% Lower quality
9% Higher cost
Potential Impact of Consumer Shopping
on Health Care
71
66
62
11
6
13
Cost
Access
Quality
Pos Neg
Would You Price Shop for Treatment
HESITATION:30% Quality of Care21% Happy w/ current
Dr13% Price Not
Everything13% Specific situation 9% Consumer burden 8% Use
recommendations
23
1175
54
Definitely Maybe Probably not Definitely not Depends
Likely to Price Shop for Specified Procedures
5954514641
17
19
13
27
26
Laser eyesurgery
Kneereplacement
Heart surgery
Back pain
Blood pressure
Very Likely Maybe Unlikely Very Unlikely
20
25
34
25
30
Past “Shopping” Behavior
60
36
18
30
14
49
35
24
0
10
20
30
40
50
60
70
Shopped forInsurance
Chosebetween
plans
ChoseLowest price
plan
Chose Dr.on own
ChoseSpecialist on
own
Asked abtCost
Forgone dueto cost
ChosenTreatment
on Cost
PROVIDERINSURANCE TREATMENT
Hypothetical: Choose Provider
69% aware that different providers charge different fees for same treatment
PROVIDER A: $10,000PROVIDER B: $7,500
Hypothetical: Choose Provider
PROVIDER A56% Better Care16% Not Sure
PROVIDER B90% Cost savings22% If Quality Equal
Hypothetical: Choose Provider
“DEPENDS”
71% Quality of Care17% Cost not only
concern12% the Procedure
Additional $$ Factors
5
6
7
45
44
44
13
14
18
16
50
19
19
INITIAL
CO-PAY
REBATE
A $10,000 B $7500 Much More Maybe Depends/ Undec
Potential Impact of Rebates on Health Care System
60
62
59
46
19
12
9
23
Overall
Cost
Access
Quality
Pos None Neg
Impact of price shopping on overall cost of health care
25
3120
22
Significant Maybe Not signif None
37
43
17
2
Long way Maybe some Little/None
Impact on personal decisions
of lowering overall cost
So, Will Consumers Shop?
Foreign concept – Difficult to relate to the question– Seen in familiar insurance context
Indicate willingness on surface– Have not thought it through– Reluctant when given time to consider
Seen as shifting cost to consumers– Personal costs rising as it is– Concern that result in avoidance of care
So, Will Consumers Shop?
Care Situation– Emergency– Costs of Component treatments– Reluctance to second guess Doctor
Information– Lack of expertise, confidence– Learning curve (time burden)– Lack of information (comparative data)
Significance of choice
So, Will Consumers Shop?
Quality is the trump card
Door is open to discussion
Economic Disruption in Healthcare Symposium - Part II
H. Stuart Elway, PhD
Will Consumers Shop
For Health Care?