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| In Focus: Information Overload: Situation Critical |
By: HealthBond - Anne Marie Talbott, MA, MBA
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In today's Information Age, many consumers feel overwhelmed by the amount and variety of information available to them. Getting advice that recommends one treatment from Doctor A and another treatment from Doctor B can leave healthcare consumers feeling lost. Add to that confusion the frustrations of dealing with the insurance forms and procedures that most privately insured American workers have...and you have a prescription for a healthcare crisis!
As healthcare professionals, how can we develop better information guidelines and resources for our clients? How can patients become more informed about their options, while avoiding bogus "cures"? How does the regular healthcare consumer feel about the state of information dissemination in the healthcare system today? In this week's In Focus article, we set out to find some answers for these questions.
A recent New York Times article, " Advice Is the Newest Prescription for Health Costs", by Milt Freudenheim, noted that companies are stepping up to the plate to help their employees understand and sift through the huge amount of medical information available. Beyond any altruism, it's saving the companies money:
Some companies are developing ways to inform their employees more about their medical choices. A growing number of companies are adding specialized services...to help their employees navigate through the mass of medical information available today, from ads for prescription medicine to pitches for doctors and hospitals in magazines, books, television and online. These companies believe that their employees will get better care and that they may be less inclined to proceed with treatments deemed not appropriate. Employers hope to save money at a time when health costs are rising 9 percent or more a year. In the long run, many employers that offer the added advice are also trying to prepare their employees' medical care. (April 9, 2000, NYT Online, Business Section)
In today's atmosphere of high employment, companies also see this as a tool to retain or attract workers. Not only does helping one's employees obtain medical information help reduce healthcare costs, it also serves as a recruitment and retention device.
...many companies also view the added services as a way to attract and retain employees at a time when workers are scarce. The new services may reduce absenteeism as well. "It is clear to us that productivity is linked to good health," said Sue Nelson, a senior benefits executive at Texas Instruments. (April 9, 2000, NYT Online, Business Section)
An interview with a healthcare consumer, John Gatens, a manager in Dallas, Texas, sheds some light on the way consumers view healthcare in general and healthcare insurance specifically.
In Focus: There is a perception among healthcare consumers that their insurance is often too difficult to understand. What are some ways you can think of to alleviate this problem or change this perception?
John Gatens: Less fifty-page books and more one-sentence answers; use a Covered/Not Covered matrix with procedure on the left side and the various levels of coverage on the right, and clear statements: if a ten-year-old can not understand the statement, the statement is not clear.
In Focus: Do you think that the average healthcare consumer is willing to make cost-cuts now in order to get better service in the long run?
John Gatens: I think the average consumer is willing to pay the price for good health care. I think the way consumers think about health care needs to change. Insurance should not be for every cold, prescription and doctor's visit. It should be for major problems, and long term care.
In Focus: With respect to business healthcare consumers, do you feel that they can deal with cost-cutting measures now in order to have long-term services available?
John Gatens: I believe that the business health care provider will do whatever they can to get "acceptable" coverage at the lowest price. They will care little about co-pays and more about the bottom line cost and being able to sell this to their employees.
In Focus: How helpful do you think having outside third parties to help consumers with the billing process is?
John Gatens: Very helpful, if the third party is efficient and knowledgeable. If those two qualities are lacking, then the third party is another barrier to resolution.
In Focus: Should private insurance packages include preventative as well as the more usual healthcare coverage?
John Gatens: Yes, it is cost effective to identify and treat any illness as quickly as possible.
In Focus: What about coverage for chiropractic or massage visits?
John Gatens: If the procedure in question is historically effective, then yes.
In Focus: Should that be included in a regular package or not?
John Gatens: Yes, otherwise the only people who will purchase the coverage will be those which know they have a need for this type of treatment.
In Focus: What do you think about employers giving medical savings accounts instead of full coverage?
John Gatens: I think this would cause employees to be caught short with a major illness, no coverage and only a fraction of the money needed saved.
In Focus: Does this create poor risk?
John Gatens: This is a poor replacement for insurance but is better than nothing; this would work best as an additional healthcare resource.
In Focus: Do you think consumers can make all the best decisions about healthcare insurance?
John Gatens: Yes, they are the only people who can make an informed choice on their personal needs.
In Focus: What do you think the insurance payer (company) thinks about this?
John Gatens: It is too much work to try to work with the consumers; it is much easier to work with a single person who purchases healthcare for a group (i.e. Human Resource directors). Also, the insurance companies feel that the consumer is not informed and therefore can not make good choices about their needs.
In Focus: Where do you get information about health care and insurance changes?
John Gatens: The news, my employer and the documentation from my insurance company.
In Focus: How useful is the Internet for this process of information gathering?
John Gatens: The Internet is quite useful in finding general information but, for specific points, contacting the insurance company directly is still key.
Consumers want information--this is the perception not only from a consumer like Mr. Gatens, but from surveys of the larger consumer population. The Internet, as great as it is, still tends to be somewhat of a let down for healthcare information searchers. "Consumers appear to be hungry for added medical advice. They are eagerly responding to drug company advertising. And at least 60 million people visit Internet health sites each year, according to Harris Interactive, a research firm. But 'many Web sites are a mile wide and an inch deep,' Professor Herzlinger said." (Milt Freudenheim, April 9, 2000, NYT Online, Business Section).
Some employees don't think the company they work for or the health insurance company contracted by their employer have their best interests at heart. This perception can poison the relationships between employer and employee, and employee and healthcare insurance provider.
Freudenheim noted this in his article: " 'Employees are suspicious and mistrustful of managed care and the health insurance industry,' said Larry Gelb, president of CareCounsel. 'People say to themselves, "Why would the insurance company really care whether I make the best decision?" when the bottom line is profit or cost containment,' said David Hines, president of Consumer's Medical Resource. (Services like his typically promise confidentiality, so employers do not know which employees are seeking help.)" (NYT Online).
He also noted the response from the managed care industry: "The managed care industry is well aware of such problems. A number of HMO's are now adding programs to help consumers understand their choices, said Susan Pisano, a spokeswoman for the American Association of Health Plans, a managed care trade group. 'We want to put the consumer at the center of the system and empower her with information and access,' said Dr. David Lawrence, chief executive of Kaiser Permanente, the California-based nonprofit HMO." (NYT Online).
How can we help, as healthcare professionals? For one, we can listen to what the consumer has to say about these issues. Two, we can provide more access to relevant and correct information, possibly using the Internet as a medium. Three, we can empower each other as consumers, not just as healthcare professionals, to focus on the solutions, and not the blame aspect of the issues. Too often, the healthcare community is torn asunder by infighting and blaming.
We have to treat the healthcare crisis as a crisis--in the Emergency Room, blame for the accident isn't an issue. If we look at the healthcare industry as an accident victim, and we want them to survive, we (healthcare professionals) must work together as a team during those critical few minutes. The healthcare consumer is willing to tell us what he or she thinks, as a businessperson, as a member of a group such as the elderly, and as a consumer in general. We must be willing to listen, and focus on solving some of these problems creatively. Any ideas?
In Focus for May, Consumers in Healthcare. Previous articles for May.
May 1-7, 2000, Consumers Care!
May 8-12, 2000, Meeting the Bottom Line
May 15- 19, 2000, The Graying of America: Elderly Healthcare Consumers
Anne Marie Talbott, atalbott@healthbond.com
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Member Opinions:
By: lwhitfield on 5/24/00
Nice article. I have been especially lucky because my employer offers two different health plans; one is an HMO with a much higher monthly premium, no annual deductible, and no co-payment, and the other is a a PPO with an annual deductible and a required co-payment. Having this simple choice of two different plans has allowed the employees to select the plan that most fits with their lifestyle. I am personally willing to pay more money per month for more complete coverage and I like having the choice to do so.
By: annemarie on 5/24/00
I think consumers feel empowered by choice, as long as they can understand what's being offered! I like the idea of being able to choose the plan which suits my lifestyle or needs, rather than have it chosen for me.
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