3 Reasons Members Aren’t Shopping for Health Care (And What You Can Do About It)

With all the buzz about health care costs and health care spending, you might be surprised to learn that not many people actually use health care shopping tools. Given the recent increase in news headlines and media outlets (Vox, KHN) covering the issue of surprise medical bills and high health care costs, this is surprising. After all, shopping for health care whenever you can should minimize your chance for an obscene bill. So why aren’t more people price shopping for health care?

Health care is complicated. There are a number of issues out there from people’s income and financial stability to health care system complexity, for example:

  • Health care costs are unmanageably high for most Americans. In any given month, one in six families face a medical bill of about $2,000, according to a recent survey. And 25% of adults can’t afford a $400 medical bill.
  • According to our recent survey, 53% of people have received an unexpected medical bill at least once in the past 12 months.
  • The financial issues people are facing have led to many people delaying care. We found 40% of respondents in our recent survey reported skipping a routine check-up and 39% did not go to see a doctor when they (or a family member) were injured – just due to the fear of surprise medical bills.
  • Compounding these issues is a lack of understanding about how health care works in America. Health literacy is low, and only 4% of Americans can define key terms that determine how much they personally have to pay for medical services when covered by insurance.
  • And even new laws aren’t really helping with these core issues, including one that requires pricing to be posted by hospitals. So, price transparency doesn’t mean much to health plan members or even uninsured individuals when it isn’t tailored to their coverage and benefits status.

While these stats might seem discouraging, this shows how important it is for people to inform themselves about their health care options and become empowered to shop. More importantly, that is where health plans can make a positive impact for consumers. Setting up your health plan website to not only educate a member throughout their onsite experience, but also offer health care shopping, has the potential to greatly influence how people interact with the health care system and tackle some of the dark facts listed above. And what is the added bonus? An improved user experience and added value for your members will make them happier and more loyal members.

So, how can you help your members learn the true costs associated with their care and shop around for the best prices? We’ve put together a few tips based on our experience helping health plans and their members make smarter health care choices.

Let your members know they can shop for care.

Today, most people don’t even know shopping for health care services is possible. Most people have very little knowledge around health care and health care issues, so keeping as much focus as possible on education and guidance throughout your health plan portal is key. Here are a couple of additional ideas to consider:

  • Provide detailed training information to your employer group HR teams and onboarding teams. Onboarding at a new employer is times a person will be most engaged in their health care without actually needing care, so maximize it by working with your clients to offer valuable educational information and resources.
    Tip: your groups can also use this information to populate their intranets with information year-round.
  • Dedicate an annual marketing campaign to education about how to be an empowered health care consumer and where to go to shop for care. Include touch points throughout the year in email and statements, as well as in your hold messaging and customer service scripts to reinforce and remind of the message.

Make cost information easy to find/navigate.

This might sound like a no-brainer, but the ‘Find a Doc’ call to action on a member portal doesn’t tell someone they can get cost estimates for needed services. Plans should make information about shopping for health care and comparing prices easy to find. Keep things as simple and clear as possible when it comes to health care. Health care is confusing and no matter how simple you think you’ve made it, you can always make it simpler.

Remember that people are coming to their health plans with a wide variety of needs. They could be excited about planning a pregnancy or stressed out looking for an MRI. The more you can personalize the experience, the better.

Make the WIIFM (What’s in it for me) clear and compelling.

Health care shopping isn’t always clear to the consumer. The plan member might just go with what their doctor tells them because it is easiest and they don’t see a convincing reason that makes it worth their while to spend time shopping or move a prior authorization to another, more reasonable provider. Money speaks volumes.

Educate your members about out-of-pocket max in addition to deductible – they both impact your members’ wallets. This is a sure way to get them engaged and listening because any shopping they do will directly save them money.

Finally, offer your members financial incentives to give them a nudge to show around! Did you know that 80% of health plan members would choose a specific imaging center or lab for an incentive as low as $25? Finding out you can miss out on free money is a powerful incentive to take action. Help your members learn the value of shopping for health care by providing them with financial rewards for choosing a high-quality, lower-cost provider for their care. [RELATED: Do Incentives Work in Health Care? The Diagnosis Might Surprise You]