// By Bill Tourlas //
Historically, consumers have played a relatively limited role in their health care decisions, especially as it relates to selecting an insurance plan. People had little concern for price or health plan comparison since employers dominated consumer choice, paying most, if not all, of the premium and typically offering employees plans with broad, open networks. Plus, high switching costs often encouraged people to stick with their current plan rather than shop around. This is no longer the case.
Consumers have transitioned from passive decision-makers to much more active participants with a greater power of choice. The Affordable Care Act’s (ACA) ambition to expand insurance coverage, along with employer actions to curb insurance cost growth, have led many individuals to purchase high-deductible health plans (HDHPs), through which people bear more of the cost of their care. With more financial “skin in the game,” consumers have become more price sensitive and value conscious when “shopping” for their health care.
A Transparent Marketplace
A hallmark of the ACA is the insurance exchange, which exemplifies health care’s new reality—a transparent marketplace where shoppers make comparisons of products, networks, performance, quality, and prices. No longer restricted by employers, people are taking control of their health care decisions, comparing, switching, and choosing plans based on their evaluation of data that has not been readily available in the past.
Welcome to the new health care.
This new consumer-driven landscape is reshaping behavior. When making health care decisions, consumers are demonstrating similar habits and patterns as they do when making other complex purchasing decisions (such as financial services) and more everyday choices (like picking a restaurant). All of these factors are changing people’s expectations of hospitals and health systems, forcing a shift toward what has been referred to as a retail-based health care market where consumer value is overwhelming provider convenience.
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