Healthcare consumerism remains a hot topic. While a recent McKinsey article did a great job of debunking the “myth” of consumerism in healthcare, the jury is still out as to the impact consumerism can have on overall healthcare costs.
Another article on Health Affairs Blog highlighted a study by the Health Care Cost Institute calling into question the amount of impact consumers can realistically have on healthcare costs. The authors argue that consumers can only have an impact on costs where services are “shoppable” (which they define as being able to be scheduled in advance, having more than one provider available, and having pricing info available by provider), and where enough pricing variation exists. In addition, they point out that the format of the consumer’s plan benefits matters, and price shopping won’t happen or won’t pay off in cases where the consumer has only a copay. The picture painted is one in which consumers can impact only a rather small percentage of overall healthcare costs. To boot, there is evidence that the vast majority of consumers are not yet searching for and using price and quality information in their healthcare decision-making.
While the evidence, analysis, and conclusions drawn are logical, I don’t think we should dismiss healthcare consumerism and its potential. Why? Because if we do, then we’re underestimating the potential impact of changing consumer decision-making behavior on an initially smaller scale. I would argue that if consumers start doing more price-shopping on things like minor illnesses and injuries – where pricing is highly variable and shopping can save the consumer a lot of money – we will start to see a spillover effect into higher cost, higher impact items.
I can say from personal experience that I’ve learned that it pays mightily to shop around for urgent care – the nearby in-pharmacy clinic or urgent care center is significantly cheaper than the ER for an after-hours sore throat emergency, especially when you have a high deductible health plan. Having experienced this a few times now, I know not to run to the emergency room first, and my pocketbook is much happier as a result! And that important lesson has spilled over into my decisions around higher ticket items such as diagnostics. I have learned to investigate freestanding imaging centers rather than the hospital location when the doctor orders a test. In addition to realizing cost savings, I’m developing comfort with using these alternative delivery mechanisms. I definitely feel that as I get more experience with seeking out cost-effective options in these smaller-impact scenarios, it is changing my behavior and making me a better, more price-conscious consumer overall.
Small steps can lead to big changes, and I believe consumers will continue to push the envelope on healthcare price transparency as they get comfortable with price shopping on a smaller scale.