Alegeus is a provider of health care spending account management services and has issued a report on how consumers are handling the shift to greater responsibility for their health care costs. (Alegeus Report) The report is based on a survey of over 4000 US consumers. It focuses on what it calls “moments of truth” in health care–choosing a plan, managing out-of-pocket costs, maintaining health, and shopping for health care services. A majority of consumers rate all of these decisions points as either challenging or extremely challenging, with 66% saying planning for out-of-pocket costs fits this description, 60% saying so for managing health care finances and for shopping for best value services and 57% for medical bill scrutiny and payment. Notably, all the most challenging activities are at least partly financial in nature. Not only did consumers describe these activities as challenging, but most had low levels of confidence in their ability to make good decisions on these activities, with 40% or less saying they were confident or vey confident in making decisions on each activity.
Consumers also generally described struggling with understanding basic benefit concepts and terminology, and with understanding differences in benefit options and potential cost consequences of choices. A majority found predicting out-of-pocket costs in the year ahead to be challenging, as they did with determining how much to save to meet those potential obligations. They also find managing health savings and health reimbursement accounts to be challenging. Interestingly, consumers feel it less stress in regard to wellness and health maintenance decisions, although many indicate they struggle with diet and exercise, and in regard to finding good quality providers. But most find it very hard to compare the costs of using different providers and to understand their medical bills. As you might expect, less confident consumers valued human interaction and assistance very highly, while more confident ones were more willing to rely on information technology tools to help them. This survey also supports findings of other research that those consumers who are in high-deductible plans with savings accounts are more engaged in both their health and their health care. This survey again demonstrates the extreme stress that consumers feel from health care financial issues.