Consumer Engagement in Health

The Employee Benefits Research Institute releases results from its most recent survey in regard to consumer engagement in health, with a useful sorting by age bracket.   (EBRI Survey)   The survey includes over 3500 adults aged 21 to 64 who had private health insurance, mostly through an employer.  Baby Boomers were born from 1946-66, so are aged 72 to 52.  Generation X was 1966-76, so ages 52 to 42, and Millennials were 1977 to 2000, so ages 43-18.  There are about 75 million each of Baby Boomers and Millennials.  Millennials tend to have more satisfaction with various aspects of the health system, and I think that is almost certainly because all they have known is the expensive system we now have and they are younger so have fewer health needs.  Overall satisfaction with their health plan comes in at 56% of Millennials, 55% of Baby Boomers and 47% or Xers saying they are very or extremely satisfied.  A lot of those BBs now have Medicare.  In terms of the quality of their health care, 66% of Ms, 69% of BBs and 61% of Xers are extremely or very satisfied.  Millennials are significantly more satisfied than the other cohorts with the number of plan choices, the affordability of those choices and the information available to make choices.   Millennials are also more satisfied with financial aspects of the plans, as 42% are extremely or very satisfied with their overall out-of-pocket costs, compared to 36% of Boomers and 31% of GenX.

While there is some tendency among all generations to have no preference, in general all of them say they would prefer lower premiums and out-of-pocket costs in exchange for less choice of doctors and treatments, rather than higher costs but more choice.  Again, this is really a case of more health needs as you age, but 85% of Boomers have a primary care physician, versus 78% of Xers and 67% of Millennials.  Among those with a PCP, Boomers are more likely to follow advice to change behavior.  Walk-in clinic use varies substantially, with 30% of Millennials having used one, 18% of Xers and 14% of BBs.  All generations have a majority who have looked for cost information, but Millennials have the highest rates and they are more likely to look for and use other information in making decisions regarding treatments and their costs.  Millennials also have higher rates of participation in most wellness type activities, although Boomers were a little more likely to get biometric screenings or health risk assessments.  They were also more interested in telemedicine.  Somewhat surprisingly, while Ms report more healthy behaviors, their rates of smoking are twice that of Boomers.  The research is interesting but again, most of the findings can be explained by health need as much as by age and attitudinal differences.