Doctors Know Little About Consumer-Directed Health Plans

The continued adoption of Consumer-Directed Health Care plans is facing a major challenge according to an article posted on the US News & World Report website.

The report sited a survey which found that 43 percent of doctors said they have heard little, if anything, about these plans, and less than half (48 percent) feel ready to discuss medical budgeting with their patients.

The Health Plan Innovation Take: I find this lack of knowledge about consumer-directed health plans to be a bit disturbing. With more and more patients becoming responsible for the cost of their routine health care, it would appear from this study that physicians are not prepared to assist their patients with cost information on services that they are recommending. In fact the survey found that half or fewer of the physicians were prepared to advise patients about the cost of radiologic studies, specialist consultations and hospitalizations.

When managed care was introduced by insurance companies in the late 1980’s a most hired a large team of “provider service reps” to meet one-on-one with physicians and detail the plan’s compensation arrangements and quality standards. This does not appear to be happening in today’s change to consumer-directed plans. The question is why.

In the US News article , Dr. Hoangmai H. Pham, a senior health researcher at the Center for Studying Health System Change in Washington, D.C. said, “I don’t think it’s at all clear in insurers’ minds what role they want doctors to play, and I don’t think physicians themselves are clear on what they’re comfortable with.”

I think Dr. Hoangmai may be right. Insurers are reluctant to give up the control over the distribution and financing of health care that they have exercised for the past four decades, and rather than educate physicians to be part of a new openness about pricing, they are relying on their health information websites to do the job.

This is a dangerous situation if you happen to believe that consumer engagement is a good thing for the healthcare industry.

As Craig Pollack, a Robert Wood Johnson Foundation clinical scholar at the University of Pennsylvania in Philadelphia points out, “If there’s going to be a lot of pushback on the part of the doctors, I think it could lead to consternation on the part of the patients.”

We all remember what “consternation” on the part of patients did to the HMOs. Consternation was to HMOs what the Chicxulub meteor was to the dinosaurs.

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