Healthcare consumerism leads to cost savings for health plans and members

July 27, 2021
Lindsey Logan

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Healthcare consumerism is becoming an increasingly popular concept. It’s the idea that patients are also consumers, and consumers like to shop for options. With price transparency becoming more available in healthcare settings, it’s important that health plans provide members with ways to shop and compare care. Giving members the tools they need to shop their care will lead to savings for both them and your health plan.

Price transparency is the foundation of healthcare consumerism.

For several decades, negotiated prices with health insurance plans haven’t been publicly available. The norm has been that patients don’t know how much they're charged until after they receive care. However, price transparency laws have been passed that now require hospitals to make negotiated rates for common services publicly available. Cash pay prices for these services must also be publicly displayed on hospitals’ websites. This transparency is great news for patients and healthcare consumerism. But unfortunately, the fine for non-compliance is so low that many hospitals have chosen to pay the fine instead of complying. However, the penalty may be going up in price, which would likely increase the number of hospitals that take part in price transparency. As price transparency becomes more prevalent, healthcare consumerism will have solid ground to build on. 

Every type of health plan can benefit.

The ability to see healthcare pricing has benefits for everybody. For example, members who benefit greatly from price transparency are those who are cash pay or pay mainly out-of-pocket. This is because shopping around ensures they’ll go to the most affordable provider. Members shopping for care is especially beneficial to:

- High deductible health plans.

- Health cost sharing groups.

- Discount medical plans.

But, every type of health plan can enjoy this type of member engagement too. After all, lower medical bills lead to lower claims costs. When members are aware of pricing upfront and prepared to pay the agreed amount, costs will be cut in back-end areas such as patient billing and collections.

Overall healthcare costs go down with healthcare consumerism.

When patients are able to shop for their care, it causes providers to offer competitive pricing. This is because it forces providers to become aware of what their competitors are charging for the same services and procedures. Patients will start to choose comparable providers with lower prices. They may even negotiate with their providers for lower rates.    

Final thoughts.

Healthcare consumerism encourages patients to be active in their own health. Patients shy away from taking control of their health when they don’t know how much a procedure will cost. Plus, engaged members tend to be healthier, which also lowers costs since they need less care. Empowering your members to be engaged healthcare consumers can be as easy as offering a shop-and-compare app. Partnering with a third-party patient advocacy company is also a simple solution. Any way you choose to embrace healthcare consumerism will lower costs and increase member satisfaction.

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Download The Patient Advocacy 2.0 White Paper

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Download The Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download The Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download Your Guide to the Transparency in Coverage Rule

Discover how the the new rule will affect TPAs and health plans and how you can start your journey to compliance.

Download The Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download The Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download The Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download The Sedera Case Study

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download The Lowering Organizational Member Cost Guide

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download The Lowering Organizational Member Cost Guide

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download the Complete Guide to Growing Your Health Plan Membership

Learn the best strategies and tips for growing your members while keeping costs low.

Download the Complete Guide to Growing Your Health Plan Membership

Learn the best strategies and tips for growing your members while keeping costs low.

Download the Complete Guide to Retaining Health Plan Members.

Learn the best strategies and tips for retaining your members while keeping costs low.

Download Healthcare Consumerism 101: A Playbook for Health Plans

Learn the best strategies and tips for retaining your members while keeping costs low.

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