Many consumer-directed health plans do little to help members find reasonably priced doctors and hospitals.[@@]
A team of researchers led by Meredith Rosenthal, a health policy researcher at Harvard University, has published a paper documenting that weakness in the latest issue of Health Affairs, a health finance academic journal.
The researchers conducted the study by reviewing a specific employer’s implementation of each of 14 consumer-directed plan programs. Half of the programs incorporated health reimbursement arrangements, health savings accounts or similar personal health accounts. The others used various types of provider tiers to guide member behavior.
Only 2 of the 14 plans studied gave members information about how much doctors and hospitals charge per service, and both were spending account-based plans, Rosenthal and her colleagues write.
The plans that used provider network tiers to single out star providers used the tiers to give members a rough idea about which providers were “cost efficient,” or good at holding down the total cost of treating an illness or injury. But none of the account-based plans provided cost-efficiency information, the researchers report.
Improving cost and quality information is critical to making consumer-directed run properly, the researchers write.
“If consumers lack access to information about the costs and quality of provider and treatment options, the notion of a discriminating health care consumer is meaningless,” the researchers write.
The researchers say the federal government could improve consumer-directed plan cost information by giving health plans access to Medicare claims data for individual doctors and hospitals. The main obstacle to expanding access to Medicare claims data is political, the researchers write.