Commentary: People are taking a more active role in how they purchase and pay for health care, with consumers driving more of the decision-making process. With millions of Americans purchasing health coverage on their own, and a growing number of people enrolling in consumer-directed health plans offered at work, understanding the health care system is more important than ever. This is especially true during open enrollment, the time each fall when most employees select or change their health benefits for the following year.
Here are five tips to share with employees to help them make more informed health care choices and become more savvy health care consumers.
1. Comparison shop. There are many online and mobile resources available to employees to help them comparison shop for health care. Examples include Health4Me, a mobile app from UnitedHealthcare that offers quality and cost information for more than 755 common medical services. Another option is the Health Care Cost Institute’s Guroo.com, which provides market-average prices based on data from more than 40 million insured individuals.
2. Select the right setting for care. There are many places employees seek care, including urgent and convenience care clinics. These options are often more cost-effective and offer shorter wait-times than other health care facilities. Everyone should have an on-going relationship with a primary care physician, as well as specialty professionals such as a dentist and optometrist, for routine and preventive care, while emergency rooms should be reserved for true emergencies. The growing popularity of telemedicine is making routine and preventive care available online and through mobile devices, usually offering lower cost and convenience. Encourage employees to evaluate all of these options when selecting care, and to share their patient care records with a primary care physician to improve coordination.
3. Know your health care providers. An estimated one-third of privately insured Americans have received a surprise medical bill, defined as their health plan paying less of the total tab than they expected, according to a study by the Consumer Reports National Research Center. One way to help avoid that is for employees to have a firm understanding of what is involved in the procedure they’ll be having, as well who will be involved. Encourage employees to get in writing the names of the health care professionals providing care and ensure they are all in the health plan’s care provider network, including physician assistants, anesthesiologists and radiologists. Employees have the right to request only in-network care providers.
4. Fill coverage gaps. Health maintenance includes more than just medical insurance. Consider adding dental and vision plans, which are often cost-effective and cover annual teeth cleanings and eye exams. Many vision plans also offer reduced pricing on frames and lenses. Some recent studies suggest that there is a connection between oral and vision health and overall health, so adding a dental and vision plan may help enhance employees’ quality of life and prevent more serious medical problems in the future.
5. Take advantage of wellness incentives. Employer wellness programs are becoming increasingly popular, with the value of those incentives doubling to $594 per employee since 2009, according to a study from the National Business Group on Health. People may earn rewards for lowering their cholesterol, quitting smoking or losing weight, with common incentives including gym membership discounts, lower premium costs or merchant gift cards. Make sure employees understand what is available to them.
Dr. Sam Ho is chief medical officer with UnitedHealthcare.
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