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The new rules of engagement

The rise of health savings accounts, flexible spending accounts, health reimbursement arrangements and more has changed the health care landscape. This move to consumer-directed accounts demands more consumer accountability and involvement than ever before, as health care decisions now come with increased financial repercussions for consumers. This is a massive shift, and health plans and employers need to help consumers better understand the financial impact of their choices.

Employers and health plans must chart the next course — better equipping consumers to make smart financial decisions while minimizing costs along the way. Most consumers are overwhelmed and do not fully understand how to properly navigate today’s complex health care system. The growing number of services and account types adds to their uncertainty.

Going further than basic education

It is not just about consumer education anymore. Mailing out shiny pamphlets with plan details and complex language about deductibles, out-of-pocket limits, etc., will not help consumers make informed health care decisions. Webinars are not enough to teach them when and how to use the funds in different accounts, and emails with extensive lists of topical resources will not help them understand the ins and outs of their insurance policy.

However, properly engaging consumers throughout their health care journey will indeed drive down overall costs. Forward-thinking health plans and employers are fully embracing the concept of consumerism and consumer empowerment, creating an ongoing engagement strategy rather than standalone initiatives to check off a to-do list. Consumers need the right educational element within the proper context at critical times in their health care path. The most important times to engage (and educate) are during the selection of a new doctor, filling a prescription, or selecting a payment option — whenever consumers are ready to take action.

Giving direction based on data

Effective engagement means giving consumers the feedback and tools they need to quickly make sound health care decisions on an ongoing basis. This means timely guidance on the most cost-effective way to get a prescription filled, poignant advice on using (and not using) funds in an HRA to pay for out-of-pocket expenses, comparisons/scoring based on their peers, and demonstrating how everyday health care spending decisions can impact their overall financial health.

As an industry, we need to take a data-driven engagement approach and use the rich data we already have at our fingertips — from claim history and spending patterns, to cost variations and geographic trends. Health plans and employers tapping the power of that data can deliver relevant, insightful advice when consumers need it most rather than overwhelming them with countless materials that they will never read. A prime example is being able to alert a consumer who is considering pulling money from an HRA to pay for a $15 co-pay what that choice will mean for retirement funds in 40 years.  This is the next destination in consumer education and empowerment.

Changing consumer behavior

Eventually, health care decisions will become as second nature as daily financial decisions for consumers. As an industry, our current focus needs to be helping consumers internalize the banking basics in a health care setting — applying the principles of healthy finances to health care decisions. Changing the course of ongoing consumer engagement will empower consumers to embrace the new consumer-directed health care dynamic and start changing their own behavior.

Ravine is Chief Revenue Officer of Acclaris.

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Healthcare benefits Client communications
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