Dig Deeper
When creating benefit and network designs for consumers, it pays to know what they want. Consumers say “value-based benefit designs”—such as reference pricing arrangements (when a payer determines the therapeutic effectiveness of drugs within a disease group and reimburses based on the least expensive option) and provider tiering (classifying providers into different groups based on certain criteria)—are fair when they offer:
• Freedom of choice. Consumers view benefit designs that offer several options to choose from more favorably than those that do not.
• Reassurance that all choices meet a minimum quality standard. Most consumers are not opposed to benefit designs that steer them toward certain choices, as long as they can be certain they are not exposing themselves to poor-quality care by going to the least expensive option.
One way some health plans and employers are encouraging consumers to engage in shared decision-making is by offering them financial incentives. Financial incentives are a form of value-based insurance design with a benefit and network design tailored to encourage the consumer to use effective services and discourage them from using ineffective services.
Benefit designs should offer several options and include quality information and clear language so consumers understand why the information is being provided and can feel assured they are not sacrificing quality when choosing a lower-cost provider.
What are some ways consumers can help improve health care?
Leadership positions and health care activism are a good start
How do I create a consumer advisory council?
AF4Q Alliances have forged a path.
When do consumers find cost and resource use information most useful for decision making?
Timing and financial stake play a large role.
What are the elements of a successful homepage on public reporting websites?
Be visual and succinct.
Why does consumer engagement matter?
It leads to better care—given by providers and received by consumers.
What is the Consumer Engagement Leadership Consortium?
An integral part of AF4Q's work.
- Why do consumers need to know how much things cost?
- How do we help employers maintain their interest and energy in our partnership?
- What role do employers play in improving care quality?
- What frameworks can I use to engage and activate consumers?
- What are the benefits of personal health records?
- What is the Consumer Engagement Leadership Consortium?
- Where should I incorporate consumers into my practice or hospital?
- How do you explain the idea of “high-quality health care"?
- How do I clarify my role as a consumer within my organization or Alliance?
- How do I become a better consumer leader?