A Survey Of Americans With High-Deductible Health Plans Identifies Opportunities To Enhance Consumer Behaviors
A Survey Of Americans With High-Deductible Health Plans Identifies Opportunities To Enhance Consumer Behaviors
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DOI：
10.1377/hlthaff.2018.05018
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发表时间：
2019-03-01
期刊：
影响因子：
9.7
通讯作者：
Fagerlin, Angela
中科院分区：
文献类型：
--
作者：
Kullgren, Jeffrey T.;Cliff, Betsy Q.;Fagerlin, Angela
大多数高免赔额健康计划(HDHP)的参与者不会从事价格购物等消费行为。为什么不行？我们调查了1637名参加HDHP的美国人--这可能与健康储蓄账户(HSA)有关，但通常不是--关于可能预测、促进或阻碍HDHP参与者参与消费行为的因素。我们发现，拥有HSA与为未来的医疗储蓄相关，高财务知识与比较价格和质量相关，与供应商谈论成本并试图谈判价格的高度自信与从事这些行为相关。雇主HSA捐款是最频繁的储蓄促进者，网站是比较价格和质量的最频繁的促进者，而“医生办公室的某人”是与提供者讨论成本和试图谈判价格的最频繁的促进者。所有这些行为最常见的障碍是在做出决定时没有考虑到它们。这些结果表明，健康计划、雇主和卫生系统应该探索战略，以促进HDHPS患者更多地参与消费者行为。
Most high-deductible health plan (HDHP) enrollees do not engage in consumer behaviors such as price shopping. Why not? We surveyed 1,637 Americans in HDHPs-which can be linked to health savings accounts (HSAs) but usually are not-about factors that may predict, facilitate, or impede HDHP enrollees' engagement in consumer behaviors. We found that having an HSA was associated with saving for future care, high financial literacy was associated with comparing prices and quality, and high confidence in talking with providers about costs and trying to negotiate prices was associated with engaging in these behaviors. Employer HSA contributions were the most frequent facilitator of saving, websites were the most frequent facilitators of comparing prices and quality, and "someone at the doctor's office" was the most frequent facilitator of discussing costs with providers and trying to negotiate prices. The most frequent impediment to all of these behaviors was not having considered them when making decisions. These results suggest strategies that health plans, employers, and health systems should explore to promote greater engagement in consumer behaviors among patients in HDHPs.