What Do Consumers Decide to Prioritize in Health Spending?

By Lisabeth Buelt, Research Manager, NPC

The National Pharmaceutical Council recently published a case study, “Prioritizing Health Care Spending: Engaging Employees in Health Care Benefit Design,” which summarized an effort developed by Janet McNichol, SPHR, CAE, human resources director at the American Speech-Hearing-Language Association (ASHA), to redesign a benefit option offered at the association. In a series of facilitated workshops, employees used a gameboard to first individually design their ideal health care benefit, and then come together as a group to develop a health plan that would best serve the entire organization. The decisions that were made and the dialogue around them elucidated the inherent trade-offs and willingness to pay for various health care services.

In an article just published on the Health Affairs Blog, the authors of this case study connect the findings from this exercise to a previous Health Affairs Blog written by Drs. Craig Mitton and Francois Dionne, which described the need to make health care decision-making tradeoffs at two levels in order to compensate for shortcomings in the U.S. market-based health care system and ultimately move the needle on U.S. health care spending.

Using a deliberative process, employees who participated in the case study engaged in an open and constructive dialogue related to both population-level (e.g. giving up an increase in salary for better health coverage) and coverage-level tradeoffs.

The Health Affairs Blog post, “Activating Employees in Discussions of Health Care Trade-Offs: It Can Be Done,” includes two main findings:

  1. Policymakers should not assume that U.S. consumers are unwilling to discuss or make tradeoffs within a constrained budget. A comparison of individual and group plan preferences revealed that individuals are willing to sacrifice their preferences for the greater good.
     
  2. A deliberative process or framework can facilitate tough trade-off decisions. Despite differences between the individual-designed plans and those that were ultimately designed by the group, satisfaction in the group-designed plan was high, illustrating that engaging employees in a discussion of health care tradeoffs could increase buy-in and satisfaction in their employer-sponsored health benefits.

The authors note that “given the size of the employer sponsored health insurance market, employee appreciation and acceptance of tradeoffs are essential to managing overall health care spending.” As policymakers and other health care stakeholders consider new policies for changing the trajectory of current health care spending, it will be increasingly important to engage in a fair dialogue about health care spending tradeoffs. This case study could provide a framework for other health care purchasers to engage consumers in constructive dialogue on health care spending.

>> Read the full blog post on engaging employees in discussions of health care trade-offs on the Health Affairs Blog.