With more quality and pricing data available now than ever before, insurers and employers are trying to figure out how to steer patients toward high-performing, low-cost doctors. Companies such as the Leapfrog Group and nonprofits like FAIR Health are creating tools that make medical data easier to access, but turning patients into rational consumers is still a challenge. More than half of hospital patients in the U.S. enter through the emergency room, according to a 2013 report by the RAND Corp. And some choice tools are less relevant for consumers in narrow provider networks.
The key to leveraging data is patient engagement, said Mario Schlosser, CEO of Oscar Health Insurance, at a Manhattan Institute conference Friday. For instance, Oscar users can earn money back by using the company’s free fitness tracker, but to use it, they have to sync it with the Oscar app. “Once they click on the app, we can get them to use it for other things,” said Mr. Schlosser.
In addition to offering patients a way to search for doctors, that includes collecting data and anticipating costs by asking about symptoms.
Bloomfield, Conn.-based Cigna has focused on ease of use in its Web portal and mobile application, said Michael Sturmer, the company’s senior director of consumer health engagement.
“If I can give them choice, but make it simplified choice, I can influence their decisions on providers,” he said at an event in Manhattan last month hosted by the Northeast Business Group on Health.
Still, only 10% to 20% of patients use those types of tools, he said.
According to Mr. Schlosser, sometimes it’s best to eliminate patient choice altogether by simply recommending the best doctor available in a customer’s care network.
Will this hands-on approach by insurers lead to a hands-off approach by employers? The rise of ACA exchanges and consumer-centric insurance companies like Oscar are driving some businesses to distance themselves from employee health care, said Laurel Pickering, president and CEO of the Northeast Business Group on Health.
“They want their employees to be better consumers,” Ms. Pickering said. “That’s why some are putting in private exchanges.”
But Ms. Pickering said that moving away from the employer-as-middleman will be a long process. Enrollment in private health exchanges grew to more than 3 million in 2014, according to a report by Accenture, but it is still relatively uncommon, Ms. Pickering said.
Jeffrey R. Ungvary President