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Fear Called Primary Factor In How Coverage Is Chosen

MANAGED CARE July 2005. © MediMedia USA
News and Commentary

Fear Called Primary Factor In How Coverage Is Chosen

MANAGED CARE July 2005. ©MediMedia USA

Health insurers that struggle to present information to consumers so that those folks can make the best choices can't afford to forget about the human factor. Fear and insecurity play a huge role in how people make decisions about health coverage, according to a study by Towers Perrin.

A survey of more than 1,400 employees of large and midsize businesses in the United States shows that 52 percent have negative feelings about their coverage and most of those people feel intensely negative.

"People are afraid, first of all, that their insurance won't protect them against financial hardship in the event of unforeseen medical needs," says Dave Guilmette, the managing director of Towers Perrin. "They also have serious concerns about navigating the provider system — not finding the right doctor, not knowing which tests to take, what treatments are best or which programs would provide the best care."

Towers Perrin uses the term "fear factor" and suggests that companies can help calm workers — and so can insurers.

"Health plans are often in a better position than employers who sponsor health coverage to give consumers confidence in their care management and purchasing decisions," says Martha B. Terry, a principal of the company. "The study tells us that consumer engagement can be increased significantly when consumers are confident and secure in their decisions."

Patients generally turn to physicians for that sense of security, "but if we can move the role of health plans from administering the experience to guiding and supporting decision-making through education, targeted outreach, and increased literacy about care delivery and management, the data suggest consumer engagement and positive emotion will follow," Terry says.

There's a message for the number-crunchers among health plan executives, as well, says Charlie Watts, another principal and the practice leader for measurement and research at the consulting company.

"While cost is certainly a continuing driver of negative opinion about the health care experience, affordability is less important than the sense of security and protection," says Watts. "In other words, simply lowering costs . . . is not the answer. Likewise, issues related to administration, quality, and choice, often featured by employers and health plans, . . . are again far less important determinants than security and protection."

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