Study: Americans Taking the Hint on Effective Health Care Use

September 24, 2003 (PLANSPONSOR.com) - Americans seem to be getting the message about the need to be good health coverage consumers, a new study found.

A Fidelity Investments study showed more than 80% of respondents chose or expecting to choose generic drugs when available and 25% decreasing or expecting to decrease their emergency room visits.

Also:

  • more than half (58%) of workers leverage or expect to leverage the Internet to better understand medical conditions and diagnoses
  • 57% review or expecting to review treatment options and costs more carefully with their doctors
  • 47% improved their diets
  • 37% had routine screening tests
  • 34% lost weight
  • 30% exercised regularly.

The Devil in the Details

While more Americans have started on the route to health nirvana, that doesn’t necessarily mean they are experts in the details of their health plan, the study found.

“With health care benefits becoming increasingly expensive, employees must understand their health plans and assess their families’ medical needs when determining which plan to enroll in for the coming year,” Sarah Donnelly, vice president, Fidelity Employer Services Company, said in a statement. “Our research indicates that while nearly every worker considers health care as one of their most important benefits, they may not use all of the planning tools and other benefit information available from their employers to make careful decisions that maximize their health benefits.”

While four out of five (80%) workers surveyed report they have as much information as they need to understand their health plans, some can’t recite specifics and may benefit from more health insurance education, the study found.

Key knowledge gaps include the differences between indemnity plans, PPOs, and HMOs (42% do not fully understand them); the difference in services covered by the health plans available (34%); and differences in co-pays, deductibles or co-insurance (32%) for medical plans offered by their employers.

Many surveyed are also less certain about prescription drug coverage/costs (49%), and less certain about what changes they can make any time during the year (39%) or only during open enrollment (24%). Seventy percent did not fully understand how to file an appeal for a denied claim.

The online survey conducted from July 30 to August 28, 2003 covered 1,775 workers at employers with at least 5,000 or more employees.

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