Values vs. value in consumer-driven health care

What motivates a consumer to choose one health plan over another, or commit to managing his newly-diagnosed chronic condition, or take on health behaviors to keep her well?

It's their values, stupid.

Borrowing from the fields of social psychology and health behavior and education, the Employee Benefit Research Institute (EBRI) has published a provocative paper on how consumer-directed health plans (CDHPs) risk failure when plans and providers ignore consumers' inner values.

Listening to Consumers: Values-Focused Health Benefits and Education offers insights into the current complexion of CDHPs and how consumers make health decisions. Among the reports' findings are that,

• Some consumers perceive the health system is adversarial and unfair.


• Many workers who have had longtime employer based health coverage don't understand how some employers do not or cannot provide health benefits.


• Some consumers lack the desire to manage the level of health literacy required by their health plans.

The authors conclude that developing an approach to values-focused health benefits would enhance consumer engagement and ultimately health and personal financial outcomes.

Health Populi's Hot Points: When EBRI's report hit my hard drive, I was preparing a speech for a group of health plan executives. One of my foci was the consumer in the "ADD economy" combined with consumers' lack of health coverage literacy. Fidelity Investments learned in their April 2007 study into consumers and health care that most employees who receive health insurance at work do not understand the basic terms used in health plans, including HSA, MSA, and similar common health insurance concepts. When you add the layer of what motivates the individual with respect to his/her health to a lack of health literacy (whether coverage or general illiteracy), there is no wonder that the grand nirvana of consumer-directed health care has not yet been met. To get to that Holy Grail, stakeholders must come together from business, unions, providers, and consumer groups to develop products and services that consumers will actually use and from which they will benefit -- based on their lens on both value and values. This isn't an actuarial exercise; it will be a multidisciplinary approach to new health plan product development. This will take the kind of consumer insights a Procter & Gamble veteran has into the hearts and mind of the consumer. Health care would benefit from taking a page out of that consumer marketing playbook.