Paying for Care You're Not Getting?Altarum conducts semiannual surveys to better understand consumer beliefs, practices, and preferences regarding health care. The fall 2014 Altarum Survey of Consumer Health Care Opinions is the seventh in this ongoing series. Survey respondents included a nationally representative sample of 1,921 adults between the ages of 18 and 64 years old. 

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Key findings:

  • Consumers want the lead role in making decisions that affect their own health. Two-thirds of consumers want to be in control of decisions concerning their health, and 28% prefer to make joint decisions with their doctors. Only 7% would like their doctor to be in charge.
  • Consumers remain concerned about health care costs but skeptical of their own ability to shop for high-value, low-cost care. Consistently with previous findings, 90% of consumers are worried about paying medical bills, but only about half ever ask their doctors about the cost of care. Confidence in their own ability to affect the value of the care that they receive remains relatively low.
  • While only one-quarter of consumers have ever used a cost comparison tool, most found it to be helpful and would use the tool again. Among consumers who have used a tool to compare health care prices, nearly all (91%) indicated that it was somewhat to very useful, and four out of five would use it again in the future. These results highlight a need for more widespread availability and use of transparency tools. As demonstrated in this study, such resources can provide valuable support to consumers and enable them to play an active role in their health.
  • Younger consumers and those with high deductibles are much more likely to compare costs. Consumers in the youngest age group were nearly three times more likely to use a cost comparison tool than their older counterparts. Similarly, 60% of consumers with a $10,000 deductible have compared prices while less than 20% of those with low deductibles have done so. These findings suggest that consumers who assume greater financial risk (and incur lower out-of-pocket costs) exhibit more cost-conscious behavior.
  • Most consumers are committed to their current doctors but would likely switch if forced to pay more. Almost 80% of consumers reported that it was important to them to keep their existing doctor. However, only 45% would pay an extra $25 per visit in order to keep seeing the same provider.
  • Most consumers place a great deal of trust in their doctors and believe that they would never deliver unnecessary or questionable care. Nearly 9 out of 10 consumers indicated that they trust their doctors. Despite national estimates that one-third of all health care is wasteful or ineffective, 71% of consumers in this study reported that their doctors would not recommend a test or procedure unless it was necessary.
  • Consumers underestimate the extent of medical errors in the United States. When asked how many deaths were caused by preventable hospital errors each year, only 8% of consumers selected the correct response of 400,000. More than 70% chose 10,000 or 50,000. Three out of five consumers also believed that car accidents were a more common cause of death, when in fact medical errors kill 10 times as many people. These findings underscore a need to better educate consumers about medical errors, risk factors, and their own role in improving the safety and quality of care.
  • More than 40% of consumers have gotten unexpected medical bills from providers whom they have never met. Fewer than half of these consumers received a good explanation. In most cases, the bill was only partially covered (59%) or not at all covered (13%) by insurance.
  • Consumers with high Altarum Consumer Engagement (ACE) Measure scores are more likely to compare health care costs. Altarum recently launched the ACE Measure to assess levels of health engagement. Consumers with high ACE Measure scores in this survey were more likely to have used a cost comparison tool than those with low scores.

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