Benefits professionals could bet the farm on the next generation of online shopping tools, hoping they make information more accessible for employees, especially consumer-friendly quality information, which is often lacking. The trouble is, most quality measures available today are not designed to be accessible to the layperson. But at the current pace of measurement development and public reporting, we can't expect a dramatic improvement any time soon. 

Three ingredients to create real consumers

All these issues are causing many employers to rethink their entire approach. Cost sharing is here to stay, and it is indeed needed and useful. But we need to do more to turn our employees into true consumers—now, if not sooner. The ingredients needed for that transition include benefit design, the right support, and trust.

First, cost sharing absolutely can be the right approach to turn employees into consumers, but it can't be the only approach. According to Willis Towers Watson's annual survey, the top performing employers also rely heavily on value-based insurance designs and network strategies, like centers of excellence, to steer their employees to higher value care as part of their overall benefit design. With these in place, employees aren't shopping for care in the dark — they have some guide rails that push them toward higher quality providers and higher value treatment options.

Second, employers need to give their employees the support they need to shop for care—no matter what the employee's health concern or specific issues may be. This is a lot of ground to cover. A growing number are relying on outside organizations to help their employees with issues like physician selection and care navigation. While more employees today have access to transparency tools, having a real person as a navigator to help them understand their options and explain the significance of quality data can make all the difference. This helps ensure they can actually understand cost and quality information without becoming overwhelmed.

For example, we recently completed a study on a large employer who used a surgical decision support program to decrease spending on employees with musculoskeletal (MSK) issues. Employees contemplating surgery for an MSK condition received a financial incentive to call and discuss their condition and options with a decision support specialist. They had the opportunity to talk through issues of both cost and quality in real time, and also investigate alternative treatment options. They could ask questions and truly learn that care options exist, and that quality matters because it varies. The point is to choose the right care, at the right time, at the right place to get the best result. Using this program, 81 percent of participants avoided a surgery they didn't need or opted for less invasive treatment, with $2.3 million in savings for the company.

If these employees just had cost sharing, they may have avoided care all together, or they may have decided to just blow through their deductible and select the highest cost surgeon, falsely assuming that the most expensive physician also provides the highest quality care. Access to price transparency tools alone may have produced similar results, or confusion resulting in inaction. But by combining benefit design with real-time support, this employer realized savings by helping its employees get the right care.

The final ingredient is trust. The example described above was, in large part, successful because employees trusted the decision support specialist. Study after study shows consumers do not trust their health plan. So employers can't reply on their health plan alone to provide transparency tools or decision support if they want to see employees become engaged consumers.

Real consumerism isn't just about cost sharing. And it isn't about providing some price information online and hoping employees figure it all out. It's about carefully crafting benefit and network strategies, coupled with real support. When employees get that from a source they trust, they receive an important education and can become savvy consumers for life. They learn that cost and quality matter, that they very, at that they are not related variables. They then understand that they need to comprehend both data points, and ask questions about the care they need and the available treatment options. It is then that the lightbulb goes on; they know what they need to do and feel empowered to take an active role in planning their own care. And ultimately, that's a win for the employee, the employer and the provider.