Consumer Driven Health Care and UNC Health Care

The latest innovation in health care financing goes by the buzz words consumer driven health care.” The essential features of CDHC are high-deductible health insurance plans, usually with a health savings account (HSA) for the insured person to use to pay the high deductibles and co-payments. The notion behind these plans is for individual Americans to have to make decisions about when and where to seek health care services. Since these patients will be paying for the large deductible from their own HSA or out of their own pockets, they will be much more cost sensitive and careful. These plans have shown that they can be effective in holding health care costs down, presumably by avoiding unnecessary or too expensive care.

As CDHC plans become more popular and widespread, we at UNC Health Care are thinking and working through what these new features will mean for us as a provider of hospital and physician services. We are gearing up to provide cost comparison information to our patients and their families — though truly “apples to apples” comparative data will be hard to come by from us and other institutions for the foreseeable future.

Another important implication for us, as a major provider of indigent care, is the imperative we face to be much more intentional and rigorous in our collection of money that our patients owe us under their CDHC plans. As long as deductibles and co-payments are $20 or $50, we need to work to collect these amounts but we can be relatively relaxed about it. But if our patients owe us $1500 or $2500 up front before their high-deductible insurance plan kicks in, we have got to be much more direct about the collections. This requirement will not endear us to many of our patients and their families — but it is a direct result of a change in their health insurance, not of a change in our desire to treat our customers well. If they get upset, however, it likely will not be at their health insurance company, but rather at us.

So this latest innovation in health care financing has important side effects for UNC Health Care and other similar institutions. What may be good for holding down health care costs will be a major challenge for us in the implementation.

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