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2006 Annual Consumer SurveyAn Independently Conducted National Studyof Consumer Attitudes Toward Health Care
June 15, 2006
Plans are offered by Great-West Life & Annuity Insurance Company. Great-West is not licensed to do business in New York. Products are sold to New York by its subsidiary,First Great-West Life & Annuity Insurance Company, White Plans, N.Y.
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About Great-West Healthcare
• Network: More than 4,250 hospitals and 550,000 providers• Membership: More than 2 million and 5,000 employer customers• Product line
• PPO, POS, HMO and Open Access health benefit products
• Great-West Healthcare Consumer AdvantageSM, a consumer-driven PPO
• Flexible Spending Accounts and account administration
• Health Reimbursement Accounts
• Health Savings Accounts
• Dental and vision plans
• Term and optional term life insurance
• Short- and long-term disability coverage
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Great-West Healthcare Highlights
• Great-West Consumer Advantage Study Results• Plan proven to reduce utilization by 5.6 percent• Lower average claims costs• Reductions in eight of nine medical service categories
• Advanced Self-Funding 201 Continuing Education Class• Examines advanced concepts that impact the selling cycle
• Contact your Great-West Healthcare sales rep or Susan Rohde at [email protected] to inquire about state availability.
• Trailblazer Magazine• Hype or Hope theme
• Explores if CDHC is living up to promises and expectations • How employers are actually embracing the concept
• Available in August 2006• For a copy, e-mail [email protected]
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Agenda
• Methodology• Consumer-Driven Health Care (CDHC) & Consumer Engagement• Knowing & Paying for Health Care Costs• Wellness: Attitudes Toward Incentive & Disincentive Programs• Conclusions
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Methodology
page 5
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Who Did the Survey?
Performed by
Commissioned by
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Have group health insurance through own employer or employer of someone else in household
Screening Criteria
18-64 years of age
Involved in decisions about health care
Have not participated in research on health care in the past year
Methodology: 1,000 Online Nationwide InterviewsAmong Participants of Employer-Sponsored Health Plans
Note: These screening criteria have resulted in an affluent sample. Median HHI for this sample is $64K while the median HHI for the US population is $44K [Source: U. S. Census Bureau, 2004].
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Methodology: This Year’s Survey Builds Uponand Is Conceptually Similar to Last Year’s
2005 2006Sample Size 2,000 1,000
Screening Criteria 18-64 year-old health care decision-
makers who are members of
employer-sponsored health plans
18-64 year-old health care decision-makers who are members of employer-sponsored
health plans
Primary Topics Understanding costs; preparedness
for CDHC
Understanding costs; preparedness for
CDHC; lifestyle and health issues
Mode of Data Collection
Telephone interview Online interview
Dates of Data Collection
1/11/05 through 2/8/05
1/19/06 through 1/26/06
Interview Length 15-20 minutes 15-20 minutesMargin of Error for Total Sample (@95% CL)
+/- 2% +/- 3%
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Consumer-Driven Health Care (CDHC) & Consumer Engagement
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People Blame Many for Rising Health Care Costs,But Hold Themselves Somewhat Less Accountable
Q. Using the scale below, please rate how responsible you think each person or organization in the list below should be for controlling the rising costs of health care…[Scale: 4=Extremely responsible; 1=Not at all responsible.]
94%91% 89%
84%
69%64%
93% 91% 90%
80%85%
70%
61%
85%
0%
20%
40%
60%
80%
100%
Healthinsurancecompanies
Hospitals Drugcompanies
The government Doctors Individuals Employers
2005 (N=2,000) 2006 (N=1,000)
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Belief in Personal Control Over Health has Declined
Q. Which one of these two statements best describes you?
18%
60%
82%
40%
0%
20%
40%
60%
80%
100%
I believe I can control whether or not I get sick by living ahealthy life
I believe that factors out of my control will have more of animpact on whether or not I get sick than living a healthy
lifestyle
2005 (N=2000) 2006 (N=1000)
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Consumers Largely Don’t Link Responsibility With CDHC
4%A gimmick/benefits are limited
5%Consumer has control/responsibility for their health care
11%Health care centered/designed around the needs/wants of the person
14%Consumer chooses/determines the coverage/services wanted/used
15%Providers are driven to provide the services that the consumer wants/demands most
15%Consumer determines what they will pay/controls the cost/will seek low-cost options
PercentIdea or Concept
Responsibility
Base consists of those who have heard of “Consumer Driven Health Care” (Q1) (N=213).Q. What phrase or words express the core idea behind “Consumer-Driven Health Care”?
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Most Employees Want Employers’ Help in Choosing a Health Plan
Base: Total respondents (N=1,000).Q. Which one of the following statements best represents your point of view about your choice of health plans?
I prefer to createmy own health plan from an unlimited number of options
I prefer to have myemployer provide
one to three healthplan options from which I can make
my choice
40% 60%
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Members Infrequently Use Health Plan Sites for Decision Support
Don't know2%
Never32%
A few times a year49%
Monthly or more often16%
Base: Total respondents (N=1,000).Q. About how often do you sign into your health plan’s Web site?
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Most Don’t Use Health Care Resources Available From Employers
27%
20%18%
15%13%
5% 5%
0%
20%
Educationalmaterials
Accessinformation on plan
coverage
Healthassessments
Health fairs 24/7 nurse line Qualitycomparisons
amongdoctors/hospitals
Cost comparisonsamong
doctors/hospitals
Base: Total respondents (N=1,000).Q. Which of the following services that your employer offers, if any, have you used in the past year? Please select all that apply.
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Knowing & Payingfor Health Care Costs
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Base: Those who have been treated for a serious health problem in the past two years (Q25a for which N=292).Q. When did you learn what the total cost of the treatment would be, including the amount your insurance company would pay?
Most Still Learn Treatment Costs Only After They Receive Care
15%7%
63%
10%2% 3%
11%7%
68%
11%
2%0%
20%
40%
60%
80%
100%
Before thetreatment
At the time of thetreatment
After the treatment Never Still intreatment/Stillhaving medical
problem
Not sure/Other
2005 (N=984) 2006 (N=292)
N/A
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Consumers Are Far Better at Guessing Cost of Non-Medical Goods
AverageAbsolute DifferenceBetween
Estimated&
ActualCost
Base: Total respondents (N=2,000 for Wave 1 and N=1,000 for Wave 2).
14%
46%40%
24%
0%
20%
40%
60%
80%
100%
Non-Medical Products/Services Medical Products/Services
2005 2006
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Sources: www.cvs.com, www.thisoldhouse.com, www.united.com, www.honda.com, www.expedia.com, www.apple.com, www.bestbuy.com, www.bose.com, www.diynetwork.com.
In 2005 Respondents Guessed the Cost of a Honda Accord Within 1%!
2005 (N=2,000)
1%$300.00$21,500.00$21,200.00A new Honda Accord
8%$37.60$477.00$514.60A round-trip plane ticket in coach class from New York to Los Angeles
17%$11.20$65.00$76.20One hour of a plumber’s time for basic repairs
30%$3.20$10.50$7.30A large bottle of aspirin that contains 250 pills
%Difference
Absolute DifferenceActual Cost
Average of Cost
EstimatesProduct
14% Average
Difference
Q. Please indicate, to the best of your knowledge, what the average cost is for the following product or service.
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In 2006 Respondents Came Close on the Cost of an Oil Changeand Bose Wave Radio/CD Player
35%$139.20$400.00$260.80An Apple iPod (60 GB)
5%$1080.00$21,500.00$20,420.00A new Honda Accord
29%$1,141.00$4,000.00$2,859.0050” plasma HDTV television
2006 (N=1,000)
6%$30.00$500.00$530.00A Bose Wave Music System Radio/CD Player
11%$2.71$25.00$27.71An oil change for your car
55%$127.20$230.00$357.20Round-trip plane ticket from New York to Chicago
%Difference
AbsoluteDifferenceActual Cost
Average of Cost
EstimatesProduct
24% Average
Difference
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Sources:www.drugstore.com, www.healthactioncouncil.org, www.medscape.com, www.uscsf.edu, www.bcbs.com, www.allaboutvision.com, www.healthatoz.com, www.usatoday.com.
But People in ’05 Were Off by 68% on Cost of 4-Day Hospital Stay ...
68%$13,600.00$20,000.00$6,400.00An average 4-day stay at a hospital
42%$500.00$1,200.00$1,700.00An outpatient colonoscopy
2005 (N=2,000)
16%$300.00$1,900.00$1,600.00An MRI
56%$222.00$400.00$622.00An emergency room visit
51%$102.00$200.00$98.00A routine doctors office visit
8%$8.00$100.00$108.00A 10-day supply of the antibiotic, Cipro
%Difference
AbsoluteDifferenceActual Cost
Average of Cost
EstimatesProduct
40% Average
Difference
Q. Please indicate, to the best of your knowledge, what the average cost is for the following medical product or service.
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… And in ’06 Were Far Off on Costs of ER Visit and Routine Doctor’s Exam
29% $7.18$25.00$32.18A flu shot
70%$280.30$400.00$680.30An emergency room visit
61%$12,238.00$20,000.00$7,762.00An average 4-day stay at a hospital
2006 (N=1,000)
34%$169.00$500.00$331.00Teeth-whitening in a dental professional’s office
32%$1,275.00$4,000.00$2,725.00Laser surgery for both eyes
52%$104.45$200.00$95.55A routine doctor’s office visit
%Difference
AbsoluteDifferenceActual Cost
Average of Cost
EstimatesProduct
46% Average
Difference
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Q. What is the total amount of money you have set aside today that, in theory, you could use for future health care needs?
’06 Survey: Only 39% Saved More than $1,000 for Health Care,Only 28% More Than $2,000 – Most Are Unprepared for CDHPs
9% 8% 9%16%
12%7%
25%
9% 11% 14% 14%
39%
12%15%
0%
20%
40%
60%
80%
100%
$0/None Less than $500 $500 to $999 $1,000 to$1,999
$2,000 to$9,999
$10,000 or more Don't Know
2005 (N=2,000) 2006 (N=1,000)
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Wellness: Attitudes Toward Incentive & Disincentive Programs
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Consumers Somewhat More Likely to Engagein Preventive Care for Cars and Homes Than for Themselves
98%93%
90% 88%84% 84% 83%
0%
20%
40%
60%
80%
100%
Got an oil changefor your car
(n=988)
Checked bloodpressure (n=998)
Turned downthermostat in cold
weather toconserve energy
(n=966)
Changed filters inhome air
conditioner orfurnace (n=909)
Clipped grocerystore coupons
(n=994)
Had teethchecked and
cleaned (n=982)
Had a physicalexam (n=997)
Base: Those for whom the behavior is applicable [the Ns vary; see above].Q. Please indicate which of the following activities you or someone in your household has done during the past year.
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Cold Cash and Lower Payroll DeductionsAre Most Appealing Wellness Incentives
51%
44%
2% 3%
0%
20%
40%
60%
80%
100%
Reduced health insurancecosts
Cash A gift valued at $100 Other
Base: Total respondents (N=1,000).Q. Most employers are now seriously considering wellness programs in which employees are offered incentives to impose their health-related behavior. If your employer offered you an incentive worth $100 for engaging in more health-conscious behavior, what form of this incentive would be most appealing to you?
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Minimum Monthly Amounts to Incent Healthy Behavior
0%
20%
40%
$10 per month $25 per month $50 per month $100 per month
Daily Flossing
0%
20%
40%
$10 per month $25 per month $50 per month $100 per month
Improve Eating Habits
0%
20%
40%
$10 per month $25 per month $50 per month $100 per month
Quit Smoking
0%
20%
40%
$10 per month $25 per month $50 per month $100 per month
Physical Exams
0%
20%
40%
$10 per month $25 per month $50 per month $100 per month
Health Assessment
0%
20%
40%
$10 per month $25 per month $50 per month $100 per month
ExerciseBase: Those for whom the behavior is applicable [the Ns vary; see each behavior’s chart for the base].
(n=355)
(n=496)
(n=195)
(n=389)
(n=417)
(n=555)
Q. What would be the minimum monthly incentive that would motivate you to change your behavior in the following area…?
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People Are Conflicted About Wellness Disincentives
Base: Total respondents (N=1,000).Q. Please rate your agreement with the following statements… [Scale: 5=Strongly agree; 1=Strongly disagree.]
84%
67%
60%
0%
20%
40%
60%
80%
100%
A person's behavior while driving an automobile should affect how much
that person pays forautomobile insurance
A person's lifestyle choices outside the workplace should affect how
much that person pays forlife insurance
A person's lifestyle choices outside the workplace should affect how much that
person pays for health insurance
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Consumers Support Higher Premiums for Speeders and Smokers,But Not for the Obese or Those Predisposed to Cancer
83%
69% 66%
37%
7%
0%
20%
40%
60%
80%
100%
A person with severalspeeding tickets pays ahigher auto insurance
premium than a personwith no speeding tickets
A smoker pays a higher lifeinsurance premium than a
non-smoker
A smoker pays a higherhealth insurance premium
than a non-smoker
An obese person pays ahigher health insurance
premium than a person ofaverage weight
A person who is geneticallypredisposed to cancer paysa higher health insurancepremium than a person
who has no genetic linkageto cancer
Base: Total respondents (N=1,000).Q. What follows are statements regarding the amount of insurance paid by people in different kinds of situations. Using the scale below, please rate how fair you think each of these situations is. [Scale: 4=Extremely fair; 1=Not at all fair.]
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Conclusions
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Key Takeaways About Health Care in General
• Blame many for rising health care costs, but do not hold themselves as accountable for the problem.
• More likely to get preventive care for cars and homes than for themselves.• Prefer lower payroll deductions or cash as incentives for wellness programs.
But it’ll cost employers much more to incent non-smoking and exercise than flossing or health assessments.
• Unsupportive of making people pay more for lifestyle choices outside workplace.
• Results suggest that consumers often may not use online and other decision-support resources. That shopping for health care is fundamentally different than shopping for other goods and services.
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Key Takeaways About CDHC Readiness
• Feel little control over or responsibility for their health or the cost of care.• Know relatively little about the cost of health care goods and services.• Use health plan member sites infrequently. Most don’t use health care
resources available from their employers to monitor health or shop for care.• Prefer that their employers help choose health plan options for them.• Don’t save money for health care – some not all, most not enough to cover
deductibles of CDHC plans.• Are consumers ready for CDHC?
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