Surprising Decline in Consumers Seeking Health Information

After a striking rise in the last decade, the proportion of American adults seeking information about a personal health concern from a source other than their doctor dropped to 50 percent in 2010, down from 56 percent in 2007, according to a national study released in November by the Center for Studying Health System Change and funded by the Robert Wood Johnson Foundation.

Although the proportion of consumers seeking health information fell between 2007 and 2010, there still has been a sizeable increase over the past decade, when 38 percent of adults in 2001 reported seeking health information, the study found.

The reduced tendency to seek health information applied to consumers across nearly all demographic categories but was most pronounced for older Americans, people with chronic conditions and people with lower-education levels, according to findings from HSC's 2010 Health Tracking Household Survey, a nationally representative survey with information on 17,000 people. Funded by RWJF, the survey for the first time included a cell phone sample to account for the growing number of households without a landline phone. Response rates were 45 percent for the landline sample and 29 percent for the cell phone sample.

Across all individual characteristics, education level remained the factor most strongly associated with consumers' inclination to seek health information, the study found. Consumers who researched health concerns widely reported positive impacts: About three in five said the information affected their overall approach to maintaining their health, and a similar proportion said the information helped them to better understand how to treat an illness or condition.

The study's findings are detailed in a new HSC Tracking Report—Surprising Decline in Consumers Seeking Health Information—available online at www.hschange.org.

Employers Work to Rein In Health Care Costs

Against the backdrop of uncertainty created by health reform, employers are accelerating their efforts to bring health benefit cost under control. According to the National Survey of Employer-Sponsored Health Plans, conducted annually by Mercer and released earlier this fall, growth in the average total health benefit cost per employee, which had reached 6.9 percent last year, slowed in 2011 to 6.1 percent, with an increase of 5.7 percent expected for 2012. Cost averaged $10,146 per employee in 2011.

Mercer's nationally projectable annual survey includes public and private organizations with 10 or more employees; 2,844 employers responded in 2011.

"In a tough economy where high benefit cost increases often have to be balanced with lower pay increases, cost management is already important," said Susan Connolly, a partner in Mercer's Boston office. "But given the new cost pressure from health reform, for many employers it's becoming an imperative."

One provision of the Patient Protection and Affordable Care Act that went into effect in 2011 was a requirement that employers extend dependent coverage eligibility to employees' children up to age 26. Health plan enrollment grew by an average of 2 percent in 2011 as a result. Provisions going into effect in 2014 include requiring employers to extend coverage eligibility to all employees working at least 30 hours per week on average and auto-enrolling newly eligible employees. Employers expect that these provisions – along with the new mandate that all individuals obtain health insurance coverage – will result in another increase in enrollment. Retailers and other employers with large part-time populations are likely to be the most affected.

Still, the provision that concerns the most employers is the excise tax on high-cost plans — nearly half say it's a "significant" or "very significant" concern. While some employers offer high-cost plans because generous benefits are part of their attraction and retention strategy, others have high-cost plans simply because they have an older or less healthy workforce or are located in a high-cost area. Only 39 percent of employers with 50 or more employees believe their current plans won't hit the excise tax cost threshold, which will be tied to CPI and increase each year.

Nearly all the rest are determined to avoid the tax if they can: 21 percent say they "will do whatever is necessary to bring cost below the threshold amounts," and 36 percent say they will attempt to bring the cost below the threshold amounts, acknowledging that "it may not be possible."  Only 4% will take no action to avoid the tax.

Report Provides Broad Look at Key Trends in Health Care

Hospitals with high performance scores in patient care are more profitable, according to the 2011 Pulse Report from Press Ganey, which serves hospitals that represent 66 percenbt of U.S. hospital admissions. Analyzing public data on hospital profitability and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores, the report found that the top 25 percent of U.S. hospitals with the highest scores on the HCAHPS question about performance were, on average, the most profitable and had the highest clinical scores. Taken together, the data suggest that excellence in patient experiences, clinical outcomes and financial profitability often occur together.

"Taking great care of patients is the best business model for hospitals," said Robert Draughon, CEO of Press Ganey. "Hospitals that are making performance on patient satisfaction and publicly reported clinical core measures a priority are proving to be the most successful." Excellence in patient experiences, clinical outcomes and financial profitability often occur together, the report concludes, likely because "quality" is often structural or systematic. When an organization focuses on quality, it tends to do so in all areas.

The report also found that since the advent of public reporting of clinical and patient satisfaction data, hospital performance across the board has increased. Compliance rates with evidence-based standards of care have increased for most of the common causes of hospitalization, including heart attacks, heart failure, pneumonia and surgical care.

"With CMS' value-based purchasing (VBP) program — the first national pay-for-performance program — beginning its performance period on July 1 this year, hospitals are more focused than ever on understanding and improving their performance," Draughon said.

The entire Press Ganey 2011 Pulse Report provides additional details, information and methodology. It is available at www.pressganey.com/2011pulsereport.