Soaring health spending has intensified the search for ways to control costs. One approach stresses encouraging patients to behave more like consumers: increasing cost sharing as a way to promote more prudent health care spending and making cost information available to consumers to encourage more informed choices. Recent RAND Health studies suggest both high rewards and risks in empowering health care consumers. Consumer-based approaches have clear potential to reduce health care costs, but consumers may not always have access to adequate information or expertise to make optimal choices.
If consumer-directed health plans grow to account for half of all employer-sponsored insurance in the United States, health costs could drop by $57 billion annually—about 4 percent of all health care spending among the nonelderly.
Coverage of specialty drugs for cancer and other diseases may be valued by healthy people thinking of future need as well as the sick. Surveyed US adults were willing to pay more for premiums than they would pay out of pocket with a less generous insurance plan, implying resistance to cost sharing on expensive drugs.
Public reporting of health care costs is intended to motivate consumers to choose lower cost providers, and motivate providers to lower costs to retain market share. However, research suggests that consumer beliefs may end up working against the intended outcomes.
For most of the 20 million endoscopies and colonoscopies performed each year, the type of clinician who administers the sedation may have more of an impact on the procedure's cost than on clinical care outcomes. Allowing GI procedure teams to administer anesthesia could save $1.1 billion in health spending each year.
HIV-related stigmas have been seen as a barrier to greater faith-based involvement in HIV prevention and care. A study of diverse religious congregations suggested that stigma doesn’t prevent HIV outreach activities, and may in fact contribute to the further reduction of stigma over time.
New combination vaccines reduce the number of injections needed for immunization, but with higher prices and increased minor adverse events. Surveys revealed people are willing to pay to avoid increased risk of minor adverse events as well as to increase community-level immunization coverage.
2011 rules limiting work hours for medical interns will increase costs for hospitals, but may also lower the amount of preventable adverse events. Costs will be be greatly affected by the specifics of the work transfer, and also the amount of change to adverse events rates.