#EmpowerHIT: Creating Effective Health Shopping Tools for Members

Often, a lot of emotion accompanies consumers when they complete a health plan purchase. Benefits professionals, who understand the influence of consumer behavior on final decisions, can take steps to enhance the shopping experience for improved satisfaction.

The reality is that many consumers find that the health plan shopping experience is anything but agreeable. The common sentiments voiced from consumers include frustration over complicated, confusing processes and uncertainties about how to pick the best plan options.

In response, benefits professionals need to consider what the influence of behavioral science on purchases is. By first acknowledging that consumers have different objectives, organizations can drill down to an important, foundational question: What’s in it for their members?

For instance, why should consumers search for a doctor or compare costs on a medical service in a health shopping platform rather than ask their friends or coworkers—or even another doctor—for a recommendation?

Peer Connections Are Important, But Not Enough

In truth, peer connections and personal experiences are important factors and should not be undervalued when finding a doctor or specialist. During a recent round of focus groups, 90 percent of consumers said they first reach out to a peer or coworker to hear their opinions before making a final decision on health plans[1].

While these viewpoints and assessments provide a good starting place, they have limitations. To make informed choices about health plans, consumers need insight into plan-benefit designs, out-of-pocket max and how networks are structured. For instance, how do they know whether a local outpatient surgery center is a preferred provider in their network?

While consumers often fail to consider how cost and quality impact their bottom line, a recent study revealed that 63 percent of consumers are interested in the cost-sharing details of their plan and a more in depth understanding of services covered[2].

The Good News

The good news is that a reliable health shopping platform can equip members with the critical information needed to make the most optimal choice.

Benefits professionals and organizations can deploy simple, smart health shopping tools while simultaneously creating a thoughtful engagement plan that educates members on the value of their healthcare.

How to Create Thoughtful Engagement

Evaluate the Process

The first step is understanding the consumer journey. Easier said than done; busy health plans and medical professionals working in the trenches must take a step back and engage members in process design. For example, ask questions and evaluate the experiences of those using member support tools. Learn about their pain points, and then, strategically use this feedback to provide relevant decision support along the consumer’s continuum of care.

Immediate consumer feedback provides actionable data needed to identify their consumers’ trends. As such, annual or bi-annual surveys often lack the specificity needed to make worthwhile changes. Over time, the consumer forgets specifics and only remembers the overall emotion of the experience— not necessarily the “why” behind those sentiments. A quick survey within the application or a follow-up email after a visit are great ways to capture consumer opinions.

Establish Trust

If health shopping tools have inaccurate provider information or misleading costs, consumer trust will erode. All health plans need a robust system that standardizes, normalizes and validates data from multiple sources.

Additionally, today’s consumers expect access to high-performing, contemporary tools, such as those used by large online retailers. Substandard designs will not foster trust, but caution. For example, research aimed at testing user appeal on star ratings for provider quality[3] found that 100 percent of those surveyed believed the ratings were actually user ratings, creating confusion. This knowledge led to an immediate change in the vendor platform to improve the experience.

Effort Must Feel Meaningful

Access to data is not enough. Consumers must engage with it to improve decision-making. For example, the presentation of cost data on millions of medical services, prescriptions and relevant provider information must be easily consumed; otherwise consumers will not return.

When users sign into a health plan shopping platform, they must immediately recognize the value with minimal effort. Consider that a consumer has already navigated through numerous clicks to reach a specific site. Shopping experiences that are not intuitive or require a lot of effort are often discontinued before a final decision is made. People are cognitive misers. Everyone wants to expend the least amount of mental effort possible to complete a task.

Unite Vendors

To maximize the consumer effort and to build trust, the environment and culture around health shopping must be a positive one. Establishing a connected, one-stop location that unites vendors into one place eliminates unnecessary friction.

One-Size Communications Don’t Fit All

Health plan populations are made of many different people in various stages of life. A message about prostate cancer prevention is only applicable to certain members, and specific nuances and differences exist even within that select group: location, income levels and education to name a few.


All of these factors influence the effectiveness of a message. Thus, benefits professionals must choose the most optimal channel for reaching populations and subsets within those groups. Considerations might include posters, direct mail, email, Facebook ads or text messages. Successful communications require matching the mode and message in a rhythm that meets a population where it is at.

The application of behavioral science in health plan shopping strategies offers opportunities for enhanced consumer experiences. When benefits organizations take a thoughtful approach to consumer engagement by including members’ feedback and input in process design, the natural outcome is a more satisfactory experience. Advanced health shopping tools and applications can provide the best platform for engaging various consumer populations and improving member loyalty.

This post is also featured on the HIMSS17 site

Tabitha Burcham, Ph.D., is a behavioral scientist at Change Healthcare™, where she conducts qualitative research, compiles academic concepts and builds behavior change strategies for the company’s engagement solutions. Tabitha previously worked on the Center of Disease Control's "Verb" campaign, the behavior change program designed to get tweens physically active every day. She holds a doctorate from The Ohio State University.

A version of this article also appears in BenefitsPro.

[1] Based on internal Change Healthcare research

[2] Marketwatch, 6/23/14

[3] Based on internal Change Healthcare research

healthcare; health IT; consumerism