In just a few weeks many people who get health insurance on the job will have to pick a health plan. Often the decision boils down to which one has your favorite doctors within the network.
Your choices might be even more limited this year than in previous ones, if your employer is looking, as most are, to slow the rise in health costs, So if you're in the market for a new doctor, how do you decide? It's not easy.
While U.S. News & World Report has "best hospital" rankings, they don’t necessarily always reflect where to go if you need a procedure. But they are, at least, compiled from hard data as well as broad surveys of specialists in the fields. But with few exceptions, there's not a lot of quality information out there on doctors.
You probably put more research into buying a new television than into picking a doctor. When consumers do shop for a physician, who they trust for advice varies a lot on the type of doctor they're looking for.
If it’s a primary care physician someone's after, about half of people turn to friends and relatives; and more than a quarter of those people look no further than people they know, according to a study by the Center for Studying Health System Change.
But when a specialist is needed, nearly 70 percent of people rely on a referral from their primary care doctor, and only 20 percent turn to friends and relatives.
Of course, most people with insurance already have a primary care physician or have visited one, so it’s easy to weigh in with suggestions. But when it comes to medical problems you need a specialist for, even if you’re willing to share private details with friends, it may be tough to find people who can make a personal recommendation for a doctor who does hip replacements or treats overactive bladders, for example.
In addition, “I think there’s still quite a lot of patient trust in their physician,” says Ha Tu, a senior health researcher at the Center for Studying Health System Change and the lead author of the study. “When they need a specialist or procedure, it’s hard for secondary data sources to replace that relationship.”
That’s unfortunate news for the health plans that are under pressure by state and federal government officials to keep costs down. They're nudging members to use physicians they rate highly for providing the best care for the least cost. People consult health plans for information less frequently than they do either friends or other doctors, according to the study.
Health insurance plans tend to evaluate doctors more on cost than on quality. Right now, most consumers still don't have much incentive to pay attention to costs, because they’re not paying much out of pocket for their care.
In fact, cost remains one of the least important factors consumers consider when choosing a physician, whether primary care or specialist, according to the study. Just under 30 percent of primary care physician shoppers considered cost; for specialists, the figure was even lower: a tad more than 12 percent.
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