Having problems with your health plan? If you speak up about it — or move on to another plan — you are a very unusual consumer, according to a new study.
The vast majority of people do not complain formally about problems with their health plans, even if those problems have significant consequences, such as costing them thousands of dollars out of pocket or denying them essential care, say health policy experts Brian Elbel, Ph.D., of New York University and Mark Schlesinger, Ph.D., of Yale University.
It is even rarer for consumers to leave their health plan in response to problems, the researchers report in the September issue of The Milbank Quarterly.
This silent majority, according to Elbel and Schlesinger, are less likely to have protection against a particular plan's shortfalls and often are unable to identify the worst plans.
Without this critical information, consumers cannot exert much influence on the health plan market and a choice between plans "would have only a modest influence on quality of care," said Elbel.
If consumers had better access to complaint and health plan exit information, "it would be interesting to them, because it would be information that they can understand," said Judith Hibbard, Dr.P.H., an expert in public reporting of health data at the University of Oregon. "People are more motivated to avoid a potentially negative experience than actively seek the best plan."
The researchers analyzed formal complaints and exits from health plans using information from a 2002 telephone survey of 5,000 consumers. They discovered that consumers who encountered a problem with their care were eight to 10 times more likely to contact their plan about the problem rather than switch plans.