1. © 2007-2014 Change Healthcare CorporationWPCH01211/01/14
White Paper
Novermber 2014
of healthcare costs continue to climb. In
2013, their share of healthcare premium costs
increased nearly 7%, from $2,782 to $2,975.
Out-of-pocket expenses also continue to rise, up
by nearly three percentage points – from 15.9%
to 18.7% – over the last four years. All told, total
employee cost share, including premiums and out-
Introduction
As individuals are increasingly faced with greater
responsibility for their healthcare costs, plan
providers, mainstream media and even the
government are urging them to shop for care.
But is the impact of financial cost shifting enough
to make individuals adopt a consumer mindset
as they consider their healthcare? How are cost
transparency and consumer engagement tools
helping them to behave differently?
In this whitepaper, we explore consumers’ feelings
around the idea of healthcare consumerism – and
how increased cost pressures, including higher
deductibles, are driving increased acceptance
and new behaviors.
Individual Healthcare Costs:
Growing, Growing, Gone!
While employer health trend increases fell to a
15-year low of 4.1% in 2013, and are expected
to average 4.4% for 2014, employees’ share
“Employees now pay more than $100 more per month in premiums and
out-of pocket costs than they did a mere three years ago.”
Towers Watson
Higher Out-of-Pocket
Costs Drive Healthcare
Consumerism

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© 2007-2014 Change Healthcare CorporationWPCH01211/01/14
Consumers are even more willing to consider
switching pharmacies to save money. More than
86% would switch pharmacies to save $20; only
8% would keep the same pharmacy despite an
opportunity to save $100.
HDHPs: A Driving Force in
Healthcare Consumerism
High-deductible health plans (HDHPs), including
consumer-directed health plans (CDHPs), remain
a “go to” strategy for employers looking to rein in
healthcare costs and shift financial responsibility –
fueling, in large part, the healthcare consumerism
movement. According to a recent survey by the
National Business Group on Health, 81% of large
employers say they’ll offer at least one CDHP in
2015. And nearly one in three – 32% – will only offer
this plan type next year, up from 22% in 2014.3
With HDHPs – or any plan with a high deductible
– comes an increased likelihood that individuals
will shop for healthcare. According to the Altarum
Institute, as a person’s deductible increases, so
of-pocket costs, has climbed from 34.4% in 2011
to 37% in 2014. In fact, employees now pay more
than $100 more per month in premiums and out-of
pocket costs than they did a mere three years ago.1
Healthcare Consumerism:
Yes, Please
While employee engagement in healthcare has been
a top priority for employers for the past several
years, recent research suggests that employees,
too, are beginning to see the importance of
individual engagement as a means for controlling
costs. According to the Altarum Institute’s Fall
2013 “Survey of Consumer Healthcare Opinions,”
consumers rank themselves among the top three
stakeholder groups with the best chance of making
healthcare more affordable. Additionally, 84% of
consumers are comfortable asking their doctor
about the cost of care, and a majority of consumers
are willing to consider changing providers for a
difference in price, even as small as $30.

3. © 2007-2014 Change Healthcare CorporationWPCH01211/01/14
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Healthcare’s Engagement Platform, including:
• Updating user preferences
• Completing savings thresholds
• Utilizing the tool
• Login activity
Across all client groups, employees with
higher out-of-pocket costs engaged more
frequently and in more meaningful ways with the
cost transparency tool.
does the likelihood that they will ask about price.
Twenty-eight percent of those with a zero deductible
insurance plan have asked about price, while 70%
of those with a $10,000 deductible plan have
asked about price.
Research by Change Healthcare confirms and
expands upon the relationship between deductible
amount and consumers’ willingness to engage
in healthcare. The consumer engagement and
cost transparency company’s recent analysis of
three very diverse clients’ user data shows that
as consumers are faced with higher out-of-pocket
costs, they are more likely to engage in the use and
features of a healthcare cost transparency tool.
The study looked at employee engagement relative
to plan design (across two PPOs and six HDHPs)
and out-of-pocket costs, including deductible,
co-pay and co-insurance, where applicable.
Engagement was measured by tabulating and
weighting specific actions taken within Change

4. © 2007-2014 Change Healthcare CorporationWPCH01211/01/14
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You’ve Got Their
Attention. Now What?
While individuals are clearly becoming more and
more receptive to the idea of engaging in healthcare,
access to information and tools they need to close
the intent-to-behavior gap and shop for care are
still lacking. Only 35% of consumers are confident
that they could take steps to find less expensive
care. Similarly, only 52% of consumers feel they
could compare information to select a more
qualified healthcare provider.2
As a plan provider, you can help by offering your
members or employees access to decision-support
tools that educate, engage and empower them to
make healthcare purchasing decisions that weigh
both quality and cost, and drive population health.
The most effective tools drive long-term behavior
change and provide measurable ROI by:
• Delivering personalized solutions that are
relevant to the individual;
• Creating awareness of resources
available to help;
• Educating on how to be a better
healthcare consumer;
• Reaching out proactively with savings
opportunities and health/wellness
reminders; and
• Encouraging sustained engagement to
transform passive healthcare users into
proactive healthcare consumers.
Summary
Research confirms that as out-of-pocket costs go
up, so does the likelihood that individuals will shop
for value-based healthcare. By enabling healthcare
consumerism, your business can drive population
health, cost savings and employee/member
satisfaction and retention.

5. © 2007-2014 Change Healthcare CorporationWPCH01211/01/14
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1 “Employer Survey on Purchasing Value in Healthcare,” Towers Watson/National Business Group on Health, April 2014
2 “Survey of Consumer Healthcare Opinions,” Altarum Institute, Fall 2012
3 “Large Employers’ 2015 Health Plan Design Changes,” National Business Group on Health, August 2014
4 Change Healthcare Database, 2014
Jack Bruner
Chief Marketing Officer
Change Healthcare Corporation
jbruner@changehealthcare.com
Laura Alabed-Olsson
Sr. Manager, Marketing and Communications
Change Healthcare Corporation
lalabed@changehealthcare.com
About Change Healthcare
Established in 2007, Change Healthcare is on a mission to transform the way Americans purchase and utilize
healthcare services by driving sustainable engagement at the individual level. With a national client base of health
plans and employers covering lives in all 50 states, and approximately 7 million users on its platform, Change
Healthcare is the premier national provider of healthcare cost transparency and consumer engagement solutions.
To learn more, visit www.changehealthcare.com.