Plan to pay for unexpected health events

Market: Family healthcare managers

Scenario: A 42-year-old family healthcare manager plans for unexpected health events by determining her healthcare budget. She lists routine out-of-pocket expenses and insurance premiums, calculating her annual costs. She creates a savings account to cover her deductible and out-of-pocket maximum. By diligently managing and tracking her budget, she ensures financial preparedness for any unforeseen medical situations.

Average Difficulty: Intense (30%+ max difficulty score across most steps)

30 Outcomes 25% to 70% Difficulty

Research Insights

This study identified three main themes related to planning to pay for unexpected health events: uncertainty and predictability in healthcare cost management, inefficiencies in health budget management, and insufficient preparedness and transparency. Participants found it difficult to predict and budget for fluctuating healthcare costs, manage out-of-pocket costs and premiums, and understand what isn't covered by insurance.

Job Steps

1. Determine your Healthcare Budget

2. List your routine expenses (usually small and out of pocket)

3. List your premiums (these are your fixed monthly payments for insurance)

4. Add routine and premium expenses together to establish your annual costs

5. Create a savings account...First to cover your deductible, next to cover your out-of-pocket max

6. Manage and track your budget

Themes Identified

• Uncertainty and Predictability in Healthcare Cost Management: Increasing the use of HSAs, decreasing difficulty in predicting and budgeting for fluctuating costs, and improving predictability in healthcare budgeting.
• Inefficiencies in Health Budget Management: Decreasing time spent managing out-of-pocket costs and premiums, understanding health insurance verbiage, and increasing availability of app-based budget management tools.
• Insufficient Preparedness and Transparency: Increasing clarity on adjusting healthcare savings, increasing savings for substantial medical expenses, and increasing extra savings for unexpected health events.

Recommendations

• Develop budgeting tools within the app that allow for the tracking, prediction, and management of healthcare costs, providing patients with a comprehensive view of their health-related expenses.
• Provide clear, accessible resources that explain health insurance verbiage and cost-related details to reduce uncertainty and unpredictability in healthcare costs.
• Implement features that aid in estimating and saving for substantial medical expenses, such as financial planning tools, savings recommendations, or predictive algorithms that consider the patient's health situation.
• Increase the use of HSAs by integrating them into the app, allowing for direct contributions and tracking of spending.
• Implement customizable notifications about upcoming or estimated healthcare costs to increase visibility and preparedness.

Cautions

• Avoid focusing on increasing visibility of automated premium expenses, as it has a lower difficulty score and might not be a priority for most users.
• Do not prioritize decreasing complexity in consolidating routine and monthly expenses, as it is not a significant concern for many users based on the lower difficulty percentages.
• Refrain from emphasizing decreasing the number of healthcare problems by taking care of oneself, as it is not directly related to the financial aspect of healthcare, which seems to be the main concern of the users.
• Ensure that any budgeting tools or resources are user-friendly and accessible to individuals with varying levels of financial literacy.
• Be mindful of the sensitivity of financial information and prioritize data security and privacy when developing features related to healthcare cost management.