Health Care Consumer Shopping Behaviors and Sentiment: Qualitative Study

BACKGROUND: Although some health care market reforms seek to better engage consumers in purchasing health care services, health consumer behavior remains poorly understood. OBJECTIVE: This study aimed to characterize the behaviors and sentiment of consumers who attempt to shop for health care services. METHODS: We used a semistructured interview guide based on grounded theory and standard qualitative research methods to examine components of a typical shopping process in a sample size of 54 insured adults. All interviews were systematically coded to capture consumer behaviors, barriers to shopping behavior, and sentiments associated with these experiences. RESULTS: Participants most commonly described determining and evaluating options, seeking value, and assessing or evaluating value. In total, 83% (45/54) of participants described engaging in negotiations regarding health care purchasing. The degree of positive sentiment expressed in the interview was positively correlated with identifying and determining the health plan, provider, or treatment options; making the decision to purchase; and evaluating the decision to purchase. Conversely, negative sentiment was correlated with seeking value and making the decision to buy. CONCLUSIONS: Consumer shopping behaviors are prevalent in health care purchasing and can be mapped to established consumer behavior models.