As healthcare costs continue to rise, more Americans are looking beyond their regular doctor’s office for care.

Some travel to Mexico for prescriptions, routine visits or diagnostic tests. Others turn to telehealth companies that promise convenient access to treatments such as weight loss medications. Increasingly, insured Americans are navigating more than one healthcare market at once. For example, they may buy some prescriptions from their in-network primary care provider and have a separate provider for their cash-based GLP-1 medication.

As researchers who study consumer decision-making, healthcare markets and consumer vulnerability, we wanted to understand how people evaluate healthcare quality when they move between different systems.

Our research suggests that many consumers face a hidden challenge: The signals they rely on to judge quality in one healthcare setting often mean something very different in another. Sometimes these misjudgments lead to adverse health outcomes.

Seeking healthcare access

For decades, employer-sponsored insurance carried an implicit promise. If you get a good job, you’ll have access to affordable healthcare. However, that promise has become harder to keep.

Healthcare spending in the United States reached nearly $5 trillion in 2023 and continues to climb. Workers with employer-sponsored insurance continue to face rising deductibles, premiums and out-of-pocket expenses. At the same time, hospital consolidation has contributed to higher prices and fewer competitive options in many communities.

Even beyond cost, many consumers struggle to access care amid the complexity of the U.S. healthcare system.

Meanwhile, Americans insured through Affordable Care Act marketplaces and Medicaid face mounting healthcare costs amid the loss of ACA subsidies and massive Medicaid cuts.

As costs rise, patients are increasingly acting like shoppers, comparing prices and looking for better deals on prescriptions and other healthcare.

For some Americans, that means crossing into Mexico, where clinic visits and........

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