Healthcare Issues & Trends

Advice & Insights for Healthcare's Leaders & HR Professionals

The Patient Evolution to a Price-Conscious Participant

Posted on October 15, 2014 by INTEGRATED

Today, more Americans are insured for catastrophic medical expenses. This is good news because it will surely mean fewer medical bankruptcies and fewer defaults on big hospital bills. But, more are paying for routine medical care—even care that is pricey compared to a weekly paycheck. This means providers may have a tough time with smaller connections. It also means that the consumer has a vested interest in getting good value for the healthcare dollar.

The emphasis on value from a consumer’s perspective has the potential to shake up the delivery of medical care. Why would a consumer choose to pay $3,500 for an MRI if he or she can get it for $1,600 at a radiology center? A hospital may feel that a state-of-the-art MRI machine that delivers the highest-quality diagnostic image is a better value, but the consumer will likely prefer a lower cost option if the image is “good enough.”

According to a Becker’s Hospital Review article from April 2014, “cost consciousness” is on the rise, with a clear majority (55 percent) of patients reporting they have been paying more attention to the details of their medical bills over the past year.” And this heightened sense of awareness is influencing consumers’ choice of providers, assessment on the quality of care received, and even the selection of insurance plans.

To learn about all three dimensions of this trend, download our free e-book: Healthcare Consumerism 3D: Rise of the Consumer.

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Leading Living: Presenting at 2014 Iowa Hospital Association's Annual Meeting

Posted on October 13, 2014 by Bill Jessee

On October 7, I attended the annual meeting of the Iowa Hospital Association in Des Moines, Iowa, and made two presentations as part of their Physician Alignment track at the meeting. The attendance was a surprise to me--about 1,500 total registrants, and 275 or so for each of my two sessions.

The first session was titled "Where Is Health Care Going? And How Will We get There?” It focused on the rapid pace of change in the delivery system, in particular the transition from volume-driven to value-driven payments for health services. After overviewing some of the major drivers of changes we are seeing (rising costs, spotty quality, etc.), we explored the industry’s response to those forces. Among the major trends were consolidation of both insurers and providers, blurring lines between the two, the huge transition in physician practices from free-standing entities to parts of hospitals and health systems, and the universal demands for increased accountability for safety, quality, efficiency, and satisfaction. 

While the first session was very content focused, the second titled, "Navigating Troubled Waters: Leading the Process of Change," was aimed much more at the critical role of leaders in driving the process of change, and the skills needed for effective healthcare leadership. We explored the personal characteristics of effective leaders, with “trust” being a theme that repeatedly surfaced. Strategies for building trust were explored, as were actions that diminish trust. Several specific leadership tools were also explored to help the attendees maximize their leadership skills. 

Both sessions were well-received. Click here to download handouts from other presentations at the three-day meeting.

Employers Now Starring as Healthcare Payors

Posted on October 7, 2014 by INTEGRATED

In the new normal of post-reform, approximately 90% of employed, non-elderly, non-poor Americans receive healthcare benefits through their employers. Within this group, 20% subscribe to a High-Deductible Health Plan (HDHP) with a savings option—a triple tax-advantaged opportunity that can be used for any purpose and a great way to supplement a 401(k).

 An unforeseen consequence of the Affordable Care Act was that employers realized they, too, could set up private insurance exchanges, enabling them to actively budget for healthcare premium expenses. Furthermore, according to HealthForum, employers such as Disney and big-box stores like Walmart are pursuing additional incentives:

  • Increased HMO offerings
  • Broad and narrow networks
  • Limited PPO reference pricing
  • Chronic disease management
  • Intensive care management
  • Wellness strategies
  • Integrated care delivery
  • Affordable primary care clinics
  • Channeling the highest quality providers with systems and processes supporting efficient care
  • Payment tied to outcomes
  • Leveraging volume

In the end, healthcare expenses are on the rise. In order to economize on employee benefits, employers as payors are moving away from a defined benefits model, where they carried the financial weight and risk, to a defined contribution model.

To get an epic behind-the-scenes look into employers as payors in today’s post-reform era, download our e-book: Healthcare Consumerism 3D: Rise of the ConsumerWe’re here to help you better understand and forecast your organization’s approach to succeed in the consumer-driven world.

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Providers: Deliver Quality Service to Get Quality Reviews

Posted on September 30, 2014 by INTEGRATED

In the technology-driven world we live in, consumers are used to looking up information on their smartphones or tablets and getting immediate answers to their questions. They have become accustomed to comparison-shopping online for hotels, airfares, and all kinds of consumer goods. They check Angie’s List to find out who’s the best plumber in their area and order paper towels from Amazon for delivery in 48 hours.

Healthcare is far from immune to these societal trends. In fact, similar to how they may search for online ratings and reviews of hotels and handymen, today’s healthcare consumers have tools at their fingertips that make it easier to search, compare, and review healthcare providers. Healthgrades and Yelp, two well-known and popular user-review websites, offer consumers the opportunity to share their experience, satisfaction, and the quality of individual providers and their facilities. And in today’s evolving healthcare environment, presenting people with the opportunity to comparison-shop for health services creates a new and essential level of transparency.

So, as consumers are making their voices heard, how can a system of providers with hospitals at its core succeed?

  • By shifting the focus from hospital-centric definitions of “value” to consumer-centric definitions of “value”
  • By making information about price and quality readily available and easy to understand
  • By meeting the consumer at the place where he or she makes healthcare decisions
  • By recognizing that the means of delivering care is perceived by patients as important as the care itself 

To get an epic behind-the-scenes look into the role of providers in this trend, download our free e-book: Healthcare Consumerism 3D: Rise of the Consumer. We’re here to help you better plan your organization’s approach to succeed in the consumer-driven world.

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Healthcare Consumerism 3D: Rise of the Consumer

Posted on September 18, 2014 by INTEGRATED

Gone are the days of healthcare systems in the United States being fairly one-dimensional; a single line between providers and their patients can no longer be clearly drawn. Today, critics agree that healthcare has shifted to a 3D era starring a new partner: consumers.

As employers began to offer a High-Deductible Health Plan (HDHP) with a savings option and the use of such insurance programs grew, the rise of healthcare consumerism was born and employers transitioned into their new, more prominent role as payors. Likewise, as patients began to pay out-of-pocket for smaller healthcare expenses, they demanded transparency and more information from their providers—and began shopping around to get it. From the Internet to mobile apps, patients have more access than ever before to a wealth of knowledge about their health and wellness, and they want to take a leading role in their own treatment.

Red and blue glasses aren’t necessary to see the three-dimensional trend proving to be this year’s blockbuster:

  • Educated consumers will demand transparency on price and quality of services—and they will want it fast
  • Payors will seek to find ways to cut healthcare expenses and economize on the cost of employee benefits
  • Providers will no longer have unchallenged top-billing in the healthcare discussion and will need to adjust to a customer-oriented mindset

To help your organization succeed in the new normal of healthcare consumerism, take a behind-the-scenes look at this trend with our e-book: Healthcare Consumerism 3D: Rise of the Consumer

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