Healthcare Issues & Trends

Advice & Insights for Healthcare's Leaders & HR Professionals

Enlisting Patients as Partners in a Consumer-Driven World

Posted on October 23, 2014 by INTEGRATED

The relationship between healthcare professionals, their patients, and their families is critically important to the healthcare partnership in this post-reform era. With the help of the Internet, patients often arrive at the doctor’s office having made a self-diagnosis. The educated consumer with information at his or her fingertips may seem like a problem patient to a traditionalist physician who isn’t accustomed to answering questions.

Doctors must not think of this as a challenge to their authority, but rather as an opportunity to enlist the patient as a partner in his or her own medical care. The patient who understands what he or she is being told to do is more likely to follow through on the treatment plan, leading to better outcomes and a lower long-term cost of care.

For example, HealthIT.gov established a Consumer eHealth Program to empower Americans to improve their health and healthcare services. The program, which is part of the Office of the National Coordinator for Health IT (ONC), is “increasing individuals’ access to their own health information, helping families take action and gain control over their health, and shifting attitudes to encourage consumers to become full partners in their care with the support of e-health tools.” Ultimately, increased access to information and healthcare transparency of quality data is essential to assist consumers with making more informed decisions about their healthcare choices.

Learn more about enlisting patients as partners and download our e-book: Healthcare Consumerism 3D: Rise of the Consumer

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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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