Health Care Consumerism

PDF

Over the past several years, there has been an increased focus on the rise of health care consumerism. Health care consumerism refers to patients taking a greater role in the managing and paying for one’s health. An increase in health care consumerism could result in patients becoming more informed regarding the costs and quality of their health care services which could affect consumers’ decisions about how and where to receive their health care. Health care leaders are taking note of the change, with a 2019 survey of national health care leaders showing that 69 % of the health care leaders list consumerism as a top priority^[1]. 

While we may not be at a point where patients are comparing the cost and quality of their providers on an app as if they were buying a car or an appliance, we are seeing a sustained trend of health care consumers having more access to data about their health care options and a stronger desire to use that data to make more informed decisions about their health care. Recent studies indicate that consumers are becoming more confident about shopping for health insurance online and are doing more research on their health care providers^[2]. 

Some factors that are accelerating this trend in health care consumerism are: changes in technology, increased use of telehealth and its integration with electronic health records (EHR), price transparency, use of patient-centric communications and patient portals by providers, and changes in health benefit designs. 

Changes in technology include the rapid development and deployment of wearable technology that allows individuals to monitor their health and wellness while they are at home or the office. This new technology comes in the form of apps for smartphones, smartwatches, fitness trackers, and other devices that track various health metrics from a number of steps taken during the day to quality of sleep. This health technology has caused many people to become more engaged in their personal health and is providing patients with data that can be integrated into their medical record and shared with their treating physicians.  In a recent study, over 57% of patients indicated that they thought that data provided by usable technology could be useful in conversations with their providers about their health^[3]. 

During the past 18 months, there has been a significant increase in the use of telehealth primarily because of the COVID-19 pandemic.  In October 2020, usage of telehealth increased by 3000%, compared to the previous October in 2019^[4]. When telehealth technology is integrated into the patients’ EHR, patients will have greater access to their health data, bill records, care information and easier communication with their health care providers. Patients appear to have embraced telehealth and it is expected it will continue to be used as long as the insurance companies reimburse it post-COVID. If providers do not support the use of telehealth, consumers may look to providers who do use telehealth for their health care needs. 

Over the past two years, two federal rules have been implemented that require hospitals and insurance companies to publicly share their pricing information on their websites. The policy behind their transparency requirements is to allow health care consumers to become more engaged in evaluating their health care choices. It remains to be seen whether the required pricing information disclosures on hospitals and insurance companies’ websites will be practically helpful to consumers, but it is expected that third party companies will aggregate this pricing data and make it available to the public in a more user-friendly format that allows consumers to compare hospitals and insurance companies to one another. In July, President Biden issued an Executive Order that is designed to promote competition in the American economy by lowering consumer prices and increasing workers’ wages. This Executive Order specifically addresses concerns about the cost of prescription drugs, the consolidation of health care providers, and promotes price transparency in health care and the ability of Americans to choose the type of health care insurance that best serves their needs through comparison of price and coverage of plans. This is another example of the focus on pricing transparency and its goal of providing health care consumers with more information that can help them make better health care decisions. Some providers are already embracing the transparency and offering pricing tools to let patients know how much their procedure or care will cost beforehand. As patients become more comfortable discussing and analyzing the cost of healthcare, knowing cost of care beforehand could affect decisions about which health care providers they choose. 

To meet demands and better serve patient preferences, health care providers have begun to use social media strategies and patient-centric portals with patients. Seventy percent of c-suite health care leaders have said that they are bulking up their staff and training them especially to enhance these patient experiences^[5]. These strategies give a patient real time access to their medical records and communication access to their physicians. Health care providers are also using patient-friendly apps for scheduling and other interactions with the practice. The use of these portals of patient-centric apps has been well received by patients and those that use these tools are in a better position to make more informed decisions about their health care. The use of these patient-centric strategies can certainly differentiate providers who use them from those who do not. 

As more insurance companies offer higher deductible plans or plans with less benefits and more out-of-pocket responsibility, insureds are facing the reality that they are going to be responsible for more of their health care cost. According to a report from the Kalorama Foundation, patient financial responsibility costs have increased by 10% since 2020 and it is projected to continue to go up by 9.9% per year through 2026^[6]. With much more skin in the game and more information available about the cost of health care, informed patients are paying more attention to health care costs. A survey from October 2020 found that 80% of patients stated that they look up the price of a medical service before accessing such care and that cost is a major factor of where to receive care^[7]. The trend of price transparency could impact specific procedures like colonoscopies or other elective surgical procedures and imaging services when a patient can research and compare providers. The bottom line is that providers will need to be prepared to discuss costs with their patients as the price transparency trend will likely continue.  Additionally, as we move from a volume-based care system to a more value-based system, providers will be paid in different ways by payors. Patient satisfaction and patient feedback could impact potential reimbursement, so providers are exploring ways to stay in touch with what patients are thinking and trying to improve the overall patient experience. Patients will also be tracking provider quality data as they manage certain patient populations. This quality data could also be a factor in where consumers decide to go for health care. 

As we enjoy the one-click convenience of online shopping in retail, it appears inevitable that patients will seek a similar type of experience when searching for health care services. Many health care services (emergency care and complex disease management) are too complex and unpredictable to be able to easily explain and predict the cost and outcome of. However, progressive providers are trying to improve the overall patient experience by communicating with patients in new ways such as text, email or social media, through post-visit feedback about all aspects of their visit and by using customer relationship management (CRM) software to manage patient interaction. 

While your next visit to the doctor’s office may not be as convenient or customer-friendly as using Amazon or your favorite app, it looks like health care consumerism is a trend that is not going away and will continue to have an impact on the health care system. Health care providers will need to be prepared for a more informed consumer who has the ability to make decisions on where to receive their health care based on cost, quality and other factors, including convenience and the overall patient experience.

^{[1] “69% of Healthcare C-suite Say Improving the Consumer Experience is a Top Priority,” Sage Growth Partners, July 9, 2019
[2] “Mega-trends in Healthcare Consumerism: A 5 Year Study,” www.connecture.com
[3] “How COVID-19 Reshaped Health Care Consumerism,” Fred Pennic, January 31, 21, NRC Health
[4] “Telehealth Usage Rises with Increase of COVID-19 Cases,” Health Leaders, January 07, 2021
[5] “Using Patient Navigation to Support Healthcare Consumerism Trends,” Patient Satisfaction News, July 10, 2019
[6] “U.S. Out-Of-Pocket Healthcare Spending Swells to $491 Billion, Up 10%,” Kalorama Foundation , August 2, 2021
[7] “Over Half of Patients Worried About Out-of-Pocket Healthcare Costs,” Patient Engagement HIT, October 29, 2020}