In the age of smartphones, social networking and the sharing economy, there’s just about nothing that can’t be done at the click of a button. Not only do we expect modern technology to give us whatever we want, whenever we want, from wherever we are, we’ve also come to expect it to learn our preferences and give us the most personalized experience possible.
This trend can help explain the recent "consumerism" phenomenon in healthcare, in which “patients” are now “consumers” – proactive participants in the healthcare process. Experts and trade publications sing its praises using favored buzzwords like price transparency, choice, and personal accountability.
To be sure, there is now a growing role for individuals and families with respect to their healthcare relationships and decisions. This is a promising development for a field that has historically viewed customer relations through a distorted consumer lens because of the reality that third parties have paid most healthcare bills, not the patient. But it is premature to claim consumerism as a transformational force in healthcare has arrived.
Yes, consumers are now armed with more information and greater choice. But these decisions are still largely being made within the complicated conundrum that is the healthcare system, with most people still struggling with how to make good choices or take greater control. There is no app for that.
The leading edge of the real change is that consumers are being asked to pay far more for the cost of their care than ever before. Whether through deductibles, premium cost-sharing, co-pays or uncovered services, the patient’s share of healthcare costs has grown significantly. And there is no sign of this trend reversing.
The other major driver for the growth in consumerism is the Affordable Care Act, though this reveals both the possibilities and perils of this transformation.
Initially, the healthcare exchanges through which thousands of Americans and Arizonans sought health insurance were real marketplaces. Choices were plentiful, as was the diversity of products. And we learned a lot about how consumer behavior could impact healthcare. For example: we quickly learned that when presented a choice between a more robust, costly health plan and one that is stripped-down but cheaper, most people select based on their pocketbook.
Today, it appears the near collapse of the health exchanges in Arizona and elsewhere has robbed consumers of the choice and affordability that were supposed to be hallmarks of the ACA.
What happens next will be determined by our elected leaders in Washington. At this moment, House Republicans are working on their second attempt at an Obamacare repeal through a revised version of the American Health Care Act, which AzHHA continues to oppose.
As I’ve said on numerous occasions, there are reforms that could be made to our nation’s healthcare system that would improve lingering challenges in the areas of healthcare choice, access and cost. By these standards, the legislation in question continues to take giant steps in the wrong direction.
Rather than get sucked into a hyper-partisan political debate, our focus should be on creating real markets that drive consumerism and expand patient choice. These are some policy prescriptions to do so:
Build protections for consumers in marketplaces that are overly complicated or dysfunctional. Patients, for example should be held harmless for those instances when an “out-of-network” cost is incurred that could not have been reasonably foreseen.
Strengthen parts of the marketplace that reinforce consumer choice. It won’t do any good from a consumer-revolution standpoint to merely allow consumers who are conscious of their choices to treat the bills from their cost-sharing as optional and not real obligations.
Renew our commitment to simplify the healthcare system so it is more understandable.
Our responsibility as healthcare providers is to lead this shift, and our challenge is to do it in collaboration with others – insurers, policymakers, employers and, of course, consumers and our patients.
We remain ready and willing to engage with our leaders in Washington on a plan that addresses these issues in a responsible, meaningful way.