Patient Consumerism Navigating Through Healthcare Changes May 7, 2015
... catalyzing the spread of healthcare best practices www.hcgc.org
Shift to Value-based Health Care
Clinical outcomes across spectrum of integrated & coordinated care Patient experience Total costs across spectrum of integrated care
Source: A Strategy for Health Care Reform — Toward a Value-Based System Michael E. Porter, Ph.D., N Engl J Med 2009; 361:109-112, July 2009
Value for the consumer and purchaser
Shift to Value-based Health Care Rising Consumerism
Population Health
Value-based Healthcare
Quality-Cost Transparency www.hcgc.org
Payment Innovation
WHY: The need to transform healthcare in the U.S.
WHY: The need to transform healthcare in the U.S.
WHY: The need to transform healthcare in the U.S.
WHY: The need to transform healthcare in the U.S.
WHY: The need to transform healthcare in the U.S. As much as 30%: wasteful, unproductive or unnecessary
WHY: The need to transform healthcare in the U.S. Variations in QUALITY: Readmissions within 30 days medical discharge Central Ohio region is one of 57 regions ranked with highest variation
WHY: The need to transform healthcare in the U.S. Variations in COST: Recent study for Lower Back MRI
Columbus Ohio Average: $1,711 Price Range: $1,335 - $2,749
Nashville TN Average: $1,066 Price Range: $531 - $1,975
WHY: Patients largely determine their own outcomes!
Patient–driven care • “Others have struggled to find a proper definition of patient-centeredness. Three useful maxims that I have encountered are these:” – “The needs of the patient come first.” – “Nothing about me without me.” – “Every patient is the only patient.” Donald M. Berwick, What 'Patient-Centered' Should Mean: Confessions Of An Extremist Health Affairs, 28, no.4 (2009):w555-w565
New definition: Patients largely determine their own outcomes.
WHY: Spending not aligned with what influences our health status?
What influences our health status 10%
Where our nation spends its health care dollars (~$3+ Trillion)
Access to Care
20%
Environment
20%
Genetics
Access to Care
88%
50%
Lifestyle & Behavior
Other
8%
Health Behaviors
4%
Source: Centers for Disease Control and Prevention, University of California at San Francisco, Institute for the Future
WHY do we need to improve patient engagement?
$1.2 trillion
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Source: The Volume-to-Value Revolution, Oliver Wyman, 2012,
WHY do we need to improve patient engagement?
$910 billion
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Source: The Volume-to-Value Revolution, Oliver Wyman, 2012,
WHAT is patient engagement?
... the actions we take to support our health and to benefit from healthcare
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WHAT is the value of improving patient engagement? Is Patient Engagement the next “Blockbuster Drug�? What could happen that would make patient engagement a standard of care in Central Ohio? What could be different? Patient and caregiver voices and perspectives embedded in quality improvement initiatives
Purchasers provide incentives to primary care teams to accelerate patient engagement as a standard of care
Clinicians fully utilizing their potential as the three most trusted* professions: Nurses, Pharmacists, Doctors (*Gallup poll)
More patients have improved health status and economic productivity
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WHAT is the value of improving patient engagement?
Patient Engagement
Quality
Patients largely determine their own outcomes!
Cost
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Source: The U.S. Health Care Market: A Strategic View of Consumer Segmentation, Deloitte Center for Health Solutions
“My health doesn’t worry me, so I’m not as engaged with the system, focused on prevention, or interested in online resources as others. I’m costconscious, think that the health care system could improve, and am generally just not interested right now.”
Source: The U.S. Health Care Market: A Strategic View of Consumer Segmentation, Deloitte Center for Health Solutions
“I’m happy with my health plan, hospitals, and doctors and see no reason to compare or switch. I trust my doctors to tell me what I need to know and make good treatment decisions for me. I follow-through with what my doctors recommend and I try to take good care of myself.”
Source: The U.S. Health Care Market: A Strategic View of Consumer Segmentation, Deloitte Center for Health Solutions
“I like to learn as much as I can online and am very interested in innovative health technologies. I am generally happy with the care I get from my doctor, but am also open to alternative providers and different care settings. Making smart, informed health decisions is important to me�
Source: The U.S. Health Care Market: A Strategic View of Consumer Segmentation, Deloitte Center for Health Solutions, 2012
“Taking care of my health is a priority for me – I use a lot of health care services and products, try to make informed decisions in partnership with my doctor, and do my best to adhere to treatment plans. I am highly informed through using online information and tools.”
Source: The U.S. Health Care Market: A Strategic View of Consumer Segmentation, Deloitte Center for Health Solutions, 2012
“I’m independent – I like to make decisions on my own, prefer doctors who use alternative approaches/natural therapies, and switch medicines more often than most. I’m not very satisfied with the doctors, hospitals, and health plan I’ve used. I’d like to customize my own plan.”
Source: The U.S. Health Care Market: A Strategic View of Consumer Segmentation, Deloitte Center for Health Solutions, 2012
“In pursuit of good value – I switch health plans and doctors, use retail clinics, order medications online, and travel for care more often than most. I am cost-conscious and improving or maintaining my health is a priority. I am open to alternatives.”
Source: The U.S. Health Care Market: A Strategic View of Consumer Segmentation, Deloitte Center for Health Solutions, 2012
Source: The U.S. Health Care Market: A Strategic View of Consumer Segmentation, Deloitte Center for Health Solutions, 2012
WHAT is emerging from patient consumerism?
KNOW your patient’s engagement levels…
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INVITE patients to start using questions at your practice!
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Patient engagement tools are emerging‌ A) Free resources for more sensible healthcare decisions consumerhealthchoices.org
B) Determine fair prices in your area for healthcare services healthcarebluebook.com C) Letter grade reflecting how safe hospitals are for patients hospitalsafetyscore.org D) Quality of care information on at over 4,000 hospitals medicare.gov/hospitalcompare F) No-cost app to help patients have a more productive visit with their doctors visithelper.com G) Tools to help find a doctor and make appointments zocdoc.com
Spring 2015
1 in 4 Medicare patients will walk out of a hospital with an issue they didn’t walk in with, many of which are fatal.
• Access via browser at visithelper.com • App available at Apple Store and Google Play
Tools provided by your employer, health plan, healthcare provider, retirement system, etc‌
Thanks for your time!
Learn from your questions and reflections!
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