Sunday, March 6, 2016

Bam! The healthcare consumer has options and it may not include you.

In 2015, it was estimated that the healthcare consumer will pay over $350 billion for healthcare in the form of insurance premiums, deductibles and co-pays. I have often written that an individual if they were willing to spend at least a little time and effort, could put together a quality, affordable medical network.

In some cases, spending a little time understanding the systems in an insurance plan as well can save time, money and heartburn too.

Most providers resist change and accountability.

Healthcare providers will continue to resist change unless there is an economic incentive.  Hospitals and system are buying physician practices, merging and acquiring to lock in market share which seems to be resulting in higher prices leading to higher insurance premiums, co-pays, and deductibles.

I know, here comes the how can you say that? Easy, name me one hospital merger in a market that resulted in lower prices, consolidation of clinical services or any economies of scale that led to a decrease in the cost of care that they claim will happen? You can’t.

Healthcare consumerism is really about the individual’s ability to make a choice that benefits them, not the healthcare provider.

With less than full transparency on the part of healthcare providers to make it easy for the healthcare consumer to find the information they need to make an informed decision and choice, alternatives have been developed and launched.

On those easy to use sites, the healthcare consumer is finding information in their buyer’s journey. Providers are over a barrel. Few choices remain over the next few years for providers who do not become the high quality, cost-efficient, responsive provider.

Now it will take a little work on the searchers part pointing and clicking, but here are the websites that will show all the information consumers and patients need to make informed decisions.  In the end, with information, the healthcare consumer can avoid poor performing and costly healthcare providers.

How do the hospitals in my area compare?

With Hospital Compare by CMS, the healthcare consumer finds understandable information that you need for choosing a hospital for your network. Add you zip code in the search box, and up will come the listing of hospitals in your area.  Select three for comparisons. Take the time and go through the tabs.

I did and found that despite all three hospitals claim to high quality, caring about me and great care with all the latest technological gizmos and new buildings, I live in a sea of hospital mediocrity.  Don’t become a victim of false advertising.  Demand better, because your life may very well depend on it.

How much can I expect a test or procedure to cost me?

In another market development benefiting the consumer is a small but significant victory in cost transparency, with Guroo.  Guroo is one of the sites providing charge information for 78 standard procedures, based on data from the Health Care Cost Institute database. Search along procedure, condition or test and then enter your zip code. Next thing you know, here comes the cost information for your area. And more hospital pricing websites come online each and every day.

Is my hospital choice a quality award winner?

There are many quality websites available that hospitals tout because they won some quality award.  The problem with that is that few if any hospitals place context on the content of quality awards. It’s more than just a look at the badge or trophy, or plaque. Here are some of the more common quality sites, for example, Healthgrades, U. S. World News and Reports Best Hospitals, 100 Top Hospitals, and Becker’s Hospital Review 100 Great Community Hospitals in America.

How do I know if my doctor or hospital receives payments from healthcare vendors?

Centers for Medicare and Medicaid Services Open Payments.  On this website, you can search for your doctor(s) and hospitals(s) to see the payments by vendors like medical device companies, pharma, etc. Now this doesn’t mean that there is a conflict of interest on the part of hospitals or doctors.  But since they aren't transparent, then you need to find the information. It could potentially impact the care and choices they are making.

What are others saying about the hospital?

Consumers turning to Yelp reviews are an everyday fact of life. Some are good. Some are bad, and some are really bad. The point is not how few reviews, but it’s a reflection of the care experience and how the provider addressed the concern.  If one is not addressing the concern publically with a response on Yelp, then the provider is flunking the consumer test.   No response is undercutting the experience, marketing messages, and brand. All it takes is a “how can we contact your response to learning more”.

Still think consumers aren’t going to exercise their options when they learn all this?

For more topics and thought leading discussions like this, join Healthcare Marketing Leaders For Change, a LinkedIn Professional Group.

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