December 15, 2017

How Stanford Health, Allina Health, and others are embracing the rise of consumerism

Daily Briefing

    Editor's note: This story was updated on June 13, 2018.

    To stay competitive in an increasingly consumer-focused health care market, providers and payers are investing in consumer-oriented services to build loyalty from patients who face increasing financial pressure to shop for health care services, Maria Castellucci reports for Modern Healthcare.

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    The rise of consumerism in health care

    Factors behind the rise of consumerism in health care include the proliferation of high-deductible health plans, online reviews, and overall more transparency in health care, Castellucci reports. Further, health care consumers expect the industry to adopt consumer-driven services—such as online scheduling and smartphone applications—since they're available in other sectors.

    David Entwistle, CEO of Stanford Health Care, said, "This is happening all around us. ... Consumers have choices and they have great access to data online, which they are using to decide … where they get their health care."

    That said, consumerism is a relatively new notion in the health care industry, Castellucci writes. Today, only about one-third of CEOs in a recent Modern Healthcare CEO Power Panel survey said they have at least one employee whose sole job is consumerism, and the survey found no agreed-upon definition among respondents for consumerism as a trend.

    Nonetheless, health care CEOs say consumerism will become a bigger part of their strategic plan in years to come, the survey found. Roughly 83% of respondents said at least one-quarter of their strategic plan currently includes consumerism. Roughly 75% of respondents said they expect more than half of their strategic plan will focus on consumerism within the next three to five years.

    How providers are addressing a consumer-focused market

    For the University of Southern California's Keck School of Medicine, being consumer-oriented involves a focus on improving patient experience—a focus that has resulted in seeking out real-time feedback from patients and physicians in ambulatory care settings, Castellucci reports.

    For example, the medical school has adopted a new system in which tablets are placed in clinics so patients and providers can provide immediate feedback on their experiences. If the experience is negative, such as a patient voicing concern about a long wait time, clinic managers are alerted immediately so they can address the matter promptly. The physician feedback, meanwhile, helps Keck determine whether the clinical staff is overwhelmed and if so identify ways to help, Keck CEO Thomas Jackiewicz said.

    Jackiewicz said he got the idea for a real-time feedback system because too much time would pass between a bad care experience and when he learned about it. "There are so many visits (in the ambulatory-care setting)—it's our lifeblood," Jackiewicz said. "If we get ambulatory care right, everything else will work out well. But I worried if we aren't doing a good job, we might just never know, and our volumes could be impacted."

    Meanwhile, Allina Health has responded to consumerism by working to better understand the needs of its diverse patient population, Castellucci reports. Branching beyond patient surveys, the system has held focus groups and implemented outside research on consumerism. Allina also has launched a program through which health care professionals visit patients who are in their last years at home to help them with end-of-life care decision-making and implementation. 

    However, one challenge for the program, which has been well-received by patients and their families, is that payers don't reimburse for it. Allina CEO Penny Wheeler said, "As we are getting more into the consumer-centric viewpoint, the payment isn't catching up."

    And another factor that can hinder an organization's efforts to become more consumer-focused is the difficultly of implementing the necessary changes—especially in a fast-changing, stressful environment, where employees can be overwhelmed by other demands, Castellucci reports.  As Jackiewicz said, "Everyone on the team has to believe (consumerism) is an organizational priority."

    What's happening on the payer side

    America's Health Insurance Plans CEO Marilyn Tavenner said payers are aware of the importance of consumerism, too. And Joanne Smith, CEO of Shirley Ryan AbilityLab in Chicago, pointed out that insurers are arguably the most influential players when it comes to the evolution of consumerism in health care, as insurers say where patients can get care.

    According to Castellucci, payers are eyeing ways for members to have a more personalized and integrated experience, with many offering care managers and online tools to consumers seeking help. Oscar Health, for instance, developed a mobile application that consumers can use to search for providers or health concerns. The app also connects users with a no-cost, 24-seven telemedicine service.

    Progress is slow—and hurdles remain for consumers, research letter suggests

    While the health care industry might be focusing ever more on the consumer, progress remains slow: According to a research letter in JAMA Internal Medicine, consumers still face difficulties comparing prices online for various health care procedures.

    For instance, after conducting 64 cost-related searches for four medical procedures on Google and Bing, the researchers from Duke University found just 234—or 17%—of websites that appeared on the first two pages of search results featured geographically relevant cost estimates, which meant consumers' chances of finding the information they sought was less than 20%.

    Moreover, the researchers found that providers in eight major U.S. cities performed poorly on price transparency, with just 27% of websites in the Chicago area offering a cost estimate for at least one of the medical procedures and only 7% of websites for the Baltimore area doing the same.

    To address the issue, the researchers recommended providers be required to share price information with consumers or that information on health insurance claims be shared and stored in statewide databases. "Given the increasing number of Americans facing high out-of-pocket healthcare expenses, we need to promote policies that make it easier for them to determine the price of their medical care in time to inform their health care choices," the researchers wrote (Castellucci, Modern Healthcare, 12/9; Kaplan, "Science Now," Los Angeles Times, 12/8). 

    June 18 webcon: Learn 5 must-have characteristics of the consumer-focused physician

    Join us on Monday, June 18 at 1 pm ET to learn the five must-have characteristics of a consumer-focused physician and best practice approaches to engaging physicians with each one.

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