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Consumer-Centric Healthcare Lags Amid Value-Based Care Priorities

Organizations are failing to deliver consumer-centric healthcare that activates the patient across the entire care continuum, according to recent reports.

consumer-centric healthcare

Source: Thinkstock

By Sara Heath

- Healthcare organizations aren’t making much progress in becoming more consumer-centric, even as industry forces are calling for better patient engagement and activation in healthcare, according to a recent report from healthcare consultant Prophet.

The report, which included survey responses from pharmacy, provider, and payer organizations, showed that these industry segments are not integrating patient centricity into their care strategies. Those patterns run counter to industry imperatives to better serve the patient as a healthcare customer and consumer.

As patients continue to assume greater financial responsibility for their care, they are recognizing the purchasing power they have. No longer is it enough for a payer to sell health insurance, or for a clinician to treat a cold. Instead, these providers need to meaningfully engage the patient in her own health.

Calls for more value-based care that prioritizes overall patient wellness likewise are putting on the pressure for more consumer-centric care. Patients who are highly engaged in and take ownership of their own health will be more likely to strive for the outcomes needed for success in value-based care models.

Ultimately, these pushes will boil down to greater patient participation in care, the report noted.

READ MORE: Consumer-Centered Healthcare Improves, Focus on Innovation Key

“Consumers want to be treated as powerful participants in their own health,” Jeff Gourdji, a partner at Prophet, said in a statement. “Increasingly healthcare organizations’ own bottom lines require meeting consumers halfway or more. So, it is increasingly in everyone’s best interests to make sure consumers are empowered, engaged, equipped and enabled so they become what we call the ‘e-consumer.’”

Driving patient- and consumer-centricity will require provider activation in five key areas, the report explained.

First, organizations must transition from “tactical fixes” and individual care encounters to a holistic patient experience. Next, they must integrate fragmented care into a coordinated and connected healthcare spectrum.

Third, organizations must focus on person-centered care efforts in addition to population-centered efforts. Additionally, they should turn to extensive industry innovation in place of more incremental improvements.

Finally, each healthcare industry sector should view consumerism in healthcare as an overall culture shift, as opposed to a department-by-department imperative.

READ MORE: Consumers Say Patient-Provider Relationship Key to Quality Care

Healthcare organizations, payers, and pharmaceutical companies are not performing as should be expected, the report suggested. Based on extensive interviews and survey questions, only about 15 percent of organizations are performing satisfactorily in any of those five areas.

Payers have a solid performance with respect to an overall culture shift toward consumerism in healthcare, as well as with using their extensive data stores. Between patient-generated health data (PGHD) from wearables, claims data, and other clinical data resources, payers have been able to pinpoint specific areas where they can better serve their consumers.

However, payers still struggle with their consumer relationships, which are often characterized as impersonal or overly transactional.

Pharmaceutical companies have also exceled at driving a culture of consumerism at their respective companies. However, these organizations struggle to drive holistic care solutions that support overall patient wellness. Instead, pharmaceutical efforts – perhaps by nature of the industry – still focus on incremental health solutions.

Clinical providers have proven proficient at turning data into important patient insights. However, they also lack the ability to view health as a holistic journey. Efforts are still encounter-based instead of rooted in a belief that wellness is a life-long process.

READ MORE: Retail Consumer Experience Key in Consumer-Driven Healthcare

Medical groups may not be using all the tools as their disposal, the report revealed. For example, fewer than 10 percent of respondents said they are willing to partner with health IT companies to improve patient care. Only 21 percent said practical and actionable innovation is coming from health IT companies, instead siting providers and medical device companies for innovation.

Just about one-quarter of respondents said they are using quality measurements to drive organizational improvement.

And when it comes to partnering with non-medical industry professionals, few respondents expressed enthusiasm. Only 15 percent said they would be interested in partnering with experts from the hospitality or retail industries, despite the consumer-centric insights those professionals could offer.

As the healthcare industry continues to respond to shifting financial forces, it will be essential for organizations to leverage more consumer-centric care strategies, said Prophet’s chief growth officer Scott Davis.

“Particularly in the US, many healthcare companies are feeling squeezed by new value-based metrics and by pushes from financiers of healthcare – such as governments and employers – toward a more cost-efficient consumer system,” Davis said in a statement. “Yet adaption to the consumer is stunted and digital naïveté is pervasive.”

Organizations should consider deploying patient-centered health technologies, utilizing clinical quality measures, and forging inter-industry partnerships to gain new perspective into patient-centricity, the report concluded. Leaning on these strategies could drive organizations closer to a more consumer-centered future.

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