- With patients bearing more financial responsibility, consumer-centered healthcare and a positive patient financial experience will become more important for healthcare organizations, says a whitepaper from the Healthcare Financial Management Association (HFMA).
HFMA defines consumerism as “a trend that reflects the growing importance of consumer choice in the healthcare marketplace.” With patients poised to make more of their own healthcare decisions, providers will need to adjust their practices to meet consumer needs.
“Patients are beginning to understand the wide variation in prices and, given their ever-increasing out-of-pocket responsibility, are seeking out lower-cost options,” HFMA says. “Consumer-oriented health plans and providers are considering how they can meet that demand.”
Consumer-centric healthcare differs greatly from the traditional fee-for-service models providers may be used to following, HFMA says, because providers are dealing more directly with patients instead of just with insurance companies. In order to succeed in a consumer-centric landscape, healthcare organizations will need to develop a deep understanding of the patient and cater their services to what they value.
“Providers must serve consumers in a way that encourages them to seek all care within the system, optimizing care management and patient engagement,” the organization explains.
In order to fully engage patients and develop consumer-centric care models, healthcare organizations must first work to promote health ownership by empowering patients with the educational tools they need to stay on top of their own healthcare.
By doing this, providers and payers can integrate patients into the care team, which is advantageous because all three stakeholders have financial incentives for maintaining general wellness, HFMA says.
Next, healthcare organizations will need to undergo a two-part process of understanding patient needs. This first requires providers to view patients as individuals with unique health preferences. Deep patient-provider relationships can inform patient stratification and population health management, helping providers to deliver individualized care.
“Providers and health plans that succeed in an era of consumerism will be those that understand their customers as individuals; group them into categories based on their attitudes, motivations, preferences, or other domains; and deliver effective communications and interventions tailored to each category,” HFMA says.
Healthcare organizations should also learn how to listen to their patients by examining consumer insights. Hospitals may consider collecting patient satisfaction data through patient surveys in order to track their performances. Patient comments can prompt changes to how a practice delivers medicine, explains concepts to patients, or offers care access.
Lastly, providers will need to overcome any barriers to consumerism, HFMA says, by making sure patients can “shop wisely” and find the right treatment at the right practice.
As more patients face out-of-pocket costs, they may ask questions about the care they receive, including who is delivering the treatment and if they the right physician for this procedure. How much cost will they need to bear? What value does this practice offer versus another?
HFMA says that being transparent about value and cost will help patients answer these questions and seek out truly value-based care.
According to HFMA, adjusting to consumer-centric strategies could make or break healthcare organizations as the industry continues to emphasize value-based payment models.
“Health plans and providers that fail to respond to the imperatives of consumerism will risk losing relevance as the move to value-based payment gains traction, while consumer-savvy organizations will have an opportunity to gain market share,” the organization says.
“The organizations that will thrive in the years ahead recognize that the traditional provider-centric delivery system must be replaced by one that seeks out, understands, and responds to the consumer’s perspective—and that doing so will support their journey to value-based health care,” the organization says.