In all the buzz about health care consumerism, innovative tools like Apple’s HealthKit and a bevy of wearable devices have dominated the spotlight. While technology plays a supporting part in the transformation that is underway, it isn’t directing the action.
Neither are consumers, points out Michelle Snyder.
Snyder, writing in MedCity News, declares that consumer-driven health care is actually a misnomer. Instead, she contends the “gift” of financial responsibility is the catalyst of change, pushing consumers into a starring role they are ill-prepared to undertake. While in the long run, greater health care cost transparency will lead to benefits, the immediate result is a burden for consumers who lack the necessary tools to take control of their health.
Tools for Empowering Health care Consumers
In her examination of various solutions aimed at helping consumers, Snyder identifies several tools companies have developed to help consumers better manage their health care journeys.
- Decision-support for choosing the right health insurance. Health insurance is complex. Between evaluating provider networks and benefits and estimating out-of-pocket expenses, consumers can find the process of choosing health insurance overwhelming. After signing up for coverage on the federal and state exchanges last year, many consumers, especially those who were previously uninsured, discovered to their chagrin that low-cost, high-deductible plans are not always the best solution. ConnectedHealth offers a platform to help consumers shop for health insurance based on likely health care use, as well as personal and financial preferences, enabling consumers to better understand their financial exposure and select the right coverage to meet unique needs.
- Navigating treatment options. Making decisions about health care is always challenging, but it is even more difficult when a consumer is facing a health issue. Two companies– WiserCare and WiserTogether– offer platforms that allow consumers to compare treatment options based on a variety of criteria including outcomes data, cost and benefit coverage, personal preferences and more. Having this information available will make it easier for consumers to discuss the options with their health care providers and make decisions with more confidence.
- Getting a second opinion. Enabling consumers to find the right clinician to confirm a diagnosis is crucial when, as Snyder notes, evidence suggests that 33 percent of medical diagnoses are incorrect and more than 60 percent of treatment plans must be revised. The Mayo Clinic has an app for that. The mobile app, called Better, functions like a personal health assistant, guiding users to the right source for second opinions, as well as providing information on other health care topics.
- Defining the costs of care. Recently, price transparency was a focal point at The Economist’s Health Care Forum 2014 held in Boston, according to coverage by FierceHealth. During the event, Harold D. Miller, president and CEO of the Center for Healthcare Quality and Payment Reform, said “If you don't know the cost of services, how can people choose wisely?” But he also indicated that price transparency alone is not enough because the current industry standard of a fragmented payment system makes it nearly impossible for consumers to capture the total cost of care. A number of companies— as well as non-profit and government entities— are working towards greater transparency, but it will be an on-going issue.
Michelle Snyder also mentioned the value of tools with which many consumers are likely more familiar — devices and platforms for managing health and wellness and social networks for peer support. These are two areas where health care consumerism is well underway as evidenced by the growing number of apps, wearable technology and community sites like PatientsLikeMe designed to help consumers maintain greater control over their health.
Knowing Your Consumers Better
Even as organizations develop the needed tools to support consumer-driven health care, they must recognize that a one-size-fits-all solution will not reach all of the desired consumers— even if they are targeted by a shared health consideration, like diabetes.
The use of psychographic segmentation, which groups individuals by share beliefs, emotions, interests and motivations, allows organizations to fine-tune their offerings and communications to maximize engagement, whether the consumers are inclined to be self-directed or need a more hands-on approach. Armed with greater insights into what drives consumer behaviors, and how to influence these behaviors, health care providers, insurers and companies looking to design the next great health innovation can market their services more effectively to health care consumers, now and into the future.