Transforming the Mindset: The Healthcare Consumer

For as long as modern healthcare has been available, providers and payers have dictated how, when and what care is delivered to the patient. However, a revolution in the field is shifting the manner in which care is consumed. Today, patients are demanding more say in their healthcare experience and are seeking transparency in pricing, more individualized solutions, and more consumer-friendly programs.

The good news — the industry is listening and companies like San Diego-based SHARP Healthcare are leading the way. According to SHARP’s Chief Marketing Officer, Jim Nuckols, “My mission is to consumer-ize SHARP. SHARP is a really strong brand and presence in San Diego that is making healthcare more consumer-friendly. Everything we can do to make SHARP more relevant, convenient, and consumer-focused is where I have put my emphasis. Changing the way we are organized and how we approach things has been somewhat of a shock to the system, so I do bring a very different perspective.”

What is Healthcare Consumerism?

Simply put, healthcare consumerism is a concept focused on transforming the patient to a consumer with a more flexible and hands-on approach to their care, thus boosting the patient experience from beginning to end. “There’s a realization that the experience needs to start the minute someone Googles for care. It doesn’t start when you enter the hospital. It starts when the consumer thinks, ‘I’m not feeling well what should I do?’ That’s the piece we’re really trying to help with,” Nuckols explains.

The old paternalistic system where the government and employees are king is slowly changing and the main focus is shifting to the patient’s happiness, engagement and convenience. Up to this point, patients had little to no input on their care plans; now the idea is for the patient to have a voice and experience benefits they have never had access to. But what does this mean? How does the consumer come out as a winner?

Transparency in Cost

Consumer markets are only effective when the consumer knows exactly what and how much they are paying for. In the traditional system, if a patient experienced a medical incident – from a minor incident such as getting stitches to more intensive occurrences requiring hospitalization — they would have no idea how much this incident would cost until they received the bill, often months after the fact. Now, consumers are seeking to access to these costs upfront so they are able to assess their options and potential financial impact. Organizations like Leapfrog Group and the National Committee for Quality Assurance are pushing providers to make quality data and costs both clearer and more assessable for the consumer to see. Health price comparison tools are also becoming more and more available to help consumers understand pricing differences between providers.

Another example of cost transparency is the popularity of high-deductible health plans. Seventy percent of employers offering at least one high-deductible option. These plans provide lower monthly payments and push cost-sharing into the delivery of care vs. ongoing fees.

Consumer-Friendly Initiatives

Many consumers with chronic diseases have been known to neglect their care, due to cost, inconvenience, education and lack of access to the appropriate resources. Without engaging these patients in a more modern way, this past behavior will continue to impact care outcomes and drive up medical costs. An example is the barrier elderly patients face when transporting to and from their appointments. Many don’t have access to cars, so appointments are missed and healthcare concerns worsen over time. To alleviate this problem, providers like CareMore are issuing ride-share programs to their patients by calling services like Lyft to take them to and from their appointments. The medical transport service market is actually projected to reach $42 billion by 2024, as this service adds value to providers, payers and patients alike

Immediate Access

When it comes to immediate access in the healthcare field, the emergency room is what comes to the top of mind. The ED is a key driver of revenue for hospitals, but when utilized inappropriately, can unnecessarily inflate the cost of care and contribute to longer wait times and poor patient experience. Alternative services like telemedicine (video conferencing and phone calls to consult on minor injuries, illnesses, and prescription refills) are being more widely used and some communities have even re-instated house calls so that sick patients don’t have to get out of bed. In 2014, a study was issued that analyzed the Veterans Health Administration’s Home-Based Primary Care Program. By increasing home-based healthcare, the VHA experienced a 24 percent reduction in total healthcare costs by reducing hospital stays.

The Emergency Department is still a key community need and to improve the ED experience, leading hospitals are allowing patients to schedule emergency room visits. Nuckols explains, “One of the most annoying things when you are sick is to think that you have to go wait five hours in the emergency room, so we played around with actually scheduling your ED visit. We had people coming from all over the place to our smaller hospital on Coronado Island because they could schedule their ED visit.”

Healthcare is clearly evolving. Gone are the days of providers dictating care. Instead, providers and payers are shifting their mindset to work with the patient to create a better experience. Healthcare marketers must be aware of the shifts towards healthcare consumerism, support the operations behind these changes and even drive decision making. The key is to keep the 5 P’s of healthcare consumerism (patient-centered, prompt, personalized, pathways, and portable) in mind at all times. By having this mindset and being the catalyst behind these changes, patients will continue to have a positive experience and providers will keep and then gain market share.