Patients in the U.S. are confused, cost-challenged and lacking control, according to The Consumer Healthcare Paradox from Maestro Health, an employee health and benefits company.

Data illustrating that “paradox” is shown in the second chart: while 78% percent of patients told Maestro Health their health care experience is positive, 69% feel they lack control over their patient journey.

Quality health care in America is too expensive, 79% of consumers said. Furthermore, one in two U.S. patients had received a medical bill that was higher than they anticipated it would be. Finally, one in two U.S. patients said the quality of the health care they received was equal to or greater than the cost.

This means that one in two U.S. patients felt the quality of the health care they received was less than what it cost.

Cost ranks as the top negative health consumer experience issue among 52% of people, the bar chart shows. That’s well above the second factor contributing to health care experience: the ability to seek out care unconstrained by a closed network of providers. The third factor consumers seek is streamlining and simplicity in their patient journey, with a single point of contact, claims, and control.

Maestro Health interviewed 1,000 U.S. consumers in the US, aged 25+, in April 2019.

Health Populi’s Hot Points:  The third-‘c’, control, addresses simplifying, streamlining — asking the question, “how would Marie Kondo make health care better” in the way she helps us clean and straighten out our cluttered closets and drawers.

I wrote “What If Marie Kondo Reorganized Health Care in the U.S.” here in Health Populi after reflecting on the useful advice she gave me for downsizing my own home. One of my recommendations in that blog post was for bricks-and-mortar health care providers to de-couple the “bed” and clinic model to peoples’ homes and mobile platforms.

“Imagine a hospital closing beds and shifting workflow to virtual care via telehealth channels,” I wrote. “For health care providers, telehealth and virtual care are converging with healthcare delivery the we used to compartmentalize ‘e-business.’ Today, e-business is just stuff done via ecommerce or online or via cloud computing….just everyday business flows. At places like Mercy (Virtual) Healthcare, Kaiser-Permanente (which conducts over 50% of their visits virtually) and Intermountain Healthcare, telehealth is just a new normal in health care delivery.”

A few health care industry updates point to some players, from one of the oldest chain pharmacy companies to a start-up going public on the stock exchange last week at a valuation of over $1 bn, to deliver a streamlining platform for “sparking joy” among patients.

The first example is Walgreens’ launch of chronic care management through the Find Care platform that will leverage the retail health provider’s virtual care network to help customer-patients manage chronic conditions. People dealing with conditions like diabetes must make many decisions on the day, and largely do so outside of the doctor’s office. A retail pharmacy close to home could be a useful community-based touchpoint to support people to better manage care, and physicians to partner in the health ecosystem for the benefit of their patients’ outcomes (and potentially the value-based payment regimes clinicians are going at-risk for).

The second story is Livongo, as new to the health/care ecosystem as Walgreens (founded in 1901) is mature in it. Livongo rang the NASDAQ bell launching the company’s IPO last week with a market cap at launch of over $3 bn. The company has developed digital health programs for people managing chronic disease with measureable outcomes in cost-savings and health improvement. Livongo’s success, thus far, is rooted in person-centered design to bolster engagement and patient outcomes in a streamlined platform that integrates wearable and remote monitoring devices like Apple watches, Samsung phones and Fitbit trackers.

These two examples illustrate that Maestro Health’s concerns are being heeded by organizations who see the opportunity to get closer to patients’ in everyday life and make a difference for them, their doctors, their employers who may fund their health insurance, and shareholders.

This last stakeholder, shareholders, has been a topic of conversation for decades in U.S. health policy circles. As politics heat up for health system reform which include variations of #Medicare4All that would/could eliminate private health insurance, versus universal health care programs that mix public and private insurance provision, the opportunity for IPOs to launch as successfully as Livongo’s and Health Catalyst’s did last week may be tempered.

These digital health developments can be integrated into peoples’ streamlined on-ramps to health care — that “one resource” the Maestro survey called out, as part of (in today’s U.S. health care framework) an employer’s health plan, a Medicaid or Medicare plan, or via Veterans Administration health benefits. If designed for easy access that’s part of a person’s overall health care experience and payment mechanism, the programs could effectively engage patients in self-care, bolster health literacy and activation, and ultimately lower health care costs for people and payors.

1 Comment on A Portrait of the Health Consumer as Confused, Cost-Challenged, and Out of Control

Report Finds Patients are ‘Confused’ on Health Care – Health Econ Bot said : Guest Report 3 months ago

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