Consumer-driven Healthcare and the Community Hospital
In a recent report by the White House National Economic Council, President Bush’s vision of the future of healthcare was communicated:
"In an ideal system, Americans would be able to choose their health care based on their individual needs and preferences. Information about range, price, and quality of available health care options would be readily available and easy to use. Purchasing decisions would be made by consumers, not by employers, insurers, or the government." The White House National Economic Council Report, February 2006.
The heart of consumer-driven health care is informed patient choice.
In the near term we will hear and participate in much debate on the future of healthcare. Bush’s opponents advocate increased government control and regulation. Unfortunately, no matter which side of the debate wins, more government imperatives are certainly around the corner.
So where will the movement toward consumer-driven healthcare lead us? What market forces will evolve? What must the rural community providers do to empower their consumers to make informed patient choices?
High-deductible Health Plans
As employers seek to reduce their expenses, they will shift control of healthcare spending from themselves to their employees. High-deductible health plans will predominate. The consumer will begin to evaluate services in light of their costs. They may defer more services for financial reasons. They will certainly compare providers’ charges and make their decisions accordingly.
With a greater share of the healthcare dollar coming from the patients, power will shift from employers and health plans to the consumer. Community hospitals, like all providers, must equip the consumer with enough relevant information to make informed choices.
Health Savings Accounts
The growth of healthcare savings accounts will continue. Such accounts allow the consumers to save up to pay for their healthcare services. Like most money accounts, those dollars will seem like free money ready to be spent. And like most money accounts, some consumers will judiciously expend the funds and others will quickly deplete them without regard for the cost of their money.
Transparency
To accommodate informed patient choices, providers will need to clearly inform consumers of their charges before the services are rendered. The patients must know their costs for services. With the exception of some elective services, like cosmetic surgery, today’s patients rarely know the level of their financial commitment. This will change.
The patient must have the power to compare what his services will cost him at all available providers. Other industries provide certified estimates for serviceswe will have to adopt this practice.
Published prices with clear descriptions will become the standard. Provider websites will allow professionals and consumers to easily look up prices. Financial counselors will need access to this information at their fingertips.
This transparency of price will empower consumers to make choices in line with their financial capabilities.
Quality transparency will also become essential. Task forces continue to develop standard indicators for quality of care that will allow consumers to know which providers provide the highest quality services. Such indicators will evolve to emphasize quality outcomes.
Equipped with relevant price and quality information, consumers will be able to make more informed choices.
Package Pricing
In order to clearly publish your prices, you must begin to identify services in packages. All anticipated services and supplies will need to be bundled into one price. This bundling will allow consumers to understand their bottom linewhat’s it going to cost them.
Your information systems must accommodate such package pricing.
Patient-friendly Billing
Statements have a long way to go to become understandable by untrained consumers. They understand their cable bills. They can read their credit card statements. But few can make out their hospital bills.
Cryptic descriptions, long lists of unfamiliar line items, and medical terminology confuse them.
Regularly evaluate your statements for clarity. Ask patients what they don’t understand. Then make adjustments to your bills to make them clearer.
Online Bill Pay
Most patients know how to navigate an Internet shopping cart. They’ve made online purchases of books, flowers, and apparel. You should provide a similar portal for paying for your services.
With online bill pay, you can allow the consumer to download original bills, see their previous payments, know their current account balances, and make their payments. Your patients will appreciate the convenience.
You can set up your online service to automatically e-mail your patients to let them know that a new statement has been issued and to provide a link to the login page.Once the patient makes the online payment, your accounts receivable system will be credited automatically.
These services are now available and are much less expensive than sending paper bills and processing checks.
American HealthNet now provides online bill pay to Clarus, NDR, and HSI clients.
A few of you will lead the way toward consumer-driven healthcare. Those who lead will reap the greater benefits. Don’t let this trend sneak up on youbegin planning and implementing your changes now.
Minor adjustments bring about major improvements.
