MedCity Influencers

Covid-19 triggers surge in healthcare consumerism: What’s the potential for quality and affordability?

What would the future look like if we continue down the path of active healthcare consumerism?

I’ve practiced internal medicine for almost 20 years. Never have I seen such a dramatic shift in the way people seek care, as we are experiencing today. Nearly overnight, we have been forced to rethink where we get care and whether we get it at all.

The scary thing about this new trend is that people may be ignoring critical symptoms such as those associated with a heart attack in fear of going to the ER and being exposed to Covid-19. The silver lining is the current pandemic has driven a level of health care engagement I have never seen in my career.

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The healthcare industry has been striving for people to be more active consumers of care for decades. We’ve tried transparency tools, high-deductible health plans—the list of unsuccessful engagement tactics goes on. Those tools weren’t successful for the patients I saw, in my practice, because treatment options were hard to navigate; there was no way to know how much their care decisions actually cost; and patients had little knowledge of the end-to-end care they might need to fully address their conditions. Studies from across the industry confirm that my experience wasn’t unique.

 An increased ownership in galvanizing consumer behavior changes is something we must harness, as an industry. We must finally deliver the condition-centered, simple-to-navigate, price-certain experience that consumers want. If we can deliver, active health care consumerism could have permanent, positive impacts on cost and quality. 

In fact, data shows that consumers spend less annually and choose more effective and efficient health care treatments when given clear, upfront pricing that’s easy to understand.

So, what would the future look like if we continue down the path of active healthcare consumerism?

The biggest change would be people are empowered and able to truly take ownership of their health. Beyond that, I see a future where we spend more time managing our health as opposed to ad hoc treatment of illnesses. We’ll use high-quality, cost-effective tools, like symptom checkers and telehealth, more frequently before opting for more expensive paths, like an ER visit when one isn’t necessary. We’’ll think about and plan our trajectory of care based on the conditions we have rather than the doctors we see.

And health insurance designs will follow suit, covering the most effective and efficient care offerings to enable and encourage people to seek what’s best for them and their condition. Overall, this could mean we’ll spend less on things we don’t need and improve our health.

Here’s a list of what I believe needs to happen to support lasting change in health care consumerism. 

Increased access to intuitive, educational tools

First and foremost, we need better tools. People deserve reliable, real-time information to support them in their health care decision-making, with plenty of opportunities to educate themselves. 

The onus is on payers and other companies developing these tools to improve ease of access to accurate information, whether to regulated sources of information or otherwise, as well as to improve the overall user experience.

 If the tools aren’t intuitive to navigate, the accuracy of information doesn’t matter—people won’t engage.i-ii Providers can play a role here, too, ensuring they’re providing high-quality information to facilitate an educated dialogue with their patient about care decisions.

Incentivization of innovative care delivery

We also need more widespread adoption of telehealth and other innovative methods of care delivery. We’ve seen this happening already with the dramatic shift to virtual visits and telemental health. It’s opening our eyes to what’s possible, and with it, peoples’ preferences are likely to change. Payers and employers need to ensure these methods of delivering care are covered, easily accessible and priced accordingly so that people are encouraged to use them when appropriate.

Enablement of condition-based care

Most patients I saw when practicing medicine were looking to address a condition—they wanted to know how best to manage their diabetes, their heart disease, their sleeplessness, or whatever was ailing them. But our system forces them to first check which providers are in-network rather than what condition they have and if the treatment paths are covered. COVID-19 is a condition. It has shown us that we can change our structure to better align with how people seek care. We need to take that model and replicate it across our health care ecosystem.

Restructuring of insurance design

And last, but definitely not least, people deserve better health insurance design. COVID-19 forced a lot of insurance companies to change their structure to enable easier access to testing and treatment. Let’s continue that momentum. Cost certainty needs to replace surprise medical bills. Value needs to become the new cost-sharing mechanism. Choice in treatment path and price transparency need to be our new normal. Insurance coverage needs to flex as the individual’s needs flex, not be a one-time-a-year decision. 

Act for better times now

I’ve heard from friends and colleagues on the frontlines in New York just how hard, and scary, navigating COVID-19 has been. I am proud and humbled by their heroism. A lot of bad has come from the pandemic, but I am also extremely hopeful that the cultural changes that are afoot are exactly what we need to lower the cost and increase the quality of health care for all of us in the future. Now is the time. We all need to channel hope into action and keep fighting for something not just better but truly different. 

Picture: Getty Images, Dmitrii_Guzhanin