Prescribing Patient Engagement (to Save Money and Lives): Part One
Originally posted on Medium. Reposted here with permission.
Part One: The Why
Health organizations are beginning to appreciate the importance of improving the patient experience and are working to move the needle beyond satisfaction. Why is it important for them to woo customers and guide them in their journey to better health?
Based on interviews conducted as part of a client assignment, Part One shares a few of the reasons why health organizations are engaging consumers.
Part Two will share how they’re doing it.
Why patient engagement is a must-have, not a want-to-have
Whether purchasing a car, eating at a restaurant or filling up the Amazon cart, consumers expect the best. Not only will they express opinions on and offline, but they’re fickle and will move on to a different flavor of the day.
Factors once relegated to cars, shoes and sofas are now imperative in an industry once ruled by a doctor’s prescription for care. Consumers have more choices in how, where and from whom they receive care. And the attitudes and behaviors they have learned from other industries will influence their expectations of providers, insurance companies, pharmacies and others who provide health services.
In the article, Measuring the Patient Experience, McKinsey suggests that patient satisfaction is influenced by a number of factors, from pre-admission scheduling and testing through to follow-up care, as well as the role that price, service offerings, physician referrals, and brand play in determining where patients seek care.
If health organizations truly want to improve outcomes and provide affordable care, they will need to track behavior along each of these the touch points of the patient journey. This means moving beyond patient satisfaction and actively engaging patients in self-care and prevention.
Changing the business model to wellness
Health systems would like to get out of the business of sick care. Helping consumers stave illness is a way to build relationships and guide them along their preventative health journey.
This objective makes sense on a number of levels. Consumers trust doctors, quite literally, with their lives. They believe doctors will take good care of them, and as such, will share as much or more about themselves than they might share with their own family members. When it comes to the how-to’s of staying healthy, it’s the doctor’s advice consumers want to hear (except the occasional movie star or two, which I always find perplexing).
That physician/prevention connection is also a way to build trust among consumers who are not yet customers. A female in her late 30s, for example, makes health decisions for her children, herself, her spouse and her parents. Even if she isn’t personally using a health system for much beyond annual exams, she is influencing health decisions for many who are.
By teaching consumers how to stay healthy, providers and insurance companies hope to avoid unnecessary and costly ER visits. Intervening earlier has positive implications for consumers and could potentially save everyone money (not to mention a myriad of health complications).
Promoting wellness makes smart business sense, while also improving quality of life. Engaging consumers in a meaningful way will help pave the path.
Building margins to promote missions
Health organizations often have noble missions to improve the health of individuals, communities and nations. Yet many health systems are struggling to operate profitably. In fact, some of the larger ones in the US are reporting net losses.
Losses stem from a variety of sources, including technology costs, labor shortages, highly paid specialists, expensive medical equipment and inefficient care delivery. But a growing drain to a health system’s bottom line is a shift in payment directly from consumers. Consumers pay more slowly than insurance companies, if they pay their bills at all. In fact, in 2017, two out of three individuals couldn’t pay their medical bills in full.
Back in my Polaroid days, we would give away cameras at cost so consumers would purchase mounds of highly profitable instant film. HP, Canon and others do the same with their printer business (ever wonder why a package of toner costs more than an Officejet 4652?). Hospitals are catching on.
To beef up margins, hospitals are directing well-insured and well-to-do patients to more profitable service lines, like general surgery, orthopedics and bariatrics, to compensate for losses they face from the under-and uninsured. Without operating margins, health systems cannot fulfill their strategic obligation to communities.
Knowing which consumers are interested in these elective procedures requires targeted outreach with customized, meaningful messages — from organizations they trust.
Driving medical costs down
For years, health organizations have tried to transition to a value-based model in which physicians are compensated by improving patient outcomes. Though the concept has been around for a while, the model is intended to reduce health costs and improve patients’ health. In reality, many health systems are still fee-based, where volume is king and more is better. (Unless patients can’t, or won’t pay, that is.)
Health insurance companies are pursuing value-based strategies, in part because they have access to a more complete patient journey — including visits to the ER, the Family Practice doctor and specialists. In fact, with mounds of data and sophisticated analytics, they often know more about patients than doctors do. (Sad but true).
Many insurance companies are working with physicians, in communities and at doctor’s offices, to share information, promote better outcomes and drive down costs.
The secret sauce is to engage patients in taking better care of themselves, especially those with costly chronic illnesses who comprise a huge share of overall medical expenses.
Value-based care is designed to improve outcomes, but other less-complex initiatives can also make a difference. Like keeping off weight and staying in shape, small changes to the everyday routine may make a difference long-term.
For example, while electronic health records are beneficial, it often feels like clinicians are treating computers, rather than patients. If physicians and other clinicians truly connect with patients in person, there is a greater likelihood they will understand their conditions, treatments and potential complications. Compliance yields better results (and happier patients, too).
Likewise, motivating individuals to seek ongoing preventative care benefits everyone in the healthcare ecosystem. If health issues are diagnosed earlier, patients may benefit from better outcomes at lower costs.
Engaging individuals in and outside the doctor’s office could positively impact a patient’s quality of life. A key to success will be capturing their attention in creative ways and nurturing relationships before, during and after appointments.
The healthcare industry is wrought with confusion: conditions hard to pronounce and understand, medications whose brand names sound like Greek (and change once they’re generic), benefits that need translation and bills which are downright cryptic. Understanding how to navigate a health system, compare the features and benefits of an insurance plan and predict how much medical care will cost are just a few of the things consumers don’t get.
What other industry uses language and pursues practices that required a Ph.D. to understand? (Except maybe the electronics industry, and specifically television streaming devices).
Patients need hand holding in this maze of complexity. Not only will this improve their experience, but it might promote compliance and accountability, too.
Linking the financial with the clinical experience
Medical care is expensive and getting more so every day. Costs are artificially inflated so that physicians and hospitals can hope to cover their costs for the services they provide. And to top it all, consumers are increasingly on the hook for their care (unless you’re 65 or older and have Medicare, one of the benefits of growing older).
Imagine walking into Whole Foods and only seeing signs that say, “We don’t publish prices because we only offer organic products which are good for you. In us you can trust.” That’s essentially what happens at a doctor’s office or hospital. Only you don’t have to pay at the check-out counter and may not get your bill for months down the road (if you’re lucky enough to get only one for care you received).
If health organizations are more transparent with fees, offer discounts when patients are eligible and provide payment options, consumers will be more satisfied with their financial experience. Improving the financial experience may also encourage patients to seek preventative care they might otherwise be avoiding due to cost.