Our complex healthcare system is often challenging for those who work in it. For those who don't – patients – a new brand of companies is rising up to help. Patient navigation companies may be patient-centric but they will impact the way the traditional healthcare system does business.
Patient navigation companies like CarePlanners, healthcarebluebook.com and Patient Care offer patients services that range from price comparisons for diagnostic tests to guidance in selecting a nursing home to help with understanding bills.
An aging baby boomer generation and the shift toward higher-deductible health plans with more out-of-pocket costs are just some of the reasons why patient navigation companies are popping up said Adam Powell, a health economist and president of Payer+Provider, a Massachusetts-based healthcare consulting firm.
"While patients have historically been passive recipients of healthcare, there has been an overall industry push towards shared decision making," he said. "Despite the desire to involve patients in care, it has been hard for patients to advocate for their needs due to the complexity of medicine. Care navigation services help facilitate the care process in a similar way to how real estate agents facilitate the purchase or sale of a home."
Like real estate agents, or lawyers helping folks navigate the legal system, patient navigation companies function as complimentary channels to the healthcare system said Alan Blaustein, co-founder of CarePlanners.
Patient navigation companies will help create efficiencies in the overall healthcare system, he thinks. "Consumers will make better decisions if they're more confident," he said. "The system will have better informed people in the decision-making process." And that's just on nitty-gritty items like having to decide in 45 minutes which nursing home mom should be discharged to from the hospital.
"Just having a third party as an objective project manager changes everybody's relationship with the system," he said.
Such a statement couldn't be more true in the case of patient navigation companies like healthcarebluebook.com, which seeks to provide price transparency on the costs of healthcare and could have the most dramatic impact on the business of healthcare.
"In American healthcare, you can pay five to 10 times too much for almost everything that you get," said Jeffrey Rice, MD, JD, healthcarebluebook.com's CEO.
Companies like healthcarebluebook.com help patients navigate the costs of healthcare. Having access to the costs of healthcare creates better value for patients – and for the companies – i.e., their employers – who pay for their care, Rice said.
Armed with the cost information they get from patient navigation companies, patients will take their feet and wallets to facilities that provide quality care at lower costs, forcing healthcare companies to make pricing changes that could eventually eliminate wide variation in prices. "It really is a wake up call for companies that are overpriced," he said. And for those companies that are holding down costs and providing good care, they'll see more business in the form of increased patients, he noted.
Patient navigation companies will have further impact on the healthcare industry in that by virtue of the services they offer, they rely on experienced healthcare professionals – nurses, social workers, billing experts and others – which opens up new career opportunities for healthcare professionals and competition with healthcare companies for the best employees.