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Why healthcare needs to become even more consumer-focused

Healthcare organizations should optimize the care process as a strategic priority, rather than enhancing consumer experiences in one-off initiatives,

Jeff Lagasse, Associate Editor

Thanks in large part to digital technology, consumers expect a lot from healthcare these days. Much like what they experience in the retail and consumer goods worlds, they want an easy, seamless, individualized experience -- and what makes healthcare unique are the pressures from governments and employers to lower costs amidst these rising consumer expectations. Becoming more consumer centric is no longer a luxury. It's a necessity.

A new report from Prophet sheds some light on some of the reasons for this shift, and provides some insight into how to make the transition. Hint: Technology is key.

[Also: Kaiser Permanente first in Medicare Advantage consumer satisfaction, study finds]

In fact, the authors suggest that every healthcare business should think and act like a technology company. Measures of patient dissatisfaction seem to bolster this claim: Prophet found that 81 percent of consumers are dissatisfied with their healthcare experiences, and the ones who are happiest are those who interact with the health system the least.

It's not hard to see why. The healthcare system has plenty of faults, including insurance plans full of indecipherable jargon, long wait times for appointments and procedures, bills that arrive in the mail months after a visit, and lack of coordination between physicians, insurers and pharmacies.

[Also: Health plans get low marks for patient engagement in new Healthmine survey]

Patients are feeling the burden, according to the report. Rising healthcare costs are expected to outpace population growth at least four times from 2017 to 2020. Meanwhile, there's been an 86 percent increase in worker contribution to to health insurance premiums from 2005 to 2015, and a 67 percent increase in employee deductibles from 2010 to 2015.

All of that means consumers are becoming more discerning shoppers. They have to be. The time they spend searching for a physician, their ability to schedule an appointment when convenient, their time spent in the waiting room, their appointment follow-up -- all of things become a lot more important when the price tag is so high.

The shift from volume-based reimbursement models to value-based models is where the rubber meets the road. The continued shift in that direction seems inevitable, and according to Prophet, consumer engagements that keep that keep patients healthier is how healthcare organizations will remain financially stable in the future.

In fact, payers predict that 59 percent of all payment models by 2021 will be a mix of capitation, pay-for-performance and episodic payment, all various forms of value-based care. This also means that private payers need to be equipped to deliver on risk-based contracts, the authors said.

So what should healthcare organizations do? A few things.

For one, healthcare organizations should optimize the entire healthcare journey as a strategic priority, rather than enhancing consumer experiences in one-off initiatives, the authors said. That requires a vision for the organization, hiring the right leaders to take change, and creating a plan to change the experience and win over consumers.

The healthcare experience also needs to become less fragmented. Fragmentation breeds frustration, inefficiencies and a whole lot of dissatisfaction; what's needed is a healthcare ecosystem.

Being person-centric rather than population-centric certainly wouldn't hurt, either. Many healthcare organizations currently create products and services for groups of similar consumers, such as those who have share the same condition of demographic. Those products and services, according to Prophet, should be tailored to consumers based on their individual needs.

It's about giving consumers a voice similar to what they experience in other industries, and also giving them the ability to manage their health in a way that keeps them well and out of the hospital. These shifts, the authors said, will ultimately lower costs and lead to stronger brand loyalty.

Twitter: @JELagasse
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