The rise of consumerism is reshaping healthcare, bringing major disruption for providers and payers as patients force important changes in care delivery systems. Empowered by social media and other new technologies, today’s patients-as-consumers are more engaged in finding and assessing cost-effective care. Although more information about physicians, hospitals, clinics, and outcomes is available, there are gaps. The general lack of price transparency and ambiguous quality data also make it difficult for patients to manage their care, and yet their decisions make a strong impact on the healthcare system.
In addition, high deductibles and copayments are forcing patients to carefully shop for providers because more of their own dollars are at risk. These newly engaged and selective patient-consumers want value, convenience, and a human experience based on trust and clear communication. In this issue of Frontiers of Health Services Management, we feature healthcare leaders who are listening to and responding to these demands. They share initiatives that hospitals and health systems are implementing to assist patient-consumers in making vital care decisions.
To succeed in this new healthcare landscape, care providers must develop consumer-centric strategies and services and consumer-friendly experiences. If healthcare is truly going to transition to a value-based delivery and payment model, consumerism will be the driving force. Patient-consumers, providers, payers, and employers must join together as partners and assume responsibility for decisions regarding care, location of service, cost, and outcome. Consumerism cannot be delegated to one individual in an organization. Rather, it must be a part of the culture and every experience. Fortunately, consumers and organizations have made progress in forging their relationships. To make further progress as consumerism accelerates, healthcare providers must continually listen, assess, and understand expectations and then innovate and develop strategies to succeed.
Feature article author Edmondo Robinson, MD, provides an enlightened and valuable examination of consumerism and its implications for healthcare delivery. He describes digital tools and technologies as accelerators, data as a critical enabler, and the fundamental role of the CEO in a consumerism strategy as well as the barriers to its implementation. He stresses the important forces of both innovation and transformation at Christiana Care, explaining that “with increasingly diverse competition, new regulatory challenges, and mounting cost pressures, healthcare must use innovation and transformation to engage and empower consumers.”
In her feature article, Kay Taylor discusses the evolution of the healthcare consumer; today’s retail and wholesale consumers as seen from the perspectives of payers, employers, and health plans; three key strategies of EvergreenHealth’s foundational approach to consumerism; and the consumer’s impact on healthcare delivery. “Embracing today’s consumerist era is a charge all health systems must heed to remain relevant, preferred partners for data-empowered patients who hold high expectations for a friction-free experience,” Taylor concludes.
Commentary author Mark P. Herzog, FACHE, shares the experience of Holy Family Memorial in implementing a “Right Care” model—the right care, in the right setting, and with the right outcomes. He makes a critical point about the challenges that organizations face: “Healthcare leaders will benefit from a deeper understanding of consumerism, the nature of facilitating and resisting factors, adopting an open approach to learning and innovation, and wisely leading forward.”
In his commentary, Bradley D. Pfeifer, FACHE, of the University of Nebraska Medical Center addresses consumerism characteristics; the roles of technology and data; the impact of consumerism on rural healthcare delivery; and new opportunities and challenges related to cost, quality, and access. As Pfeifer writes, “Healthcare systems that are slow to adapt to this environment will struggle to retain market share and will be vulnerable to aggressive competition, including disruptors who are pushing the envelope and finding alternative ways to deliver the right care, at the right cost, and in the right place.”
MaryEllen Pratt, FACHE, elucidates in her commentary the key elements of St. James Parish Hospital’s consumer-driven experience, starting with a revised organizational vision statement. She further describes the hospital’s development of more convenient access points and services, personalized patient experiences, user-friendly technology, and new employer and payer partnerships. Through consumer-centric strategy and processes, the focus is on value as achieved through quality and cost outcomes. Pratt agrees with the views that her fellow authors express in this issue of Frontiers: “Consumerism in healthcare is here to stay. CEOs must develop the data to measure it, the analytical capabilities to understand it, and the innovative culture to capitalize on it. Whether your organization is large or small, consumer expectations are the same.”