Closing the Chasm between Cost and Quality in Healthcare

NOV 11

Consumer directed health has long been viewed as an initiative finding its way into products like High-Deductible Health Plans (HDHPs), Health Savings Accounts (HSAs) and Health Reimbursement Arrangements (HRAs).  It’s not surprising that adoption of these programs has historically underperformed against expectations and in light of economic turmoil and pending reform, these products will be altered as cost burdens for healthcare shifts to the consumer.

With consumers now tuned into costs, they are not surprisingly focused on making better informed decisions.  Just like buying any other consumer product or service – the informed consumer is the empowered consumer.  This was a key point of discussion in a recent web cast we facilitated on the topic of specialty benefit management – find a summary and replay of that web cast here.

The net result to all of this change is that consumers are starting to “shop” for better, affordable healthcare from providers.   Similar to the phenomenon over a decade ago that accompanied the rise of eCommerce (an increased reliance on direct marketing, price matching and an intense focus on customer service) hospitals, clinics and physicians are going to need to focus on ways to retain and attract patients through providing greater value – a previously foreign concept.  While value is a subjective label, a formula including many elements of cost, outcomes, and patient satisfaction need to be assembled to help healthcare providers as they rapidly adjust their business models to meet marketplace changes and cater to a new breed of healthcare consumer.

TripleTree believes that information will be a key driver in this new era of retail-based healthcare. We are seeing many companies attempt to provide consumers with the necessary healthcare information-centric tools to support informed decisions about matching the right providers to the quality and cost of care being sought.  Many of these vendors could learn a thing or two from CRM vendors, where features like enterprise feedback management and unstructured data analysis have proven adoption.   As a result, we’re seeing both vertical and horizontal players get a seat at the table where healthcare needs and retail delivery are coming together.  A few examples:

  • The federal government offers solutions that aren’t as user friendly, via the Centers for Medicare & Medicaid Services (CMS) and companies that seek to demystify this data such as Healthcare Reviews and MyHealthCompare.  Each are striving to provide consumers with survey driven information on patient experience (i.e. customer satisfaction) based on cost and quality of care (Note:  Much of the data reported in CMS is dated, sometimes by as much as a year).

Healthcare provider comparative analysis tools are still in the early innings of relevance because they lack depth of information and a broad suite of capabilities.  However, we are confident that a lot of innovation and investment will occur in this space and are watching the likes Castlight Health (a consumer health comparative shopping engine weighing service, location, cost, quality and convenience) prove that the delta between cost and quality is starting to close.

Let us know what you think and have a great week.

Jamie Lockhart
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