Is a Lack of ‘Outcomes Transparency’ Tools Hindering Consumer Healthcare Decisions?

JAN 20

With all the attention in 2014 on cost transparency, our team has been considering how consumers are choosing providers and when we might see comparable attention to outcomes transparency.

More specifically, how consumers today go about identifying the right provider (doctor, specialist, surgeon, etc.) for their healthcare needs – because for most, cost is but one factor among many as provider decisions are also based on a combination of medical urgency, geography, insurance coverage, and provider availability.

Factoring in these elements, there are a number of tools beyond ‘word of mouth’ and recommendations from friends or colleagues that consumers can use to research potential doctors when making choices.

  • For the most serious situations requiring a specialist, the most likely determinant is a referral from one’s primary care physician.
  • Many insurers provide online tools for members to research physicians or hospitals that accept their insurance in their geography.
  • Some consumers prefer healthcare specific information sites like Healthgrades or Vitals to research potential doctors.
  • There are online review sites such as Yelp that offer reviews on doctors, and U.S. News and World Report which ranks its ’best hospitals’.

It is worth stating that the majority of the list above is based on anecdotal views from fellow patients rather than actual data ─ which may lead to poor decisions.  Compounding this is the ongoing debate of whether patient satisfaction actually correlates with improved health outcomes.  Said differently, a doctor with good bedside manner doesn’t mean they are the best provider, and hospitals with respectable reputations don’t always equate to high-quality care across all specialties.

While the stakes aren’t as high for primary care and wellness needs, once the lens is applied to complex care decisions the relevance of provider selection becomes more pressing.

When faced with a life threatening diagnosis or a complicated surgery, there are few objective tools for consumers seeking hospitals and/or specialists that can discern:

  • Highest volumes for a particular medical condition
  • Lists of surgeons with the most experience in a particular type of surgery
  • List of hospitals and surgeons with the lowest complication rates

While a number of companies offer cost transparency solutions, there are few providing outcomes information and informing consumer choice.

A knowledgeable consumer can access potentially relevant information from Medicare via its Hospital Compare and Physician Compare websites which offer benchmarking data to help inform choice.  However, this information is often very limited or unavailable and is not able to be tailored for a personalized health experience.

In lieu of comprehensive, customizable and accessible health outcomes information that can inform consumers’ care decisions, a number of companies are trying to offer tools to meet this need or at least provide access to experts to help navigate the care decision process. For example, WiserTogether offers evidence-based tools to help consumers choose between treatment alternatives. Solutions from the likes of Grand RoundsBest DoctorsConsumerMedical and 2nd.MD provide access to top physicians for second opinions or to review care plans.

For complicated care decisions, the use of evidence-based tools or expert-based services is clearly a stronger base for insight than a collection of patient satisfaction scores.  Understanding how consumers can make more informed care decisions is an area of focus for our team ─ we’d like to know what you think.

Brice Baradel
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