Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Claims Management News

Communication, Cost Transparency Impact Patient Engagement

Along with improving cost transparency, health payers who are looking to improve patient engagement should gear their efforts toward enabling consumer choice.

Patient engagement is becoming a more and more relevant term in today’s changing healthcare landscape. With more consumers than ever before becoming responsible for their healthcare costs via high-deductible health plans and out-of-pocket spending, it becomes more imperative to comparison shop for healthcare services.

Patient-Provider Communication

As such, patient engagement is slowly rising throughout the country, new research shows. The Alegeus 2016 Healthcare Consumerism Index found that consumer engagement has increased from 48.3 in 2015 to 54.4 this year.

However, comparison shopping seems to be more prevalent among other areas such as when arranging travel plans or buying a television set, according to the report. The problem may be that the healthcare industry is still lacking transparency with regard to healthcare costs. Without clear guidance on how much a service or treatment will end up costing, patients are unable to make wise decisions regarding their medical finances.

However, there are steps that both public and private payers can take to improve cost transparency throughout the healthcare industry, said Joel Ario, former Director of the Department of Health and Human Services (HHS).

“The first step is that the regulators would make available this data that allows the consumer to understand what their cost-sharing responsibilities would be under different health plan choices,” Ario told HealthPayerIntelligence.com. “Making this data available, which CMS has started to do and has done a good job at taking data about the types of plans that are offered on the marketplaces and making it available through standardized data templates and through public use files that make that data easier to use by researchers and other people who want to use that data to understand trends and help consumers understand their options.”

“A lot of individuals still purchase off-exchange rather than on-exchange so state regulators should do the same as federal regulators in terms of making this information available about benefit plans and cost-sharing structures,” Ario pointed out.

Along with improving cost transparency, health payers who are looking to improve patient engagement should gear their efforts toward enabling consumer choice. Essentially, enabling consumer choice can play a large role in improving patient satisfaction.

A report from PwC shows that only 49 percent of surveyed Americans are happy and satisfied with the current healthcare delivery system. Many current consumers are expecting the healthcare market to operate through digital and user-friendly solutions and show more transparent pricing options for relevant services and products.

Simplifying the healthcare shopping experience can also be beneficial for boosting patient engagement, said Steve Auerbach, Chief Executive Officer of Alegeus.

“What we see more of the innovative healthcare companies doing is simplifying the experience. This means making it easy for the consumers to understand how to save better and how to spend more efficiently. Most of the industry that we see is actually starting to integrate and simplify,” Auerbach told HealthPayerIntelligence.com.

“One of our customers is doing a shared savings program. This means that if a consumer buys healthy food, they get rewards. If they exercise, they get rewards. If they utilize preferred, higher quality, and better value providers, they can actually get rewarded from that perspective as well.”

“The number one thing most plans are doing is trying to simplify the experience and give the right, integrated tools that guide the consumer on recommendations to save more money and spend more effectively,” Auerbach concluded.

One report published in the International Journal of Health Policy and Management outlines the importance of stressing individuality within consumer choice. Providers and payers would benefit from getting a stronger backstory for each family or individual served under an offered health plan. Learning about their individuality could give more opportunity to better serve them while boosting patient engagement.

As outlined by PatientEngagementHIT.com, patient satisfaction and effective patient-provider communication is key for improving engagement across the board. Opening up communication between the patient and provider is necessary to keep a genuine connection stimulating the patients’ interest in their treatment and outcomes. Patient engagement is key for strengthening the patients’ resolve to improve their well-being by adhering to prescribed medication and a healthy lifestyle.

When it comes to enhancing patient satisfaction, this comes back to understanding individuality such as cultural or personal needs as well as remaining compassionate and respectful of patients and their families.

Cheri Bankston, Director of Clinical Advisory Services at Curaspan, spoke with HealthPayerIntelligence.com about strategies that health insurers could follow to boost patient engagement.

“I think it’s critical that we think about things from the patients’ and families’ point of view,” Bankston said. “One of the best ways that I’ve seen that done is to develop a panel of patient and family advisors that can help drive some of these conversations. There are some critical points during the discharge planning process that must be configured and addressed.”

“One of those is making sure that we’re giving the patient all the information that they need in order to make an informed choice about their post-acute provider whether that’s a new primary care physician, a home health agency, or a nursing home,” Bankston continued. “They need to be made aware of those providers’ star ratings and quality ratings. They need to be informed if the hospital is affiliated with any of these agencies or providers.”

“They need to understand that with this information, they are empowered to choose who they’d like to choose,” she concluded. “If the hospital has developed a narrow network of top-performing home health agencies, the patient needs to understand they have the right to choose outside of that network. You really have to educate the staff and inform them on how to engage patients. You’ve got to continually seek feedback from the patient and family about their experience so that you can continue to address any gaps in service."

 

Dig Deeper:

Why Payers Should Include Consumer Engagement in Health Plans

Cost Transparency, ‘Consumer-driven Healthcare’ Impacts Payers

X

Sign up for our free newsletter:

Our privacy policy

no, thanks