- The biggest healthcare reforms impacting health payers today include the movement toward consumer engagement and patient satisfaction. Patient advocacy groups are bringing more attention toward keeping the patient voice at the center of healthcare payment reform especially with regard to ensuring the best health outcomes at reasonable prices.
With patient satisfaction gaining greater traction, Partners for Better Care, a patient advocacy coalition, has created a Patient Charter geared around ensuring greater cost transparency with out-of-pocket spending and any cost sharing.
This coalition has a number of partnering organizations including the latest addition of Novo Nordisk and Aetna. These companies are stressing patient satisfaction in any new healthcare legislation coming out of Congress.
For more information about the Patient Charter and how payers can improve both cost transparency and patient satisfaction, HealthPayerIntelligence.com spoke with Mary Richards, Executive Director at Partners for Better Care.
HealthPayerIntelligence.com: What are some of the most vital parts of the Patient Charter that would make an impact on patient satisfaction and cost reduction?
Mary Richards: “The Patient Charter itself was crafted by patient advocacy organizations that are in membership of Partners for Better Care. We released it back in February. The nine points in the patient charter speak to the patient experience and have patient advocacy organizations at the core.”
“These are the folks who devised it. The key items of interest would be, as incorporating patients around healthcare have been ongoing after the Affordable Care Act, we are still thinking about affordability, transparency and patient-centered care.”
“One of the things that Partners for Better Care and the Patient Charter articulate specifically is that patients will have an active and formal voice in system transformation discussions including payment and delivery system reform.”
“We believe very strongly that industry stakeholders have a seat at the table and ought to continue having seat at the table. Many of these folks we hope to have an allied membership with at Partners for Better Care in the future.”
“The missing voice at the table has been patients and patient advocacy organizations. Especially as out-of-pocket costs are increasing and we’re seeing patients as a component of the healthcare system from an economic perspective as well as an end-user perspective, that those advocacy organizations and the patients they represent have a necessary voice as we talk about how payment and delivery system reform may impact consumers.”
“We don’t want to look at just point of sale cost issues, but rather systemic efforts to contain costs. As we think about quality and affordable care, patients should be at the center of the discussion.”
HealthPayerIntelligence.com: What do you hope Aetna’s partnership with your coalition will achieve for patient-centered care and healthcare legislation?
Mary Richards: “One of the really important things about how Aetna and Partners for Better Care are really working together to have a meaningful relationship is that Partners for Better Care were looking for allied members (i.e. industry stakeholders) to come into membership who are interested in focusing on development of meaningful solutions to healthcare challenges that we can see across the stakeholders.”
“We were trying to have a constructive dialogue with all of the relevant stakeholders who have a hand in observing the challenges that exist in our system and then coming up with the solutions to them.”
“Aetna has been a part of these meaningful conversations that we’re having with patients at the heart of the discussion. Aetna and others have been trying to come up with good solutions in a collaborative atmosphere where we recognize that change is both necessary and where opportunities exist that we’re not capitalizing on that extend across payers, providers, and other industry stakeholders.”
HealthPayerIntelligence.com: What steps should payers take to improve healthcare cost transparency to its consumer base?
Mary Richards: “As Partners for Better Care has articulated this within the Patient Charter, the idea of having easily understood and up-to-date information about covered services including network information, formulary information, and out of pocket costs is important for payers to incorporate.”
“This is a very significant challenge both in terms of plain language and understandability but it’s also a challenge in terms of ensuring up-to-date and accurate information. The interest of payers is to provide that kind of information.”
“We do know that in the healthcare landscape, those of us who live and breathe this issue professionally, there’s a lot of language that’s tough and we operate both in policy and in healthcare with quite a lot of jargon. Making sure that we’re actually communicating what we intend to communicate among people who are making healthcare choices is vital.”
“There is some room for improvement and we’re happy to be working with folks to help think through how to make medical bills and coverage easier to understand. We think there’s a lot of progress to be made there.”
HealthPayerIntelligence.com: How can health payers and providers work together to reduce patients’ out-of-pocket costs and cost-shifting to the consumer?
Mary Richards: “One of the things we’re trying to do at Partners for Better Care is to bring together a diverse set of leaders like people who are experts from the payer perspective and from the provider perspective.”
“There is a lot of work going on in both understandability for what to buy in the healthcare marketplace, what coverage to have, and whether you have an in-network provider. Then there’s also a bigger conversation to be had with patient advocacy organizations to discuss the known challenges and where we’re seeing any hiccups with that.”
“To be able to have a collegial environment in which they’re able to represent that expert position and understand where sometimes the connection isn’t being made. Those discussions are underway now. Those kind of discussions that would help a payer better understand the unique issues that are preventing someone from receiving needed care from HIV to cerebral palsy or diabetes. We are trying to bring together diverse stakeholders who can actually share some information so that we have better details to go off of and we can be making a difference."