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Cost Shifting to Consumers May Reduce Patient Satisfaction

It is also vital to mention the importance of engagement and consumer choice in the strive toward improving patient satisfaction with the continuum of care.

By Vera Gruessner

Consumer choice, patient satisfaction, and out-of-pocket spending is becoming a more pressing issue in the new political climate caused due to a blossoming of healthcare reforms. Within this new landscape, a new coalition called Partners for Better Care formed in which multiple healthcare organizations have come together to address rising premium prices and difficulties consumers face in managing medical bills.

Patient Engagement

Gaining greater patient satisfaction will entail improving cost transparency among health plans and provider services, explained Mary Richards, Executive Director at Partners for Better Care, in an interview earlier this year.

“I think one of the things that we think as important as Partners for Better Care is transparency of cost and information,” Richards explained. “We want people to have access to good information during enrollment periods and also throughout the year. Simply making sure that a fairly detailed level of information is available and essential prior to enrollment is a real necessity.”

“Partners for Better Care will be digging into ways to answer that question further. We are finalizing a patient charter to rally around and build an action agenda. I do expect payers can ensure patients have access to cost as well as value, which is a core function of what we’ll be advocating for.”

The Patient Charter created by the Partners for Better Care coalition involves nine different steps including  ensuring to include the patient voice in any healthcare system reforms and payment deviations.

READ MORE: Affordability, Cost Transparency Key for Patient Satisfaction

Additionally, the Patient Charter outlines that patients will have a limit to their cost sharing and all out-of-pocket spending will be transparent and affordable, discrimination will be eliminated and patients will have full access to needed medications, services, and medical devices, patients will have timely access to their in-network providers, and preauthorization and renewal processes will no longer limit access to medical care.

The latest news that has come from Partners for Better Care entails the partnership of Novo Nordisk and Aetna, which are joining the coalition on behalf of patient advocacy. Both Aetna and Novo Nordisk will work toward improving patient satisfaction by speaking with legislators to ensure that the patient voice plays a role in upcoming regulations.

Tricia Brooks, Senior Director of Public Policy for Novo Nordisk U.S., spoke with HealthPayerIntelligence.com about her organizations partnership with Aetna through the Partners for Better Care coalition. When discussing the reforms that Novo Nordisk will advocate when working with Aetna, Brooks said, “Partners for Better Care is a coalition that brings the patient voice to the center. The Patient Charter that was developed and finalized through the founding members - those are the tenets and the principles by which our work comes from.”

“Truly, the agenda is set by that voice of the patient. The charter was crafted by patients for patients. Any allied member who comes to the table now, we leave our agendas at the door and we really join the solutions table on how we can address obstacles and opportunities in the system right now as it evolves,” she continued.

“There are a number of things on the table including working with the platform to ensure patients are part of the dialogue in the evolving healthcare scenario, balanced billing in states, and nondiscrimination issues,” Brooks explained. “There are a number of things that the patient advocacy organizations have identified as opportunities to impact the patient voice. As an allied member, our commitment is to see how we can amplify that and continue to advance the full benefit of healthcare delivery so that patients have affordable access.”

READ MORE: Communication, Cost Transparency Impact Patient Engagement

It is also vital to mention the importance of engagement and consumer choice in the strive toward improving patient satisfaction with the continuum of care. For further clarification, Brooks mentioned the benefits of preventive care and the obstacles of cost shifting.

“When we look at healthcare reform where it currently stands and where it will evolve, bringing in a coalition of patient advocacy voices [is vital]. Truly this effort of preventive care, wellness and coordinated, managed care - all that effort - means that individuals will better manage their own disease,” Brooks added.

“Except what we’re seeing is that with this cost shifting to patients themselves, we’re actually finding people are dropping out of care or acting as if they don’t have insurance because it’s actually cost prohibitive and there’s no predictability for an individual,” she continued. “We don’t have the tools yet in place to have predictability for patients to best understand what their out-of-pocket costs would be.”

“We as an industry are patient-centered, so how do we ensure the experience of a patient walking into a doctor’s office or a pharmacy are best armed with understanding how to utilize their care?” she questioned.

“To me, the experience is how do we ensure that people have the tools they need to stay healthier longer? Unfortunately, we often see with cost-shifting that an individual will wait until they’re a trainwreck before they actually engage in care and incur personal cost. How do you ensure the mechanisms and tools are in place that people best understand what they’re committing to before they walk into a doctor’s office?” Brooks posed the question.

READ MORE: Consumer Healthcare Spending Trends Show Uptick in Engagement

When asked about some of the biggest challenges affecting consumers and patients when it comes to healthcare delivery and its costs, Brooks continued to reference the difficulties that cost-shifting is bringing to patients who need to access medical care.

“In the exchange market price, the insurance industry was given a lot of latitude to stand and the exchange market place is a great place where we can try new things on delivery,” she added. “Unfortunately, we’re not seeing the utilization at the level that we would want to see utilization, so I think that having a place such as Partners for Better Care could help incentivize an individual to access care and management.”

“I think the biggest solution is getting all the players around one table,” Brooks continued. “To have the voice of patient at the table is key. We’re finding cost shifting being an impediment to people accessing care, which brings an impediment for people living a healthier life.”

“The issue in actually meeting the needs of patients right now is that the experience of the individual patient to have a role and responsibility in disease management is broken down by sheer difficulty in accessing and paying for that care,” Brooks concluded. “Having the tools to best be able to search cost transparency is needed. Right now, there is no predictability to coverage. I think we really want to be part of driving the optimal outcome to ensure a healthier quality of life by incentivizing all of the players including patients."

 

Dig Deeper:

Consumer Healthcare Spending Trends Show Uptick in Engagement

Why Payers Should Adhere to Patient Engagement, Consumer Choice

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