Don Berwick, the embattled former administrator of the Centers for Medicare & Medicaid Services, should be proud. Consumers are embracing the triple aim of healthcare: better care, better health, and lower cost. Okay, they may not be familiar with Berwick's mantra, and they may not understand all the in and outs of healthcare reform, but a look at a consumer survey from the PwC Health Research Institute indicates that they have embraced some of the basic tenets.
Health insurers need to sit up and take notice. Jeff Gitlin, a partner at PwC Health Industries, says the survey results show that consumers are interested in taking a more active and educated role in assessing their healthcare coverage options. "We're seeing a willingness on the part of consumers to look at different care models," he says.
That doesn't mean consumers are going to march into their physician's offices and demand to be part of an accountable care organization, but the survey results do demonstrate that consumers have embraced many of the big ideas of healthcare reform.
Here are some of the key findings of the PwC consumer survey:
Consumers want their health plans to link cost and effectiveness. Just over half (52%) of consumers surveyed indicated interest in value-based insurance plans, which reward their members for using cost-effective treatments while charging higher prices for new treatments where the benefits are not proven. Health plans have been releasing a steady stream of products aimed at meeting this demand, including one old chestnut: the narrow network. Years ago narrow networks were often based around a particular hospital and its contracted providers and reimbursement rates. This time around, health insurers are developing narrow tertiary care networks connected with primary care physicians and based on the delivery of quality and coordinated care.
Consumers put off care. In the short term this is sweet for health insurers, who have seen their bottom lines explode as members limit visits to physicians and hospitals. At issue are higher deductibles and co-payments, which often cramp utilization. Some 46% of respondents to the PwC survey said they deferred care—some as many as five times—in the past year because of cost. Studies have shown that deferred care often includes cutting back on prescriptions and preventive services such as vaccinations, mammograms, and cancer screening. That could mean long-term trouble for insurers in the form of increased medical bills and declining revenue.
Consumers think integrated healthcare is a good idea. Some 72% prefer an integrated healthcare model, with 38% linking that model to reduced healthcare costs. Meanwhile, 36% think the quality of care will increase if their health insurer and hospital or physician merge. Health insurers committed more than $2 billion in the last year to acquire or align with physician groups, clinics, and hospitals, according to PwC. That's probably just the tip of the iceberg. Gitlin says it's just a matter of time before integration becomes more of a differentiating factor for consumers in the selection of providers.
Consumers are willing to share their medical data. Sixty percent of survey respondents are willing to share data among healthcare organizations to improve their care coordination and 54% said they are okay with sharing data to support real-time decision-making for their care. That's good news for the Department of Health and Human Services, which has been promoting information exchange as part of healthcare reform. Farzad Mostashari, MD, the national coordinator for health information technology at HHS, likes to mention a study that looked at the delivery of basic care for diabetics, such as getting their eyes and blood sugars checked. Only 7% of people with paper records had that basic standard of care, compared to 51% with electronic records.
Consumers are looking forward to health insurance exchanges. Thirty-seven percent of the respondents indicated HIX will make it easier to find and purchase a competitive health insurance plan. Health plans considering skipping HIX may want to reconsider. Thirty-four percent of consumers said they would have a less favorable impression of a health insurance company that decided not to participate in their state's health insurance exchange.
Consumers want to "friend" you. About one-third of survey respondents have used social media channels for healthcare purposes, such as connecting with health organizations and other people with shared health interests. Facebook (18%) and YouTube (12%) are the most popular social media venues. Health plans are employing social media to let their members know about plan benefits, personal health, and wellness goals, among other uses. Healthcare organizations are experimenting with building stronger connections and communities through social media, a trend expected to continue in 2012.
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
