"Physicians have been able to be blind to [cost] because it's never part of the conversation with patients," says Intermountain Healthcare System's CHIO. That will have to change if population health is going to succeed.
At the heart of population health efforts is the hunt for a way to give physicians the ability to improve patient outcomes at a lower cost. At this year's HealthLeaders Media Population Health Exchange, executives in charge of overseeing physicians, specialty practices, quality, IT, and transformation, said transparency within organizations is a hurdle that needs to be cleared to meet patient demands and to move their systems closer to population health's goal.
Some organizations, such as the American Gastroenterological Association (AGA), are pursuing ways to give patients more price transparency. Larry Kosinski, MD, chairman of the AGA's practice management and economics committee, and owner of Illinois Gastroenterology Group, says the auto industry's Monroney sticker, which is on the window of every new car detailing price, crash rating, and cost for options, provides a good template for one of the most common procedures GI doctors perform.
"Every car dealership has a Monroney sticker," he says. "We are in the process of creating one at the AGA for a colonoscopy because the consumer needs to know, 'What is a colonoscopy? What should be in a quality colonoscopy?' We have to think this way."
Physicians need to start thinking this way because it's the new mindset of patients, especially those who are participating in high deductible plans. In previous years, when a $10 or $20 co-pay was all patients paid out-of-pocket, patients acquiesced to physicians ordering tests, procedures, etc. Now that more money is coming out of patients' pockets, they want to know how much services cost, says Sameer Badlani, MD, chief health information officer for Intermountain Healthcare System in Salt Lake City.
Sameer Badlani, MD
"For the first time in my life, I'm on a high deductible health plan," he says. "I look at things closely now. I never looked at my bill before, and that, in my mind, is the start of patient engagement."
Badlani says his experience as a high-deductible plan consumer gives him insight into new expectations for doctors. "Physicians have been able to be blind to [cost] because it's never part of the conversation with patients," he says. "As a physician I have the responsibility to answer [patients'] questions."
Intermountain is working on a transparency project that gives its physicians quality data, but Badlani would like to eventually create a dashboard that shows physicians how their decisions are affecting cost, which in turn, impacts their own reimbursement.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.