Will Consumerism Rein in Healthcare Costs? Why the Answer Is No
October 5, 2016
U.S. healthcare is nearly twice as expensive per person as it is for other developed countries – and the treatment outcomes are worse. In 1960, total healthcare cost per person was $146. Today, it’s close to $10,000. And according to a recent Commonwealth Fund Report on healthcare systems, the U.S. ranked last overall among the richest 11 nations on measures of health outcomes, quality and efficiency.
Additionally, employers in the U.S. spend three times more per employee for healthcare than in other wealthy countries. And the employee’s share of this cost burden has gone up too. On the surface, a consumer-driven healthcare system sounds like a feasible way to lower costs.
After all, consumers who are more focused on their health, more concerned about costs and generally better informed should spur greater competition, better choices among insurance plans and ultimately increased affordability. But it just won’t work.
In this Executive Insights, L.E.K.’s Wiley Bell and Kevin Grabenstatter get down to the root causes of why consumerism in healthcare will fall short. Key highlights in the report include:
Total healthcare costs in large U.S. metro areas and drivers of excess price and overutilization
Employer and employee coverage cost, both of which are steadily increasing
Six fundamental aspects of U.S. employer-based healthcare that prevent an empowered consumer from reining in costs
Four scenarios that would bring the U.S. employer healthcare market more in line with those of most other industrialized countries
According to a June 2016 survey completed by the HealthLeaders Media Council, pre-authorization is a consistent pain point that impacts leaders from the C-Suite to operations and billing. For as much as healthcare has been transformed by technology, there are still areas where it seems to be a game of catch up—such as obtaining pre-service authorization. While patients are becoming more involved in their own care, providers are increasingly incentivized to secure authorization from payers before procedures are performed to increase their likelihood of receiving payment.
Download this Custom Research Brief to discover:
The top pre-service authorization pain points
Comments and insights from Health First Director of Revenue Operations and Patient Access, Michelle Fox
Tips to improve authorization and move to more streamlined solutions
A new ruling on managed care, the first of its kind since 2002, was issued by the Department of Health and Human Services (HHS) on April 25, 2016. Its intention to modernize managed care in Medicaid. While important, it is actually more significant in its foreshadowing of what is to come. Optum is helping payers prepare for the ongoing evolution of managed care. Our Medicaid focus aligns with the new ruling and the trajectory of rulings to come. This Optum executive brief outlines 5 key implications you should know now.
How interactive patient technologies are transforming the care experience
September 15, 2016
Historically, health care has been more task-oriented and focused on the delivery of prescriptive health. As hospitals move toward a patient-centric model, health care leaders must determine where Interactive Patient Technology fits and how it can help the satisfaction of their patients. Health care leaders who continue to explore various strategies in the clinical setting to improve patient satisfaction and engagement will be in a much stronger competitive position to thrive in a new age of value-based care and patient consumerism.
Power Patient Engagement with Technology: 10 Tips for Enhancing Care By Empowering and Educating Patients
September 13, 2016
Involved, informed patients are better able to manage their own care. Today’s technology plays a big role in helping patients to take ownership of their health and collaborate more closely with providers to achieve better outcomes.
Here are 10 tips from Lenovo Health for putting technology to work to reach your patient engagement goals:
Mobile devices, tablets, and interactive technology improve the patient experience
Healthcare facilities can remotely monitor patient progress and health post-discharge
Providers can leverage patient portals and other tools to promote population health