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The Consumer-Driven Healthcare System

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July 11, 2019

The Consumer-Driven Healthcare System

Jennifer Morency

picture The Consumer-Driven Healthcare System

A consumer-driven industry is one in which the consumer puts pressure on an industry to act a certain way or provide a certain product or service that is influenced by their needs. In the healthcare industry, consumer-driven, often synonymous with patient-centered, applies in more ways than one. From price to accountability to the tools used, patients are influencing their clinicians, practices and the industry as a whole.

The Healthcare Experience

With the approach to empower patients, new technology has provided patients with ways in which healthcare has truly shifted towards a digital landscape. As much of what we do is technology-focused, it is only natural this has made its way into healthcare and become what we now refer to as digital health.

Patient portals, Voice User Interfaces (VUI) for appointment bookings and others, online review sites, educational tools and many more have all influenced and shaped the way patients are choosing to receive care. The healthcare industry needs to stay on top of not only the latest medical developments, but the ways in which to deliver these medical services to an increasingly demanding consumer market.

This has led to healthcare professionals seeking technological tools to help them understand their patient’s needs and ultimately provide them with personalized care. Through informed patients and relevant technology, clinicians can provide effective care and coordinate with a community of clinicians.

Differing and Evolving Healthcare Needs

Healthcare has largely been influenced by the Baby Boomer generation. Accounting for more than 76 million Americans who are approaching Medicare enrollment, they require needs such as chronic care, post-acute care and more.

More specifically:

  • They represent 20% of the population
  • Of these 54 million Medicare beneficiaries, 14% have 6 or more chronic conditions
  • Close to 42% require post-acute care after a hospital discharge

This has and will influence where and how healthcare is delivered. However, these needs are met with specific technology and services, which differ from the other generation that has now since surpassed this older generation.

The Baby Boomers, dropping to an approximate population of 72 million in 2018, is now below the millennial population, which accounts for about 73 million. Millennials are now America’s largest generation. With this comes different and changing needs in healthcare and the way they expect it to be delivered, which of course, is more technology-focused.

All these factors have shaped the healthcare industry and will continue to push and pull it in various directions. It will require professionals, industry leaders, companies and more to keep a watchful eye on trends, delivery of care, technological advancements and the changing needs of their environment.

Consumer-Driven Factors

With the available technology, patients are increasingly more engaged and involved in their health and wellness. This has contributed to healthcare professionals needing extra resources and shifted care delivery from treatment to preventive measures.

Transparency plays a big role in today’s healthcare. Patients have access to a wide variety of information that allows them to make informed decisions on quality of care, patient engagement features and more. This perceived care outcome results from tools such as online review sites, star-rating systems and more.

Another consumer-driven factor is price. Increasing health costs have driven many to opt to be seen for treatments rather than healthcare options geared towards preventive medicine. This has led to more Medicare eligible patients, which has had an opposite effect on price and lowered out-of-pocket costs. Furthermore, with less restrictions on care and many clinicians to choose from, patients have the upper hand as to what range of services they want, influencing the range of healthcare options physicians and hospitals are providing.

Consumer Healthcare in Practice

The new approaches to healthcare, coupled with specific, population-based contexts, have led states such as Indiana to instore new services, such as the Health Savings Account (HSA). First introduced in late 2016, this program, called the Healthy Indiana Plan (HIP), allows residents between the ages of 19 to 64 to save and spend their money for healthcare services according to their needs.

Open to patients who are ineligible for Medicare and Medicaid coverage, the HIP covers patients with family incomes below 138% of the poverty line. This accounts for roughly 330,000-600,000 residents. As patients increasingly want preventive treatments, by paying a monthly payment of 2% of their income, they benefit from vision, dental and other services. Over 70% of the enrollees continue to pay the program, reveling in preventive care that suits their needs and what they can afford.

Wearables are also a great example of how consumers have influenced the market towards a technology-based, patient-centered care models. Health monitoring devices provide individuals with a way to connect them to their clinicians and insurance companies.

Consumers want to feel like they have a choice in their healthcare services and want to feel empowered through the tools at their disposal. Technology has greatly shifted the way healthcare is delivered, but costs and available information have also shaped it into what it is and will continue to do so.