Medical laboratories are in key position to advise and guide other healthcare organizations to implementing strategies and technologies that support consumerism in healthcare

Dark Daily has regularly alerted our readers to the fact that employers and healthcare policymakers are seeking ways for consumers to take more active roles in their healthcare. That includes requiring more out-of-pocket payments from patients to control prices, and quality metrics, so patients can select hospitals, doctors, and clinical laboratories based on price and performance.

Capitalizing on such consumerism in healthcare is not only an area where pathology groups and medical laboratories can play a key role, but also a trend where they hold a commanding lead over many healthcare organizations.

Because appointment setting and the ability to review test results has long been in demand by consumers of clinical laboratory services, many blood labs have already implemented easy-to-understand but highly functional patient portals,. Two examples that have attracted national attention are Kaiser Permanente’s “My Health Manager” and Quest Diagnostics’ (NYSE:DGX)” patient portal.

Large Gap between Healthcare Organizations’ Priorities and Abilities

This critical tool, however, is still lacking in many healthcare organizations and independent practices, according to a recent study by Kaufman, Hall and Associates (Kaufman Hall), and Cadent Consulting Group.

According to the study, although high-deductible health plans are becoming the norm and consumerism in healthcare is becoming an accepted reality, few healthcare organizations have strategies in place to meet consumers’ changing expectations.

The researchers found a large gap exists in how healthcare organizations give consumerism a high strategic priority and their ability to apply consumer insights to healthcare delivery. Two-thirds of the more than 100 US hospitals and health systems that responded say developing consumerism insights is an above-average priority, but only 23% have an advanced capability to do so.

“Our findings show that healthcare executives recognize the many operational areas that require consumer insights, from strategic planning to site selection,” Ken Harris, Managing Partner, Cadent Consulting Group, said in a news release. “The next step is for organizations to establish clear strategic and business-unit goals that ensure consumer-centric insights are developed and applied across the enterprise.”

Some Execs Not Convinced Demand Exists

The study, however, also revealed that not all healthcare executives are convinced there is a consumerism revolution taking place. Within their organizations, they cited resistance to change, lack of urgency, competing priorities, skepticism, lack of clarity, and lack of data and analytics as barriers to action. One respondent to the survey stated, “Show me the data that suggests people are shopping; wake me up when that happens.”

In a Morning Consult op-ed, Robert Popovian, Vice President, US Government Relations at Pfizer, argued that patients cannot yet shop for healthcare the way they do a smart phone because medical consumers do not have access to all the information they need.

“Physicians, pharmacists, insurance brokers, and health benefit managers, to name a few, are the ones with all the information regarding purchasing of healthcare services,” he wrote in Morning Consult. “Subsequently, this major obstacle has kept consumerism from taking a foothold in the healthcare purchasing ecosystem.”

Graphic above illustrates the gap that exists in each of four critical elements of consumerism: patient experience, use of consumer insights, patient access, and strategic pricing. (Caption and image copyright: Kaufman, Hall and Associates, LLC.)

Graphic above illustrates the gap that exists in each of four critical elements of consumerism: patient experience, use of consumer insights, patient access, and strategic pricing. (Caption and image copyright: Kaufman, Hall and Associates, LLC.)

Popovian says the information gap won’t be eliminated until transparency is championed around access to healthcare benefits most valued by consumers. That would mean access to information about their physicians, pharmacies, hospitals, and medicines. “For starters, patients need to know the most up-to-date provider, pharmacy, and hospital network information, including immediate notification when a provider, pharmacy, or hospital is no longer in network or accepting new patients,” he stated in the op-ed.

Consumerism Key to Healthcare System Growth

“Providers of care are starting to realize that they need to compete in the marketplace just like any other business does,” stated Paul Crnkovich, Managing Director at Kaufman Hall, in a MedCity News article.

Crnkovich says forward-thinking healthcare executives do recognize a strong consumer orientation by health systems is necessary and they are putting consumer-focused practices into place.

“Emerging leaders recognize that in today’s healthcare environment, consumerism is not a program or problem to be solved, but a key to growth,” he said in a news release. “Typically, successful organizations start with a high-impact focus area, while laying the foundation for broader consumer-centric capabilities.”

The Kaufman Hall/Cadent Consulting report provides healthcare organizations with this blueprint for taking action:

• Organizational Alignment: Ensure that consumerism is a clear C-suite priority; establish clear link to strategic and business-unit goals.

• Content: Develop foundational consumer, competitive, and market information; research key competitive issues; measure performance, and use information for improvement.

• Capability: Start with a small team; build out analytical capabilities.

• Data/IT: Audit current data (where it resides and who “owns” it); create data and analytics infrastructure; establish dashboards, performance metrics, and tracking.

Medical Laboratory Data and Consumerism Strategies

This all indicates an ever-increasing need for medical laboratories to post testing prices on their websites, as well as to provide information to consumers on quality-performance and customer-satisfaction survey results. The trend toward consumer-driven healthcare will allow consumers to make informed choices about the labs they want to perform their tests, which could have direct benefits for smaller laboratories and pathology groups.

While most of the information laid out in the study seems related directly to large-scale healthcare organizations and practices, the lead clinical laboratories currently have in implementing consumerism strategies should not be undervalued. Medical labs have quality experience engaging and supporting patients and physicians to make better healthcare decisions that could be emulated by hospitals and ambulatory clinics nationwide.

—Andrea Downing Peck

Related Information:

2016 State of Consumerism in Healthcare: The Words Don’t Match the Pictures

Strategies into Action, According to First Annual Kaufman Hall and Cadent Consulting Group Report

Consumerism in Healthcare Is One Trend That Few Hospitals are Ready for

Let the ‘Buyer Beware’ for Health Care Purchases

Preparing Providers for the Healthcare Consumerism Shift