However, research published in JAMA Internal Medicine suggests outpatients with primary care doctors have better healthcare experiences and receive “significantly more” high-value care. These findings come on the heels of a Kaiser Family Foundation (KFF) Health Tracking Poll which revealed that 26% of 1,200 adults surveyed did not have primary care physicians. And of the millennials polled (ages 18-29), nearly half (45%) had no primary care provider.
Why is this important? High-value care include many
diagnostic and preventative screenings that involve clinical laboratory
testing, such as colorectal and mammography cancer screenings, diabetes, and
And, this is where clinical laboratories can help.
In the Millennial’s World, Convenience Is King
Millennials are Americans born between the early 1980s to
late 1990s (AKA, Gen Y). And, as Dark
Daily reported, they value convenience, saving money, and connectivity.
Things they reportedly do not associate with traditional primary care
According to the KFF poll:
45% of 18 to 29-year-olds,
28% of 30 to 49-year-olds,
18% of 50 to 64-year-olds, and
12% of those age 65 and older, have no
relationship with a primary care provider.
Thus, it’s not just millennials who are not seeing primary
care doctors. They are just the largest age group.
When this many people skip visits to primary care doctors, medical
laboratories may see a marked decline in test volume. Furthermore, shifting
consumer preferences and priorities means clinical laboratories need to reach
out and serve all healthcare consumers, not just millennials, in new and
Consider Changes in
Lab Business Model
Dark Daily advises
clinical laboratory leaders to consider changes in how they do business to
better serve busy consumers. Here are a few ways to appeal to people of all
ages who seek value, fast service, and connectivity:
Offer walk-in testing with no appointments.
Create easy-to-navigate online scheduling tools.
Enable patients to request tests without doctors’ orders as the lab’s market allows.
Make results quickly available and in easy-to-understand reports.
Post test results online for patients to securely access in patient portals.
Make it easy to interact with personnel or receive information through lab websites.
Use social media to promote the lab and respond to online reviews.
Younger Americans Do
Not Perceive Value of Primary Care
The JAMA researchers studied 49,286 adults with primary care and 21,133
adults without primary care between 2012 and 2014. The methodology entailed:
39 clinical quality measures,
Seven patient experience measures, and
10 clinical quality composites (six high-value
and four low-value services).
“Americans with primary care received significantly more
high-value care, received slightly more low-value care, and reported
significantly better healthcare access and experience,” the JAMA authors
Healthcare Dive notes that the JAMA study may be the first time researchers have substantiated the higher value of primary care, which generally provides services for:
Cancer screening (colorectal and mammography),
Diagnostic and preventive testing,
Diabetes care, and
“Poor primary care supply or access may be hurdles, or some
Americans do not perceive the potential value of primary care, particularly if
they are younger … and healthier,” the JAMA
The study found that “Only 60% of outpatient antibiotic
prescriptions dispensed in the United States are written in traditional
ambulatory care settings [defined as medical offices and emergency departments].
Growing markets, including urgent care centers and retail clinics, may
contribute to the remaining 40%.”
A Washington Post analysis of this JAMA study reports that “nearly half of patients who sought treatment at an urgent-care clinic for a cold, the flu, or a similar respiratory ailment left with an unnecessary and potentially harmful prescription for antibiotics, compared with 17% of those seen in a doctor’s office.”
This drives home the importance of having a primary care
“Antibiotics are useless against viruses and may expose patients to severe side effects with just a single dose,” notes Kevin Fleming, Chief Executive Officer of Loyale Healthcare, a healthcare financial technology company, in its analysis of the earlier JAMA study. “Care that’s delivered on a per-event basis by an array of unrelated providers can’t match the continuity of care that is achievable when a patient receives holistic care within the context of a longer-term physician relationship,” he concluded.
Clinical laboratory leaders and pathologists are advised to
regularly engage with primary care physicians—not just oncologists and other
specialists—and keep them informed on what the lab is doing to better attract
millennials and develop long-term relationships with them based on their values.
Oscar Health is billed by its Millennial cofounders as a new type of health insurance—one that “curates” or coordinates members’ care with the help of health information technology (HIT) on the Internet, a smartphone app, and personalized services by concierge teams. So, it is interesting for pathologists and medical laboratory leaders to note that New York-based Oscar is partnering, through two different deals, with well-established Cleveland Clinic and rival Humana to enter the Ohio and Tennessee healthcare markets.
As Dark Daily reported in a previous e-briefing, Oscar aims to leverage sophisticated technology solutions and data to challenge complexity and costs associated with traditional healthcare insurance. An approach no doubt driven by the modern thinking of the company’s young founders. We alerted lab leaders that the insurance startup could be the latest example of technology’s power in the hands of Gen Y and Gen X entrepreneurs.
And while Oscar has reportedly experienced financial challenges, it is moving forward with the widely publicized new partnerships, as well as additional plans to expand insurance coverage in more states. Therefore, it’s important for clinical laboratory professionals to follow Oscar, which soon could be a healthcare payer of clinical laboratory and anatomic pathology services in more regions of the country.
Why Is Oscar Teaming Up with Cleveland Clinic, Humana?
In short, Cleveland Clinic is making its debut into the health insurance market with Oscar. And Oscar is moving into Ohio on the coat tails of this nationally prominent healthcare provider. The co-branded Cleveland Clinic/Oscar Health insurance plan will be offered to northeast Ohio residents in the fall for coverage effective Jan. 1, according to a Cleveland Clinic news release.
“This is a rare opportunity to work with the Cleveland Clinic to deliver the simpler, better, and affordable healthcare experience that consumers want,” said Mario Schlosser, Oscar’s Chief Executive Officer and cofounder in the news release.
Josh Kushner (left) and Mario Schlosser (right) cofounded Oscar Health, a New York-based health insurer that employs computer technologies, a mobile app, and concierge-style healthcare teams to provide members with a modern health plan experience and easy access to quality healthcare providers. (Photo copyright: Los Angeles Times.)
Access to primary care providers affiliated with the Cleveland Clinic, and an Oscar Health concierge team (a nurse and three care guides) that can refer patients based on their needs to other providers in the care continuum;
Smartphone technology to make it possible for members to explore their health needs, find options, and review costs.
“We are looking to build a new relationship among payers, providers, and patients. This relationship goes beyond the traditional approach of getting sick and seeing the doctor,” noted Brian Donley, MD, Cleveland Clinic’s Chief of Staff.
In an article on the partnership, Forbes suggested that narrow healthcare networks like the Cleveland Clinic/Oscar model might be just what the ACA exchanges need to remain operational.
However, a Business Insider article suggests that Oscar—already active in New York, Texas, and California health exchanges—could be adversely affected by a successful replacement of the ACA, currently being debated by Congressional lawmakers.
Nevertheless, Alan Warren, PhD, Oscar’s Chief Technology Officer, told Business Insider that the Cleveland Clinic/Oscar Health insurance plan would go forward even if Obamacare did not.
Formal Rival Humana Now Oscar’s Partner in Small Business Insurance
Meanwhile, the partnership with Humana takes Oscar, which launched Oscar for Business in April, 2017, further into the small business health insurance market. Humana and Oscar will sell commercial health insurance to small businesses in a nine-county Nashville, Tenn., area effective in the fall, according to a joint Oscar/Humana news release.
“The individual market was a good starting point. But it was clear from the beginning that the majority of insurance in the US is delivered through employers,” Schlosser stated in a New YorkTimes article.
As to who does what, Beth Bierbower, Humana’s Group and Specialty Segment President, explained in an article in the Tennessean that Humana will contract with hospitals and doctors for small business insurance, while Oscar’s technology solutions will help small businesses and their employees manage healthcare benefits and gain access to providers. “These people [at Oscar] are on to something,” she noted. “They are doing something a little different. Maybe this is a situation where one plus one, together, might equal three.”
Future Growth Planned by Oscar
The New York Times called Nashville “a new step for Oscar,” and noted that it follows Oscar’s recent loss of $25.8 million during the first three months of 2017—47% less than Oscar lost during the same period in 2016. Since its inception, however, Oscar has raised $350 million in investment capital, much of it from Silicon Valley investors.
Also, Oscar’s small-business health insurance plans, which started in the spring in New York, might launch in New Jersey and California as well, an Oscar spokesperson stated in a Modern Healthcare article that also reported on Oscar’s intent to increase individual plans sold in the ACA Marketplace from three states to six in 2018.
Clinical Laboratories Benefit from Increased Consumer Access to Health Providers
Could Oscar succeed with its new Cleveland Clinic and Humana partners? Possibly. Both deals are pending regulatory approval as of this writing.
In any case, the whole idea of making insurance more palatable for consumers is something clinical laboratories, which are gateways to healthcare, should applaud and support. It is good to know that insurers like Oscar are using technology and personal outreach to ease consumers’ access to providers and help them explore options and costs.
As they hire young pathologists, pathology groups and clinical laboratories will need to factor in the generational preferences of these Gen Y physicians
Generation Y doctors take a much different approach to the practice of medicine than the Gen X and Baby Boomer doctors who preceded them. It will be important for clinical laboratories and pathology groups serving Gen Y physicians to understand these important differences.
While Gen Y doctors remain just as dedicated to the high standards of medicine as their predecessors, the current crop of young doctors approach the practice of medicine with a much broader world-view than previous generations of physicians, according to a recent story in Modern Healthcare (MH). (more…)
Experts tell us that each generation has a unique set of preferences, work ethics, and personal goals. Thus, a specific management initiative that typically motivates one generation may actually be a disincentive for another generation.
Young physicians want more transparency in financial relationships
By their actions, Generation Y doctors are sending a clear message that they want to take the ethical high road in their dealings with drug companies and medical device developers. In medical schools across the nation, young physicians are speaking up about what they consider to be one element of greed in their profession.
Their advocacy group, the American Medical Student Association (AMSA), is calling for a crackdown on professional ethics violations. Medical students are particularly concerned about relationships with drug and medical device developers that pose a conflict of interest. To call attention to this issue, AMSA now rates academic medical centers on how well they monitor and control money from drug and medical products companies. These results are available to the public.