As John pointed out last week, I’m the newest member of Chilmark Research. I’ve joined the team to wrap my head around the role of the patient/consumer/citizen in the healthcare process. This role has changed dramatically since I started covering health IT in late 2009. Heck, it’s changed a lot in the last five and a half months, let alone the last five and a half years. That said, I’m thrilled to have an opportunity to learn more about it.
Looking back, no single, seminal moment piqued my interest in consumer health. My medical history is free of lengthy hospitalizations, chronic conditions, or bad accidents. Even in August 2010, when I was rear-ended at a stoplight and my Ford Focus was sandwiched between two SUVs, I stepped out of my crumbled car with only a bruise, an airbag burn, and a sore back. I am, in a word, lucky.
Many others are not. You can’t cover health IT – and, more broadly, healthcare – without coming across people who suffer tremendously, whether from the physical pain of their conditions or the emotional pain of relying on a system that’s at times cold, complicated, and uncaring. With a curious mind like mine, you also can’t help but wonder if there’s a better way.
The authors of the Affordable Care Act (ACA) seemed to think so. Amid the reforms that have caused so much recent controversy stands a noble idea with which few people disagree: Healthcare works a lot better when it actually focuses on the person who needs care.
Broadly speaking, two principles guide this idea. The first is that patients/consumers/citizens should take greater ownership of their care. That’s the proverbial carrot. The second is that, to motivate them to make the types of healthy decisions that help them avoid system utilization in the first place, they should also share in paying for the cost of their care. That’s the stick, and it’s often described as making sure consumers have “more skin in the game.” (That’s up there with “Uber for healthcare” on my list of catchphrases that need to disappear.)
The years since the passage of ACA have given consumers far more sticks than carrots. Yes, we’ve seen price transparency, accountable care, pockets of payment reform, and an explosion of health and wellness technology, but we’ve also seen narrow networks, exorbitant out-of-network fees, high-deductible health plans, rising premiums, and an endless supply of jargon-filled paper discharge summaries and explanations of benefits. None of these sticks have a positive effect on the care delivery process and certainly not on ultimately improving the patient experience.
Why, then, am I thrilled to join Chilmark Research? I devoted most of my first several days at Chilmark to reading about the latest trends in consumer-driven health – value-based care, wellness programs, telehealth, direct primary care, retail clinics and anything else that caught my attention. I learned a lot from that research, but ultimately it boils down to this: For every problem that today’s healthcare citizen faces, you can find dozens of players of all shapes and sizes searching for and/or proposing a solution.
Making sense of this growing market will be a challenge. Fortunately, as someone who runs marathons for fun – even and especially when it means training through a cold, snowy New England winter – I clearly like a challenge.
As I familiarize myself with the wide world of consumer health, I look forward to sharing the insights from my curious mind, always with the goal of helping market leaders in the healthcare industry use technology to improve the patient/consumer/citizen experience. In the meantime, feel free to drop me a line.
Your comment – “For every problem that today’s healthcare citizen faces, you can find dozens of players of all shapes and sizes searching for and/or proposing a solution” is a good summary.
This is precisely what the ACA wanted to do – stimulate minds and bodies to propose and find solutions that work. When something works, others find out about it very quickly in the connected world and gravitate towards it.
That should have a positive snowball effect.
The only catch to it is, as always, I hope vested interests and lobbyists don’t spoil it.
Chandresh, thank you for your kind words. I too hope that the stakeholders who have to power to stifle innovation – whether it be government regulatory agencies or healthcare organizations themselves – choose not to use it.
Happy to see you are focused on this important domain. I wonder if behavior modification technologies/vendors will be a topic of your research given that in the end, this is the nugget that will turn the tide of costs in managing chronic care…
Thanks for your kind words. Behavior modification is definitely an area of interest. I agree that it’s an important aspect of making lasting and long-term changes to a person’s health. The key, of course, is finding a solution that will stick, especially for those consumers who tend to need more help (for whatever reason) with healthy decisions.