Understanding the Impact of Patient Consumerization  

By Sal Casillas

As patients increasingly take on direct cost for their healthcare, they’re also becoming more discerning in how they shop and pay for services.

Note: The following article is an extension of one of five key trends highlighted in a larger briefing report available for download here: The New Medical Economy.

The physician-patient relationship is one of constant evolution. In the past decade alone, the spread of physician reviews, online medical information, and mobile apps has shifted new power to patients in the exam room. As consumers take on more personal financial responsibility for their healthcare costs than ever before, particularly those seeing deductible, coinsurance, and copay increases, it is changing the way patients shop for care. Insurance premiums have climbed 213 percent since 1999 for family coverage purchased through an employer, and patients now pay for a full 25 percent of their medical costs out-of-pocket.

“Chronic — and often preventable — diseases are a huge driver of personal health spending. The three most expensive diseases in 2013: diabetes ($101 billion), the most common form of heart disease ($88 billion), and back and neck pain ($88 billion),” reported the Washington Post.

As the new payer group, patients are looking for precise information on what services will cost, what options are available, and what it all means in the context of their overall care plan and budget. This consumerization is creating new competitive opportunities for medical providers to differentiate and gain “flight-risk” patients from other providers. CareCloud’s 2016 Patient Experience Index found millennials are twice as likely as those in other age groups to switch providers in order to access online financial and medical records tools.

“The rise of consumerism is likely to precipitate a sea change in how business is conducted in every sector of the healthcare industry. The industry, which has been focused on its institutional stakeholders — insurers, employers, and hospitals — will shift to a new basis, in which health plans, care delivery, and even administrative services are reoriented to focus on individuals and families,”
– PwC Strategy Report.

Along with shopping around for providers and procedures, patients are also taking a more proactive role in managing their care. Patients are becoming more informed, armed with near-endless information on diagnoses and treatments online, and more engaged, with a wealth of health apps, data, and devices.

“The rise of consumerism is likely to precipitate a sea change in how business is conducted in every sector of the healthcare industry. The industry, which has been focused on its institutional stakeholders — insurers, employers, and hospitals — will shift to a new basis, in which health plans, care delivery, and even administrative services are reoriented to focus on individuals and families,” according to the PwC Strategy Report.

What to watch:

Look for a surge in new provider models such as retail urgent care clinics and concierge practices that target consumer-minded patients. Medical providers will be investing more in technology that delivers customer service to patients, including telemedicine, online appointment booking, secure messaging, and financial tools. There’s also ample opportunity around improved collections. Currently, about half of medical groups (59 percent) collect patient payments at the time of the visit, and 85 percent of those charges are made with a credit card.

Read more about five key trends driving The New Medical Economy in this free briefing paper available for download from CareCloud today.