By Tate McDaniel, SVP, engagement solutions, Change Healthcare
Most patients find it difficult to locate timely, accurate, and complete health data. Yet data is exactly what they need now that they must make health decisions they’ve never had to before.
For example, many patients today have to choose not only the best providers for their families, but also the best insurance policies from numerous options including high-deductible health plans. While price transparency might be top of mind, price is actually only one piece of the greater value puzzle.
Optimal decision-making goes beyond merely finding the lowest cost. What patients really need is “information” transparency. In addition to price data, patients want clinical and financial details about provider quality, outcomes, facility ratings, and other indicators of care value.
All stakeholders — patients, payers, and providers — stand to benefit from making it easier for patients to access information. In fact, an inherent opportunity exists for providers and payers to demystify healthcare information for patients. This can be accomplished by a holistic strategy that ensures:
Improve Information Access
Offering a more holistic approach to information helps patients answer important questions such as: Which services and providers offer the greatest value in terms of cost and quality? How can I get better and stay better? How much money will come out of my pocket?
To get these answers, however, requires infrastructures that are integrated enough to overcome data fragmentation. It takes more than just claims data; systems must also be able to pull together information from disparate provider and ancillary health systems. End-to-end data management is necessary to standardize, normalize, and clean data before patients ever see it. This way, information is understandable and actionable for decision-making.
The best strategies for improving information access utilize transparency tools that compile pertinent data into one place for patients. Patient portals offer a good example of this but are often difficult to use. Users might have trouble entering the directory, searching for and deciphering relevant information, or accessing comprehensive medical information. Instead, they should be user-friendly as well as include information about various benefits. Rather than just medical data, for instance, they could offer patients information around their medical, dental, and prescription benefits.
Use of multimodal communication channels is also an important factor in data access. A recent Aite Group study, for example, underscores how patients typically access and use information. Of the $134.5 billion paid directly to public and private insurers in 2016 by patients, the study tied 86 percent to electronic payments. Patients increasingly expect to receive information through mobile devices and applications, so providers and payers must consider how to offer it that way.
Timing is another critical aspect to the patient experience. In addition to user-friendly portals and mobile apps, point-of-care tools can help providers better educate their patients about cost and quality options. This gives patients a greater voice in their referral choices and care plan design, while they’re still face-to-face with their providers.
Engage Patients Proactively
While access tools play a role, a comprehensive information transparency strategy does not stop there. It is incumbent upon providers and payers to proactively engage patients in the communication process.
This starts with a baseline understanding of how patients are using tools such as portals. Providers should ask questions such as: How many patients are registered for the patient portal? Of those registered, how many actually use it? How many of my sickest and highest cost patients — those who might benefit the most — use the portal regularly?
Providers can then drill down to see how specific populations are accessing and using information and develop strategies to better engage them. If older, diabetic populations are more reluctant to use a portal, for instance, providers could reach out to these patients with education designed to help them overcome their hesitations.
It is important to note that data accuracy has a big impact on patient engagement as well as satisfaction. In truth, accuracy is an industry issue: The Centers for Medicare and Medicaid Services recently called out 21 Medicare Advantage plans for high error rates in their online provider directories. Likewise, if patients use a portal but the available information is limited or incorrect, the probability they will return is low. That’s why information integrity is critical.
Optimal engagement strategies use all available resources — not just those that connect physicians with their patients. Health plans, for example, often provide health coaching and clinical support as a member benefit. Equipping these teams with price, quality, and other information can pay off even further in terms of better patient engagement and satisfaction.
Elevate Payer-Provider Collaboration
It’s clear that providers and payers must combine forces — linking providers’ robust clinical information with payers’ deep financial data — to give patients the full picture of care quality and cost.
Collaborative bundled payment initiatives are one way to offer transparency and simplify patient choices for specific types of care. These arrangements often pull together high-value providers within a pre-determined, all-inclusive reimbursement and price structure. In the case of a knee surgery, a bundled arrangement might include pre-surgery prep, images, surgery, inpatient stays, physical therapy, and medications — all built into one cost.
This framework helps patients understand the bottom-line impact of their care and eliminates the confusion of multiple bills and provider choices. Payers can then produce a benefit differential for members to choose providers within this arrangement, creating a win-win for all involved.
Information Is The Remedy
There’s a lot of talk in healthcare these days about why it’s important to give patients price transparency. While a step in the right direction, that’s not quite enough. What patients really need is information transparency. Providers and payers must work together to offer patients easy access to all of the data they need to help drive the best care at the lowest cost.