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Midwest Business Group on Health: Annual Health Care Conference May 1011, 2007

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Activating Health Care Consumerism. WHY 'CONSUMERISM' NOW? ... There is no question that the health care system would be more appropriately used and ... – PowerPoint PPT presentation

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Title: Midwest Business Group on Health: Annual Health Care Conference May 1011, 2007


1
Midwest Business Group on Health Annual Health
Care Conference May 10-11, 2007
  • Health Benefits GPS
  • Mapping Your 2008 Strategy
  • Activating Health Care Consumerism by Addressing
    Health Literacy, Values and Emotions
  • Ray Werntz, Sr. Consultant
  • HPN WorldWide, Inc.

2
Activating Health Care Consumerism
  • WHY CONSUMERISM NOW?
  • There has long been a tendency to underrate
    the ability and will of the American people to
    understand complex issues and make wise decisions
    about their own health care...Many of us believe
    that the consumer (or his or her family member)
    will have to be a key decision maker in all
    health care. Consumers will most certainly be
    spending much more of their own money on health
    care in the near future. They will want to know,
    and their employers will want them to know, what
    their medical treatment options are, as well as
    treatment benefits and harms.-- Helen Darling,
    President of the National Business Group on Health

3
Activating Health Care Consumerism
  • THE ESSENCE OF HEALTH CARE CONSUMERISM
  • In the new health care consumerism,
    employers, health plans and other benefit plan
    sponsors have overwhelmingly supported the
    provision of information and choice for employees
    as consumers. Health Web sites,
    employer-sponsored health intranets, self-care
    books and the like abound, as do a complex
    assortment of benefit plan options designed to
    share increasingly more financial responsibility
    with employees through higher deductibles,
    co-payments, coinsurance and the like
    Consumerism in health care relies upon individual
    employees and their covered dependents making a
    variety of decisions leading up to, and
    oftentimes during, health care service delivery.
    From the initial task of selecting which benefit
    plan is best suited for them, to choosing a
    provider for any number of medical needs, to
    participating in wellness and incentive programs,
    to properly managing diagnosed conditions and
    responding appropriately to catastrophic events,
    the complexity of the current health care system
    is such that even the most well educated
    individuals with perfect information and perfect
    knowledge struggle to know what to do in every
    situation. Daniel D. Cave President and Chief
    Executive Officer, Cardium health

4
Activating Health Care Consumerism
  • THE GOALS OF HEALTH CARE CONSUMERISM
  • Consumers use services more judiciously
  • Consumers make better choices among providers
  • Providers respond to shifts in market share

5
Activating Health Care Consumerism
  • CONSUMERISM WILL DRIVE QUALITY, AFFORDABLE HEALTH
    CARE
  • Only individuals are capable of
  • Avoiding health risks
  • Performing self examinations and home treatments
  • Choosing quality health professionals and
    facilities
  • Communicating effectively with health
    professionals
  • Making cost effective diagnosis and treatment
    decisions
  • Guarding against unsafe care practices and
    potentially harmful inadequate care hand offs
  • Complying with treatment plans

6
Activating Health Care Consumerism
  • IN SUMMARY
  • The success of the consumer-directed
    approach rests on a basic assumption if
    consumers are given financial incentives,
    choices, and information to support those
    choices, they will take charge of their health
    and health care and make prudent and wise
    choices. Being in charge (or activated)
    implies more than just having the right
    information. It means understanding and accepting
    a higher level of responsibility and possessing
    the knowledge, skills, and confidence to take
    this on. Will well-designed consumer information
    products coupled with financial incentives be
    sufficient to stimulate activation? There is no
    question that the health care system would be
    more appropriately used and that individual
    consumers would be better off if more consumers
    were activated. The key unanswered questions are
    what will it take to activate more consumers and
    what will happen to those who do not become
    activated? AARP Public Policy Institute Decision
    Making In Consumer-Directed Health Plans 2003-05

7
Activating Health Care Consumerism
  • WHERE ARE WE TODAY?
  • Other than CDHPs and the internet, consumerism
    tools in use today have been around for decades
  • According to AHRQ, quality improves somewhat each
    year but gains are mainly in hospitals
  • Per capita costs are still the highest in the
    world and are predicted to double by 2014
  • US population health compares unfavorably with
    other industrialized countries
  • Inadequate prevention and other out-of-hospital
    services and use of evidence based medicine still
    frustrate decision makers
  • Recent research (of EBRI, Rand, the Commonwealth
    Fund others) says CDHPs have not met expectations
    and may reduce necessary care

8
Activating Health Care Consumerism
  • THE CHOICES-an example
  • MRIs for detecting breast cancer-expensive and
    effective, but so are other tests
  • The evidence-more tests more diagnoses
  • But not all cancers are life threatening
  • The prevailing view-more diagnoses can only help.
    The reality is some people may be helped, while
    others will almost certainly be harmed
  • What will a woman fearing cancer do?

9
Activating Health Care Consumerism
  • ITS MORE THAN INFORMATION AND INCENTIVES
  • Uncertainty permeates many choices
  • 50 of the population has difficulty with
    instructions on prescription drug bottles,
    appointment slips, medical education brochures,
    health benefits contracts, booklets and other
    documents, doctor's directions and consent forms
  • Making health and health care choices involves a
    complex group of reading, listening, analytical,
    and decision-making skills, and the ability to
    apply these skills to health situations

10
Activating Health Care Consumerism
  • ITS MORE THAN INFORMATION AND INCENTIVES
  • Health care decisions often involve financial
    trade-offs- someone must choose between health
    care and other uses of money
  • Health care decisions occur in the midst of a
    dynamic interplay among knowledge, understanding
    and values
  • Even more than feeling healthy, most people want
    to feel free and in control. Dean Ornish MD,
    president of the non-profit Preventive Medicine
    Research Institute in Sausalito, California,

11
Activating Health Care Consumerism
  • WHAT DOES MORE MEAN?
  • Get the right information to the right people the
    right way
  • Personalize
  • Consider culture and ethnography
  • Redefine the health team to blend medical and
    personal information and support
  • Upgrade and expand health counseling-consider
    what weve learned from EAP and principles of
    mentoring
  • Consider the impact of bad news on decision making

12
Activating Health Care Consumerism
  • IN SUMMARY
  • Heightened consumerism, or health and health care
    self management is not an option
  • Its a matter of how and how soon we get there
  • We cant ignore the intangible HUMAN factors that
    drive health and health care decisions
  • Doing the right thing requires sustained, ongoing
    investments in people
  • Pay close attention to the evidence and innovate!

13
Activating Health Care Consumerism
  • THE FINAL WORD
  • Health care is a sacred mission. It is a
    moral enterprise and a scientific enterprise but
    not fundamentally a commercial one. We are not
    selling a product. We don't have a consumer who
    understands everything and makes rational choices
    and I include myself here- Dr. Avedis
    Donabedian of the University of Michigan
    internationally known for his research and
    teaching related to health care system quality.
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