This week, I had the honor of sharing the stage as part of a Chicago Health 2.0 Meet-Up panel with three rather diverse Chicago-based healthcare experts and entrepreneurs – Ken Anderson, Co-Founder & COO of First Stop Health, Barbara Otto, CEO of Health & Disability Advocates, and Andrew Sykes, Chairman of Health At Work. The panel, titled “Consumerism in Healthcare: It’s Here, Like It Or Not!,” was artfully moderated by our very own Fred Karutz.
Among the many interesting points and discussion, I wanted to highlight a few that were of particular interest or insight to me:
1. Consumer Responsibility and Accountability Part 1: Financial
There was a lot of discussion about whether consumers really can make smart choices about their healthcare and finances on their own. For many of us, the answer was a qualified yes – they can and they will…eventually, and with the right sort of resources and incentives. It will take time for them to adapt their behaviors and decisions to this accountability. (Ken Anderson shared a great example about how First Stop Health’s own CEO almost forgot to use his own service!) And, they will benefit from tools and resources that help reframe their decisions in terms they can better understand. As consumers take on true financial responsibility and not just a gradually increasing share of the cost burden, we are likely to see that they can and will make smart decisions about their health and health-related expenses.
Andrew Sykes illustrated this using a story from his work with a group of miners in South Africa who were put on high-deductible health plans (HDHPs) coupled with health savings accounts (HSAs). Somewhat counterintuitively, the low-income employees were the ones who truly grasped the concept of financial accountability for their choices, and they overwhelmingly had a good experience with HDHPs/HSAs. Not so counterintuitive, however, when you consider that these are people who are incredibly careful about how they spend their limited income, and the combination of HDHP and HSA forced them to choose their healthcare resources carefully. On the flip side, it was those higher up in the organization who struggled the most with the shift to HDHPs/HSAs – probably due in large part to not wanting to give up their status quo. The key success factor, as Andrew pointed out, is to couple the HDHPs with HSAs, so the consumer has a fund with which to make healthcare expense decisions and which can potentially grow over time as an investment.
2. Expanding Care Options for Consumers
New care delivery vehicles – for example, telehealth, as delivered by companies such as panelist Ken Anderson’s First Stop Health – will not necessarily supplant existing modes of delivery (i.e., physician office visits). Instead, they will become one of several complementary and/or alternative access options for consumers. To me, it’s not unlike realizing that Amazon or Zappos has become an alternative delivery channel to my neighborhood store when they don’t have the exact item I want.
3. Consumer Responsibility and Accountability Part 2: Health
It is clear there is lack of consensus – among our panel and audience, as well as throughout the industry – on what it will take to change consumer behavior regarding their health, and not just their healthcare and related expenses. According to Barbara Otto, among the four inputs to health – biological determinants, health care, environmental exposure, and behavior and lifestyle (and socioeconomic status underlying all of these) – a surprising 80% of health outcomes are not attributed to healthcare, so getting people access to care through insurance is only a small part of the battle. And, it is interesting that so much of our tool development in the industry is designed to address sick care, when the real question should be how do we move consumers toward better health, rather than sick care. Will it take government (or employer) mandates, or can we motivate consumers without mandating behaviors? This is the real work ahead of us if we are ever going to shift from a system of sick care to a system that promotes health.
Look for a recording of the full panel discussion on this site soon.