The Dbriefs Health Sciences series presents: Patients as consumers: How engaged patients could reshape health care Dan Housman, Director, Deloitte Consulting LLP Quinn Solomon, Principal, Deloitte Consulting LLP Robert Williams, MD, Director, Deloitte Consulting LLP Harry Greenspun, MD, Director, Deloitte Center for Health Solutions, Deloitte Services LP September 15, 2015
Agenda The imperative for a consumer-centric model Understanding today s health care consumer Making care more customer-centric
The imperative for a consumer-centric model
New dynamics for consumers Technology New technology to interact with consumers Rise of digital communication is causing interactions between stakeholders to proliferate Emerging mobile apps tailored to health care/health management The ACA and exchanges Consumers pushed to make choices Some employers have shifted costs to employees Plans available via exchanges often involve more cost-sharing The ACA accelerates the need to improve outcomes and patient engagement New entrants Non-traditional players are disrupting the marketplace Provision of services is shifting to unconventional domains (e.g., retail clinics, online health plans) New entrants are technologically nimble Other industries Consumer desires influenced by other industries Consumers are surrounded by personalized and data-driven tools that enhance their experience High levels of engagement in other industries are setting a high bar Source: Deloitte University Press: Rising consumerism: Winning the hearts and minds of health care consumers
Poll question #1 In your opinion, why has the health care industry lagged behind other industries in moving to a more consumer-centric model? Lack of aligned incentives Unclear return on investment Privacy concerns Fragmentation Not sure, no opinion
Developing a consumer-centric system Data fragmentation and the lack of data interoperability This has made it difficult to collect, centralize, and distribute medical information in a way that can engage the patient more thoroughly Stakeholder competition In the provider and health plan sectors, these competitive factors have resulted in a reluctance to both share patient data and collaborate within networks Information asymmetry Information asymmetry between the medical professional and the patient and the dichotomy between the consumer and payer Source: A view from the Center blog, From patient to customer: Making patient care more customer-centric
Population health management requires consumer engagement 1 Engaged professionals Engaged patients 2 3 Engaged consumers
Consumer demand for health care technology As out-of-pocket costs rise, consumers want tools to help make more informed decisions about care Gaps between consumer use and interest indicate there is unmet demand for technologies that can support greater consumer engagement More than two-thirds of HIX enrollees are INTERESTED in using digital technologies to Source: Deloitte Center for Health Solutions 2015 Survey of US Health Care Consumers Less than one-third, however, has USED websites, mobile apps, and personal devices in the last year to 72% Pay medical bills 32% 72% Communicate with providers 17% 68% Access their records 19% 67% Track changes in their health 21%
Debates surrounding meaningful use requirements Patient advocates say Regulators need to require easy access to patient records Patients need to be informed of their right to access their information Providers say Two-thirds of hospitals did not have a single patient request electronic personal health records Don t want to be penalized or miss out on EHR funding because of minimal demand Source: Modern Healthcare Former ONC chief opposes CMS rule weakening patient access to records, April 2015
Understanding today s health care consumer
Poll question #2 In your opinion, what has kept patients from acting like consumers? Lack of incentives Lack of tools Uniqueness of health care Lack of expertise Not sure or no opinion
Half of CEOs surveyed agreed that health care is moving towards a consumer-centric model* Patient/consumer first. Physicians will need to meet patient demands to be seen within 24 hours of requesting a visit. Digital. Digital technologies will need to improve access and create new opportunities for patients to see physicians. Retail. Retail health care practices will grow, as will care by non-physician clinical staff. Transparency. Consumers expect transparency in pricing and services. Security. The assurance that financial and health information are securely stored and transmitted is critical. *Source: Deloitte Center for Health Solutions 2015 Survey of US Health System CEOs
56 percent of consumers are passive health care consumers Out & About 8% Shop & Save 6% 34% Casual & Cautious Sick & Savvy 11% Online & Onboard 19% 22% Content & Compliant Source: Deloitte Center for Health Solutions: 2015 Survey of US Health Care Consumers
Poll question #3 In your opinion, what strategies can providers use to make patient engagement systems stick with their patients? Mobile enablement Focus on patient priorities Incorporate direct engagement/communication with physicians beyond the visit Cultural initiatives to adjust health system staff behavior Implementing CRM for patients distinct from EHRs Not sure or no opinion
Making care more customer-centric
Benefits of a differentiated consumer experience Growth and retention Increase growth and capture deeper relationships, better insights, lower cost to acquire and serve, brand awareness and loyalty Healthier behavior and care delivery innovation Better information and personalized options; collaboration and integration will drive more efficient and effective care Consumer attrition/churn rates Brand recognition Acquisition cost Selection of appropriate level of care Activation of self-care options Medical cost Administrative efficiency Drive operational efficiency through lower cost delivery/ service channels Web and mobile usage Timely and accurate information Redundant. misaligned administration Share of wallet Growth and diversification beyond the premium dollar through increased cross-sell Clinical/incentive program participation Non-insurance revenue
Health care is only a small part of health outcomes Physical environment Health services Biology and genetics 10% 10% 10% Health status 40% Social factors 30% Behavior choices Source: Health Affairs, The Relative Contribution of Multiple Determinants to Health Outcomes. August 2014
New approaches Encourage individuals to be engaged while managing their health. Help individuals set their own health and activity goals and track them. Educate individuals with the wealth of existing wellness and care resources available today. Provide individuals the ability to connect and collaborate with non-clinical care team members.
Strategies to help make care more customercentric Build systems that incorporate e-commerce/ CRM tools Identify, personalize, and utilize appropriate communication channels to help ensure higher levels of patient engagement 4 1 3 2 Develop, promote, and utilize available mobile apps Consider utilizing traditional CRM systems Source: A view from the Center blog, From patient to customer: Making patient care more customer-centric
Poll question #4 In your opinion, consumer engagement will: Dramatically improve health overall Be limited to a small group of motivated patients Be a passing fad Not sure or no opinion
Considerations moving forward Life sciences Government Health plans Consumers Health care providers Technology companies
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Contact info Dan Housman Director Deloitte Consulting LLP dhousman@deloitte.com Harry Greenspun, MD Director Deloitte Center for Health Solutions Deloitte Services LP hgreenspun@deloitte.com @HarryGreenspun Quinn Solomon Principal Deloitte Consulting LLP qsolomon@deloitte.com Robert Williams, MD Director Deloitte Consulting LLP rbrwilliams@deloitte.com
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