Woman paying co-pay at clinic

Consumerism: Healthcare’s Four-Letter Word

Recently, my wife had a doctor’s appointment that lasted all of 5 minutes. We were in and out of the office in record time; all the doctor did was listen to her complaint and refer us to another colleague of his at another facility.

The information and referral he provided were valuable, and I didn’t experience the usual sticker shock when I opened the bill that arrived a couple of weeks after the appointment. “$70 for the appointment?” I thought. “Well, that was less than I expected, and why have we been saving HSA money if not for these expenses?”

Dutifully, I went to the URL listed on the paper bill to settle the debt. I entered the 7-digit PIN on the bill and found that the account showed no outstanding debts. Curious, I walked through the process twice more, double checking all the information I had entered: still no bill.

Had I worked in a field other than healthcare IT I would’ve happily accepted that something mysterious had happened and that the facility had forgotten about the bill entirely. But I was curious to see just how deep the payment problems went. I logged out of the bill-pay account I had just created and instead opted for the “one-time pay” option.

There, I entered the same information and was brought to a summary page completely different from the one I had seen in the account I had created. So different in fact, that while this one didn’t show a $70 bill needing to be paid, it did show a long-overdue, $1,800 bill marked, “PENDING INSURANCE.” At this point, I might owe: $70, $1,800, or absolutely nothing. Who knows? I certainly don’t.

The Need for Transparency

When I told this story to a friend of mine, his response was, “Always wait for the second notice on a medical bill.” Because, as he explained, you don’t know how much you actually owe until then. This is painful advice if you’re the VP of Revenue Cycle, the CFO, or the Business Office Director of a healthcare organization.

As a patient, it’s frustrating to struggle under the complexities of the healthcare system. Costs of care aren’t transparent up front, and the back end of many visits devolves into a confusing barrage of bills and emails that amount to a game of “Who’s gonna pay?” These deficiencies in healthcare might not feel so frustrating if patients weren’t already used to easy transactions in every other aspect of their lives.

The Consumerism Debate

In everything from travel to grocery shopping, industries have innovated ceaselessly to provide customers with a seamless experience. Their motivation? To reduce purchase friction and drive consumers to spend as much as possible. This motive is typically what causes those in healthcare to balk at the suggestion that consumerism is coming.

It’s a reaction I understand completely, considering the average American sees as many as 5,000 ads daily. Often, patients don’t have the option to shop around for healthcare because of insurance limitations or the urgency of treatment. Because of this, healthcare providers exist as micro-monopolies in that patient’s life, able to control healthcare transactions entirely. It’s abhorrent to think of applying a “maximize profit” mentality to a group as vulnerable as patients.

Service and Ease of Use

Regardless of motive, there is one benefit of all this innovation. In industries where customers choose where to spend their hard-earned money, businesses have learned that one key factor to winning over the market is service and, by extension, user experience. Competing technologies like Google’s assistant and Siri, for example, are the consumer tech giants’ way of trying to edge out competition by making the most user-friendly product.

In fact, the best piece of technology I use daily is my Pixel smartphone. In everything from entertainment to financial management to travel, Google has created a tool that allows me to conveniently bring my life into order in the palm of my hand.

Most in favor of healthcare adopting a consumer-focused mindset approach the shift from this perspective: treat the patient as if they have the power of the consumer. I understand how naively altruistic this view of healthcare seems. Arguably, the only reason that other industries have adopted a service-forward model is the impact it has on their bottom line.

Patients, largely disengaged from the financial transaction of a care visit, don’t have buying power, so there is minimal incentive for vendors or provider organizations to invest deeply into creating a consumer-grade patient experience.

Beyond that, the regulatory burdens faced by healthcare providers simply mean that the time and attention pouring into HIT development has been focused on compliance and billing, not clinician usability or patient experience.

Despite these barriers, changes to improve the “customer” experience are still under way. President Trump recently signed an executive order calling for the upfront disclosure of prices for common procedures and tests. Though real outcomes are probably months or years out, this is a sizable step in the direction of more transparent healthcare costs.

Healthcare’s Bottom Line

I believe that this trend toward improved patient experience would continue even without government involvement. Why? Because patients are demanding it.

Convenience is now the top factor when patients choose a provider, and while patients may not have much buying power, they do have selection power. For better or worse, consumerism is coming to healthcare, and if you ask me, it’s about time.




     Photo cred: Shutterstock, Stokkete