July 12 2017 | 0 Comments | 175 reads Average Rating: 3

Providers & Plumbers: Answering Common Consumer Questions

by EXL Healthcare in Health Analytics

Physicians soon will be emulating plumbers. At least in terms of how they interact with their “customers” or patients.

Think of the typical “knocking pipes” scenario: A homeowner notices the problem and consults with a plumber. The plumber inspects the situation and the homeowner immediately wants to know:

1. What is causing the problem?

2. How much will it cost to address the issue?

3. What will happen if I do and if I don’t take action?

Fortunately, plumbers are accustomed to such queries and can typically provide answers on the spot. Indeed, the ensuing conversation would most likely start with the plumber explaining that the knocking is occurring as a result of irregular water pressure and the cost to fix the issue is estimated at $3000.

The plumber would then explain what would happen if the homeowner does or does not proceed. In some situations, the plumber might explain that if the issue is not addressed the faint knocking will continue but nothing else will happen. In these instances, the homeowner would be likely to hold off. However, if the plumber points out that choosing to neglect the knocking could cause a pipe to burst and significantly damage the house, then the homeowner is likely to take the plunge (so to speak) and have the plumber apply the fix. In essence, the plumber provides the information that enables the homeowner to make an educated decision weighing the costs of addressing the problem versus the risks associated with leaving it go.

Physicians and other care providers will need to have access to the data analytics that can enable them to provide consumers with answers.

With consumers taking on more financial responsibility for their healthcare under high-deductible health plans (HDHP), healthcare providers – similar to plumbers and many other service providers – will be plying their trade under a market driven model. As a result, preference sensitive decision making is expected to become more prevalent.

In such an environment, physicians and other care providers will need to have access to the data analytics that can enable them to provide consumers with answers. For example, providers will need to estimate how much a spine surgery or high-tech imaging test will cost before the consumer agrees to the procedure. In addition, providers will need to compare options from a cost perspective. For example, when prescribing medications, physicians will need to provide costs for brand name drugs versus costs for generics.

Perhaps, most important, care providers will need to leverage data to access risk for their patients – enabling them to make preference sensitive decisions. For example, after providing the price for an upper endoscopy, a patient might want to know what could happen if she forgoes the procedure. As such, the care provider might explain to the patient that if the stomach pain she had been experiencing dissipates with medication, then she will probably be fine. So, the patient might decide not to spend the money on the upper endoscopy and wait to see how well the medications work. However, if the patient has a history of esophageal changes from stomach acid, she may decide to immediately invest in the diagnostic procedure as a precautionary measure.

This will be a paradigm shift for physicians in their thinking. The analytics to help them must be pristine, understandable, and easy to access.

This is just one example that illustrates how providers will need to leverage data to make it possible for consumers to make preference sensitive decisions as the healthcare industry becomes more market driven.

Can you think of any other scenarios that will require providers to better educate their patients on both the clinical and financial implications of their choices?

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