Advancing Shared Decision Making
The Informed Medical Decisions Foundation, now a division of Healthwise, has been working to advance evidence-based shared decision making since 1989. We believe the only way to ensure that high quality health care decisions are being made is for a fully informed patient to participate in a shared decision making process with their clinician. Through our research and advocacy efforts, we are dedicated to helping people make better health decisions.
Editor’s Note: This is the second in a series about the business case for patient engagement. Read the first post, on the Medicare patient and efficiency.
Managing the financial mix of patient populations in hospitals or clinics is a bit of science and a bit of an art. Today’s insured may be tomorrow’s at-risk or value-based-payment patient or member. The changes in reimbursement highlight the need for providers to retain patients or members for longer-term relationships versus the episodic care model of the past. These relationships will help promote efficiency in operations as well as financial and quality outcomes. Providers who build strong relationships, customer loyalty, and care coordination will be able to retain patients regardless of the fluid status of each individual’s financial relationship. Financial stability will come from providing appropriate levels of care to each individual.
Management of Insured Patients Today
“A customer is the most important visitor on our premises. He is not dependent on us. We are dependent on him. He is not an interruption in our work. He is the purpose of it. He is not an outsider in our business. He is part of it. We are not doing him a favor by serving him. He is doing us a favor by giving us an opportunity to do so.” –Mahatma Gandhi
Competition has never been greater. Hospitals, free-standing ambulatory surgery centers, and more are all competing for the same patient. So loyalty and relationships matter. Yet, customer service is often dismal. A recent study by Surescripts indicates that most people find that calling their providers is as difficult as talking to their bank’s call center.
Today’s insured patient is tomorrow’s Medicare patient. As providers train these patients now to be proactive in their health, to be copartners in their own care, and to stay in-network, this population helps keep costs down now and will be ideal Medicare patients in the future.
Aim for Retention
How do we retain patients? We make sure that patients want to come back when they need to and that they tell their families and friends about the excellent care they receive—in essence, engaged and satisfied patients.
Think about your best customer service experience. You likely felt connected, cared about, and valued. That’s what patients are looking for in health care too. Retention is all about building a health care journey that meets the patient where he or she is, and customer service is a big part of that.
Patients are seeking more fee-for-value features like concierge health, membership, and a breadth of services—online, telehealth, mobile. They want to do as much as they can for themselves and their families, and they want to get care and support when they need or want it. They are looking for more engagement with their providers, the health system, and others like themselves. In this model, we’ll see things like health coaching, shared decision making, personalized health education, and support groups.
Customers will come back when we make things easier, more personalized, and convenient—not simply making the hassles easier and faster, but eliminating the hassles and maximizing the relationships. Retaining patients not only improves today’s bottom line but prepares these patients for the future, training them in new ways to interact online, so that when we all move into new reimbursement models, together we will be efficient, connected, and engaged.
Come back next month to read about the wild card (you’ll have to read the post to find out who this population really is) and convenience.
October 18‒24, 2015, is RightCare Action Week, a grassroots initiative of the Lown Institute, a nonprofit think tank, built on taking action to remind patients and health care professionals of “what good medical care can and should be.” Here at the Foundation and at our sister organization, Healthwise, we encouraged employees to think about what “right care” means to them and to participate in the “What RightCare Means to Me” photo campaign. Continue reading
I attended the 6th annual Wennberg International Collaborative (WIC) Fall Research Meeting in London September 2-4, 2015. This invitation-only meeting is a collaboration between The Dartmouth Institute (TDI) and the London School of Economics and Political Science (LSE). The WIC is a research network committed to improving health care by examining organizational and regional variation in health care resources, utilization, and outcomes. The goal of the collaboration is to better understand the causes and consequences of unwarranted variation—that is, variation in health care not explained by differences in population needs or preferences—around the world, leading to clinical improvement and policy change. Continue reading
A significant challenge in serving the Medicare population is how to provide quality care while still ensuring financial stability and growth. Looking at the current state of health systems, overall they run a pretty modest profit margin of 6.5%. Overall occupancy rate is 61%, but the majority of that percentage is Medicare patients. This group of patients runs about a -5.4% margin and holds a disproportionate share of the occupied beds in the health system per hospital. What this means is that Medicare patients, whose numbers are increasing, must be managed effectively. Continue reading
Every other year, members of the shared-decision-making community gather in a different hub of the world to discuss the evolution of patients and providers engaging in a collaborative conversation around health care decisions. This July, the gathering was quite the landmark event as shared decision making and evidence-based practice united at the first joint International Shared Decision-Making/International Society for Evidence-Based Health Care (ISDM/ISEHC) Conference in Sydney, Australia. Over 300 people from around the globe met at the University of Sydney July 19–22 to share knowledge and inspire action to improve the entire care experience. Continue reading