Richard L. Clarke, DHA, FHFMA
President and CEO, HFMA
Embrace consumerism? Am I crazy?
Consumerism relates to high-deductible health plans that potentially increase providers’ bad debt. It relates to explaining to patients why their upfront payments are so high. And it relates to patients wanting to know what things cost. But it also relates to engaging consumers in their care—and developing more of a customer service mindset.
Perhaps I am crazy. But I believe consumerism is the last, best hope for a market solution to quality and cost challenges facing hospitals and other healthcare providers. That is the carrot. Here is the stick: if we don’t embrace consumerism, government will become much more actively involved in the financing and delivery of health services, similar to many health systems around the world.
Quality and cost concerns are well documented in the public press, academic research, and pubic policy debates. The reasons for these concerns are many and varied, but a common theme is that consumers are not fully involved in their health and medical care. In its broadest sense, therefore, consumerism is engaging the consumer in key healthcare decisions. Of course the devil is in the details, and that is where healthcare executives express concern. To engage consumers more fully, they need economic “skin” in the game. And that economic skin often takes the form of increased consumer/employee cost sharing.
So what is the impact of consumerism on providers, and how should they respond? One clear challenge is managing the impact of high-deductible health plans on collection activities. But equally challenging is designing and implementing the specific methods to achieve quality and price transparency, retail pricing approaches, needed collaborations, and training and development of staff. In other words, we need the details. Many, many details.
To lead the way in embracing consumerism in health care, and to identify leading practices that address the details of implementing consumer-directed health care, HFMA has launched a new phase of the PATIENT FRIENDLY BILLING(R) project. This month, the project will release a report that identifies key objectives, barriers, and suggested actions to help providers prepare for and embrace consumerism. The report will be sent to HFMA members and other healthcare leaders. Practical tools such as case studies, scripts, and process maps will be added the Patient Friendly Billing web site in the coming weeks and months. Highlights of this effort will be presented at HFMA’s Annual National Institute in June.
Providing consumers clear, correct, and concise financial and other information is a key tenet of the Patient Friendly Billing project. Embracing consumerism is another way to demonstrate commitment to this goal. Let’s not wait for the government to address our industry’s problems. Embracing consumerism is the right thing to do for providers and for patients.
This phase of the PATIENT FRIENDLY BILLING® project was led by HFMA with the help of the Medical Group Management Association (www.mgma.org), and input from the Coalition for Affordable, Quality Healthcare—a coalition of health plans and insurers (www.cahq.org). Twelve leading healthcare hospitals, clinics, and systems provided funding and expertise, and PricewaterhouseCoopers provided consulting and research assistance. For more information, visit www.patientfriendlybilling.org.