We help healthcare organizations, caregivers, payers and employers find innovative, growth-oriented solutions for tough business challenges.
In the “great debate” as to whether to refer to patients as consumers, one argument is that consumers have choice and patients often don’t. Let’s drop the semantics dispute and focus on WHY patients often don’t have choice. Let’s start by examining the premise that patients lack choices when it comes to healthcare. So many questions. Is not knowing your options the same as lack of choices? Might as well be. So why don't we know our options? ➡️ Lack of Information Is the information unavailable to us? Hidden from us? Is the information we seek often confusing, opaque, and impossible to decipher? Are we too overwhelmed or disinterested to do the homework to find the information we need? Is the difficulty in finding and understanding the information designed intentionally to be so in order to convince us that the juice isn’t worth the squeeze? That we should just go where we’re told, wait as long as we’re told to wait, accept lack of answers or confusing responses as “just the way it is?” For all of these questions, the answer is either “yes” or “often.” Neither should be acceptable. As it pertains to price shopping healthcare, is it the many variables that affect how most healthcare service prices are calculated or is this the unintentionally intentional business model of pricing in healthcare? How much do we care to have access to all of our medical records or are we fine with multiple doctors, hospitals and EHR companies holding various pieces of this information for us? ➡️ Health insurance limitations Do we have more choice here than we exercise? Assuming we have even some choice among different health plans (either through an employer, an exchange, Medicare and Medicaid plan options, etc.), do we have the ability (and patience) to understand healthcare coverage benefits, exceptions, restrictions – all couched in confusing legalese? Should we be expected to seek out information on prior authorization and claim denial trends among different payers and plans? Would we understand the implications of the data even if we could find it? Do we need an advanced degree in medication formularies and coverage gaps in order to make educated decisions among different health plans? Do we choose to accept restricted provider networks in exchange for lower premiums and maybe some supplemental benefits? Even if we have insurance, could we face insurmountable financial barriers in our out-of-pocket costs of treatments and medications that are not covered (which we can research, theoretically) or may be denied by the health plan (which we can’t research)? ➡️ Geographic constraints How far do I need to travel to access the in-person care I need? ➡️ Choice constraints based on time and ability to anticipate needs (particularly for emergencies) I don’t care that much whether you think of me as a patient, a consumer, or both at different times. I care about my lack of choice. #healthcare #patients #consumers #choice
Hisham Ahmad
3mo
it's not about labels. Patients often don’t have choices in healthcare. Shouldn't we be focusing on fixing that instead of arguing semantics?
Peter Cranstone
3mo
Now you know why we named our solution Choice®.
Consumers have too many choices and no transparency in the differences from what they are “choosing”. Order a hamburger, don’t know the quality or price and simply get what you “chose”. On topof that someone else’s is often paying for it. Cheaper might deliver more but not better. Its crazy.
Great points on patient choice and information.
Joe Roy
3mo
Aptly put !!!
We help healthcare organizations, caregivers, payers and employers find innovative, growth-oriented solutions for tough business challenges.
3moMy point exactly, Mick. When you don’t have the information you need to make an educated, informed choice or that information is opaque and maddeningly confusing, your “choice” isn’t really a choice at all.