Collector - February 2016 - 36


HEALTHCARE

The Shift From Patients to Consumers
As the healthcare market grows, providers have to embrace a consumer-centric model of outreach and understanding.
By Katy Zillmer

I

n the healthcare industry today, patients
are also consumers.
The Affordable Care Act requires
consumers to have health insurance and
provides many more options for consumers
to find the price, plan and provider that work
for them. Since the law was passed, the U.S.
Department of Health and Human Services
also reports that approximately 16.4 million
uninsured people now have coverage through
the marketplace, Medicaid expansions or as
a result of young adults being able to stay on
their parents' plans until age 26.
As the healthcare market grows, providers
have to expand their scope to all consumers,
not just patients they see for scheduled
doctor appointments or emergency care.
Representatives of Welltok, a consumer
health platform company, and the Oliver
Wyman Health Innovation Center discussed
the trend of working with consumers, not just
patients, during a webinar in November 2015.
Healthcare and health plan providers
should understand where consumers live,
where they shop, their support system, their
income, their family background and their

"Consumers with
increased responsibility
and financial exposure
are very, very hungry
to take control."
36

health status, said Welltok chairman and
CEO Jeff Margolis.
"This holistic view is absolutely required
to move ahead," Margolis said.
It's also important to consider these
multiple factors because of the expense
consumers face for their healthcare.
Deductibles are increasing faster than
premiums and wages, according to
findings in the Kaiser Family Foundation/
Health Research & Educational Trust 2015
Employer Health Benefits Survey.
Last year, the average annual premium for
single health insurance coverage was $6,251,
and workers on average paid $1,071 of that
amount. The average premium for families
was $17,545, and workers contributed an
average of $4,955. Each of those totals rose 4
percent above the 2014 average premiums.
"Consumers with increased responsibility
and financial exposure are very, very hungry
to take control," said Tom Main, founder of
the Oliver Wyman Health Innovation Center.
There is also a lot of innovation in
technology in the marketplace for consumers
and healthcare providers to use.
"We spend a lot of time in this industry
talking about industry technology... we
think that there needs to be a new type of
enterprise consumer platform that hasn't
existed before," Margolis said.
With that, there is also the opportunity
to increase digital access to information and
resources available from providers or health
plans for consumers.

"How much of this experience can be
digital?" Main asked. "We really live our
life in a Web environment-everywhere
but healthcare. We're predicting that that is
going to change."
Margolis added that increasing
consumers' use of digital technologies
could mean mixing the "traditional with
the new" to change their experience
for the better. "You can't just chase the
next digital technologies if you're going
to create an effective experience for
consumers," he said.
Overall, Margolis and Main identified the
need to transfer patients from the "sick care"
system to a more consumer-centric model.
"The 'sick care' system is based around
claims," said Michelle Snyder, Welltok's
chief marketing officer. "You have to
take a very different approach with a
consumer-centric model. If you're starting
with claims and benefit information, you
won't understand what's happening with
[consumers] when they're not inside the
healthcare system receiving care."
Providers may have a long way to
go before they fully understand the
consumers they need to reach, but they are
making progress.
"I think when we can get there," Margolis
said, "we're really doing something
important for the industry."
Katy Zillmer is ACA International's
communications specialist.

ACAINTERNATIONAL.ORG


http://www.ACAINTERNATIONAL.ORG

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