Remember the Patient Perspective in Cost Conversations

Making healthcare cost data more publicly available won’t change the fact that it’s a dense and unwieldy topic. Michael Koppenheffer at The Advisory Board summarizes why healthcare price transparency is only one piece to a larger puzzle.

“… Thanks to high-deductible health plans and the health insurance exchanges, consumers are more directly exposed to health care costs than they have been in generations. By the same token, though, the way payments work for most people in today’s health system is poorly suited to a consumer-payment environment. …”

So what are consumers supposed to take away from published healthcare costs? Insurers say the information will help their members learn about and navigate a complicated system. The government has multiple interests in exposing cost data, including helping consumers manage how much money they spend on healthcare and possibly achieving standardization in healthcare expenses paid by Medicaid and Medicare. Employers that offer benefits, especially those with self-funded plans, hope that consumers use the data to make more cost-conscious decisions.

But what about providers? What perspective should you adopt?

For a moment, let’s set aside the metrics and malaise that come with talking about costs via the healthcare business lens. Instead, let’s present costs the way we all experience them – as patients. A few thoughts to get providers started:

  1. Focus on what you do best. Your clinicians provide exceptional healthcare. Make sure that they’re empowered to deliver care first and foremost, and that cost counseling aligns with clinical philosophies. As an example, the American Society of Clinical Oncology produced this patient education guide in 2014.
  2. Remember the individual. No one likes to be seen as a number. Help your patients remember that their care experience is theirs and theirs alone, and so is the associated cost. As it aligns with your mission, meet with patients one-on-one to inform them about payment assistance programs.
  3. Paint the bigger picture. Cost is not the only factor in diagnoses and treatment plans. Patients should also consider the quality of the care they receive, in addition to cost, to arrive at the real value of what they’re purchasing. Take knee replacement, for instance. While a provider across town may offer the surgery at a lower cost, a broader look at the data may show that their patients have a higher rate of post-procedure complications.
  4. Then, frame it. Also factored into the cost of each procedure or office visit is the patient’s portion of our collective responsibility to sustain healthcare as a resource in our communities, much like our parks and public transit. Equipping and staffing an organization that can respond to any and all healthcare needs, expected or not, requires significant investment.
  5. Encourage healthcare literacy. Patients are often just as or more surprised at what their insurance doesn’t cover than the total cost of care. Counsel them to become experts on their health plan, and if they don’t like it, to shop around.

Soon, providers won’t have a choice about if or when to talk about healthcare costs in the public arena. At least now, the how is still up to you. Better to put a stake in ground where you want it than have it done for you. As discussed on the Health Affairs Blog, price transparency doesn’t necessarily mean patients will stop using healthcare. The imperative for providers is to highlight their efficiencies and, as needed, clearly explain when higher-cost services offer added benefits beyond lower-cost alternatives. Like with other consumer goods, patients will opt for the services that offer greater value for each dollar spent.

February 17, 2015
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