The Consumerization of Healthcare: Three Stages of Patient-Centric Transformation Accelerated by COVID-19
Tashfeen Ekram, MD
The consumerization of healthcare has been a hot topic in medical circles for years. Last year, John Sharp, Director of Thought Innovation at the Personal Connected Health Alliance, tackled it head-on in a blog post, noting that “My first thought is that ‘consumerization’ of healthcare involves convenience of care… Our current healthcare system is notoriously inconvenient for patients, garnering criticism for long wait times, requirements for prior approvals, confusing insurance coverage and lack of transparency on costs, to name a few.”
Medical providers and practice directors have witnessed the inconveniences of the existing healthcare system time and time again. Discussions and debates about how to best enhance patient care have been ongoing, but (until now) few substantive changes have been made. Yet in the midst of the COVID-19 pandemic chaos, progress has finally been made.
The consumerization of healthcare, and its corresponding focus on patient convenience, has now emerged as a mainstream practice born out of necessity.
I recently spoke with Don Lee of the #HCBIZ show, where we talked about serving patients and doing business in spite of COVID-19. Our discussion about how the pandemic has accelerated the adoption of patient-centric, consumer-inspired technologies was one of the conversation’s highlights. While the developments are nearly endless, many practices have adopted a three-stage transformation journey to make patient-centric care a reality.
Transformation of the Regulatory Environment and Reimbursement Models
The shift to patient-centric care has largely been facilitated by significant changes to the regulatory environment and reimbursement models in our healthcare system.
First and foremost, the Office of Civil Rights (OCR) and the US Department of Health and Human Services (HHS) announced HIPAA enforcement discretion related to telehealth initiatives. This likely eased some of the concerns that many providers had in regard to televisits prior to the announcement.
Secondly, the Centers for Medicare and Medicaid Services (CMS), issued regulatory waivers and new rules that allow medical providers to offer more services through telehealth, reimbursed at the same rate as an office visit, for both existing and new patients. Following this directive, many of the commercial payers have followed suit.
These two developments have created an environment where medical practices are encouraged to take the plunge with three stages of consumerization of healthcare initiatives. These initiatives help providers stay connected to their patients, minimize downward pressure on existing revenue streams and add new ones, and make in-office care practices better for patients and providers alike.
Here’s an overview of the three-stage transformation journey to make patient-centric care a reality:
Watch our on-demand webinar to learn more about how to leverage reimbursable HIPAA-compliant virtual visits to deliver care and minimize appointment backlogs and cancellations.
Stage 1: Communication Transformation
Before the COVID-19 pandemic, Luma Health’s customers primarily used mass notifications for isolated incidents, such as office closures due to weather events, or appointment cancellations when a provider falls ill.
But since the pandemic, providers have taken a broad-based approach to mass notification. For example:
Notifications about the types of appointments available: Practices have used notifications to advise patients about the cancellation of in-person appointments, but have also informed about the move to telehealth visits and enabled self-scheduling of televisit consultations.
Awareness of services: Practices have expanded their online/digital presence, and have used mass notifications to let patients know about new services and supports that are now available. These new offerings, such as screening and self-assessment tools, help providers get a better understanding of patient health status and improve provider visibility into who needs closer monitoring due to COVID-19 and/or other health conditions.
Support for new and alternative revenue streams: To reduce the impact of lost revenues from cancelled in-person visits, savvy providers have used mass notifications to drive patients to alternative engagements that deliver revenue and keep communication lines open. An example I gave to Don on the podcast was how primary care practices can send out messages to patients inquiring about their condition o sharing best practices for chronic condition management. If patients reply back, the resulting asynchronous conversation becomes billable, and simultaneously keeps patients’ health management plans on track.
There are numerous reasons to embrace telehealth: patients can more easily accommodate visits into their daily obligations, and time spent driving to and from the appointment and waiting for the doctor is eliminated, as are, of course, the chances of catching an illness in the waiting room. But while we know about all the potential advantages of a telehealth approach, its use in practice has been very limited.
As I mentioned earlier, perhaps the biggest barrier for telehealth adoption has been the disparity in reimbursement for telehealth vs in-office visits. Why should a provider offer a telehealth visit, if they would get paid less than they would for an in-office visit that takes the same amount of time?
Fortunately, COVID-driven reforms to reimbursable amounts have eliminated the economic disincentive that was hampering the adoption of telehealth initiatives prior to the pandemic.
Telehealth is essential for providers to regain visit volumes. As we discussed in a recent blog, How Has COVID-19 Impacted Access to Healthcare?, we’ve seen that appointment cancellation rates have risen while confirmation rates have fallen.
In practice, the benefits of telehealth are clear:
Providers with telehealth solutions have been able to recover visit volume more efficiently than those without. Visit volume is paramount for the survival of most clinics because so many providers are reimbursed on a fee-for-service basis.
Now that telehealth is here, it’s hard to imagine turning back the clock.
Stage 3: In-office Transformation
Across the country medical offices are beginning to re-open, but many are struggling with how to balance re-opening and public health regulations around social distancing.
Many healthcare providers are turning to technology to streamline their processes and expand their waiting rooms to create a safer and simpler experience for patients who do need to come into the office.
One of our customers, Dr. Medhavi Jogi of the Houston Thyroid and Endocrine Specialists clinic, explained how his practice is maximizing technology in a recent blog, with an emphasis on adapting practices used at customer-focused service businesses to meet the new requirements of today’s medical practices.
As these initiatives take hold, many practices will find, like Dr. Jogi did, that the patient-centric models foisted on clinics as a result of adapting to the pandemic, have made for a more convenient experience all around.
If you’re interested in learning more about how consumerization of healthcare initiatives can help your practice thrive, I recommend you take a listen to my conversation with Don Lee for a deeper dive.
Our ROI calculator is also a great place to start. Until next time, stay healthy and stay safe.