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Why Consumerism is Healthcare's Future

Published October 1st, 2020

 

The future of the healthcare industry relies on its ability to provide care in a manner people have come to expect from consumer-focused industries.

This is the first in a series looking at consumerism in healthcare.

 

Consumers in healthcare

It’s 7pm on a Friday evening. You’re just coming home from work, and aren’t feeling well. In fact, you haven’t felt well all week. Your primary care practitioner’s office doesn’t have an appointment available until next week, and you’re still not sure you’ll be able to get the time off of work. You’re hesitant to go to an urgent care clinic because the last time you did you received a bill in the mail for several hundred dollars, and the clinic said that was the cost after your insurance claim had been filed. All of this is made worse by the fact that you’re trying to be seen during a pandemic. In order to get care, every interaction you have with healthcare requires sacrifice, travel, and surprise costs. Essentially, the experience is the opposite of how you do your banking or how you buy clothes, groceries, and items for your home.

Healthcare is intended to be comprehensive, serving individuals and communities as whole entities instead of as siloed pieces. As the world evolves, so do those people and communities. Their needs and wants change, and so how we meet those needs and wants has to change as well. Take, for example, consumerism. “Consumer” is a tricky term in healthcare, and one which has many people readily offering up an opinion on its use. Regardless of the language we use, individuals purchase healthcare goods and services, and therefore have both needs and wants with regard to those goods and services. In order to truly be comprehensive, healthcare has to adopt aspects of consumerism, or miss out on meeting its mission.

Defining patients as consumers isn’t particularly new, and shows up in 1930s publications in the context of organized consumerism. In this context, consumerism referred to advocating for what was best for the collective, and was in support of universal healthcare. (There is a definition of consumerism which relates more to materialism -- that’s not where we’re headed here.) Surprisingly, the argument against consumerism at the time was choice -- namely, the ability to choose one’s physician.

Another aspect of consumerism has to do with people being informed decision makers in the marketplace. In considering the future of healthcare, this facet of consumerism is absolutely shaping how people interact with the entire spectrum, from wellness, to sick care, to end-of-life decision making. Here, consumerism is also about advocacy, but this time it’s advocating for the individual to make informed choices about their own care. This mindset aligns well with autonomy and informed consent, fundamental patient rights in health care.

 

Marketplace

The wide-reaching concept of healthcare as a marketplace where people should be informed about their choices is still pretty new (and not global). Healthcare - and medicine especially - has long been paternalistic in its approach. Historically, physicians tell patients what to do, and patients are expected to comply. While many factors have contributed to a shift in this mentality, ease of access to information and cost of care in the US stand out.

In 2019, 269.4 million people in the US owned a smartphone -- roughly 82% of the 328.2 million residents -- a number expected to continue to grow. Information is literally at the fingertips of almost everyone. At the same time, spending in healthcare and wellness is growing at a tremendous rate. Healthcare is 18% of US GDP - a whopping $4 trillion in 2020, and the US generates some of the most revenue in the global wellness industry (a $4.5 trillion market in 2018). Couple this with the fact that the US has lower rates of insurance coverage when compared to other wealthy countries, and that 32% of American workers have medical debt, and it makes perfect sense that people want a say in their care. People are invested in mind, body, and wallet; and, regardless of the terms we use for those who interact with healthcare, we’re missing huge opportunities to serve people if we neglect what they’re very obviously looking for.

 

Bringing consumerism to healthcare

As with all good solutioning, we need to start with what the ideal state is and then work backward to see what needs to happen in order to get us there. At the core of what people want is for healthcare to be easy. It seems like this would be an argument in support of paternalism, where just having someone tell you what to do is the simplest way to make healthcare easy. That approach, however, negates autonomy and ignores informed decision making. The ideal state finds a balance among all three (easy, autonomous, informed) and incorporates value. Value is another term with multiple meanings inside and outside of healthcare. While healthcare is a unique industry in the US, it is also very clearly a business. Any discussion of value to healthcare consumers has to encompass both the concepts of health outcomes per dollar spent as well as what the consumer perceived to be benefits in relation to cost.

So what are people looking for when it comes to easily interacting with healthcare? This is a time when we’re lucky that healthcare lags behind other industries: we can see what consumerism is already demanding and apply it, instead of having to start from scratch. There are a number of examples from which to pull, and the success of Amazon makes it an easy place to start when considering what people want:

 

  • -Choice. Think of all the options you get if you look to Amazon for a new shirt. To some degree, that’s what consumers want. There are theories about consumer choice and how we make decisions. There’s also a “sweet spot” with choice, and more is not necessarily better. Choice has been a driving force in healthcare debates for quite some time and all signs point to that being what consumers are looking for. Not surprisingly, Amazon is also working to bring choice to healthcare. The Amazon Care approach allows consumers to choose the method in which care is delivered: video, chat, or in-person.

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  • -Convenience. Earlier this year Hunter Byrnes, our Head of Customer Success here at Workpath, wrote about consumer demand for convenience. He referenced Amazon (as well as pizza delivery), and he was on target. Healthcare consumers are empowered shoppers, and are looking to be treated as such, with the same convenience as if they were shopping online. Ro, a telehealth company who calls themselves “The Patient Company”, focuses on reducing the healthcare wait from days to minutes. Limited wait times, virtual visits, and delivery of medications all in a single provider create the convenience that consumers crave.

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    • -Price transparency. Pricing in US healthcare is complex, and even “simple” explanations are anything but. Buying consumer goods allows for significantly more price transparency and comparison than most interactions in healthcare, and consumers are noticing. Lawmakers are, too: the Trump Administration passed an Executive Order on Improving Price and Quality Transparency in American Healthcare which introduced the Transparency in Coverage Proposed Rule. The actual application of such transparency is still lacking, however. One company leading the way is GoodRx, where you can compare medication prices at local pharmacies right on their app.

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      • -User experience. One sentiment on the term “patient” is that patients are typically those who are passive, and have something done to them. Consumers, on the other hand, actively engage. They’re looking for good design, ease of use, and personalization. In a passive state, there’s no push to focus heavily on user experience. With consumers, however, design becomes a differentiator for organizations looking to influence consumer choice. Vault Health is taking on both experience and personalization: their approach to men’s health combines telehealth, at-home in-person lab draws, and customized treatment plans with delivery to the consumer’s front door.

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The advent of COVID brought with it long-lasting implications for healthcare consumers. Where people may have been willing to interact with a lagging industry before, they’re now asking why they can’t have more of what they want -- especially if they’re paying for it. Consumerism has long been thought of as a trend in healthcare, but the future of this industry relies heavily on its ability to provide services and care in a manner people have come to expect from consumer-focused industries.