How The Empowered Consumer Is Changing Healthcare

What can the consumer do to optimize their treatment in a 'democratized' system?


In the world of healthcare, as in so many industries, the consumer is becoming less passive. The wider availability of information regarding treatments, coupled with the increased scrutiny that comes with web reviews and consumer-to-consumer dialogue, has created an informed consumer that will not necessarily be as blind in their search for treatment. The increasingly delocalized and personalized healthcare system made possible by digital technologies has placed the patient at the center.

Employer-sponsored group insurance, once the dominant channel for insurance revenue, is giving way to direct-to-consumer marketplaces in which customers can make more informed decisions and, ultimately, improve their relationship with healthcare. Value-based care is growing, as well as the risk and accountability for care moving away from the payers and toward the providers in what could be described as a democratized system.

Healthcare consumers are now making decisions based on information rather than instinct. Patients will travel to a hospital further away for the promise of better treatment. The days of the local treatment center are over, the industry is becoming more specialized and the trend, one hopes, will improve American healthcare by virtue of increased competition. The Blue Cross Blue Shield Association believe that 'empowered healthcare consumers play a key role in improving access to quality care in America.' They allow consumers to find easily accessible information online regarding the best doctors and hospitals for their particular ailment, as well as offering decision-influencing information on pricing. Ultimately, the emphasis on immediate treatment - i.e. going to the nearest hospital in order to neutralize pain as quickly as possible - has been dampened by the growth of available information.

The trend is data driven, too. The Blue National Doctor and Hospital Finder, for example, allows users to find doctors and hospitals in their plan's network, as well as see reviews of the institutions in question and reliable estimates on cost. The development is, to an extent, creating a community-driven healthcare system wherein patients and doctors share a more equal stake in the provision of quality treatment. The democratization of healthcare data is leading to a situation in which high-quality health information will be readily available not just anytime, but anywhere. Consumer-to-consumer advice sites are not new, but are part of the increased amount of online research now done by consumers before healthcare decisions are made.

The opinion of a doctor is still important, though, and studies have found that people are more comfortable with the outcomes of their healthcare decisions if they have been informed by doctors rather than personal research. The potential consumer regret - made possible by the perceived lack of authority of decision-making when self-treating - will be an important hurdle for competitors to the doctors' surgery to overcome if they are to succeed.

The burgeoning consumer-centric healthcare market will change the way companies compete for new customers. The likes of CVS and Walgreens are moving into the provider business, a move which could provide an alternative to a doctors visit, with cheaper availability of care perhaps compensation for the less thorough, informed examination. Again, the matter returns to consumer responsibility; a patient should be as informed as possible regarding the choice between a doctor and a clinic. Understanding the biases at play when assessing conditions online will be important too, as biased reviews and persuasive marketing tactics are just two examples of how this ostensibly democratized environment can be manipulated by providers.

The recommendation from the likes of Blue Cross Blue Shield is that consumers become more familiar with the options available locally, including emergency care, which can vary greatly from location to location. The amount of choice in direct-to-consumer healthcare can be overwhelming, but informed decision-making will benefit not just the individual consumer but the American healthcare system overall. 

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