Democratization of Healthcare

March 21, 2016

Democratization of Healthcare

Democratization of Healthcare

So much has been written recently about the “Democratization of Healthcare” that it merits a deeper investigation. Is this just a trendy buzzword or is it really a phenomenon?  Dr. Eric Topol highlighted the trend in his recent book, “The Patient Will See You Now.” In the book, he provides detailed evidence for a knowledge-driven shift of power from doctors to patients facilitated by emerging technologies. Dr. Topal writes, “We are about to see a medical revolution with little mobile devices, where smartphones will play a role well beyond a passive conduit.” He predicts a future where mobile devices are used for blood tests, medical scans, fitness tracking and even parts of the physical examination—where digitally empowered patients will take charge of their healthcare.

Rising Costs Forcing More Engaged Healthcare Consumers

While technology is one of the primary facilitators of the Democratization of Healthcare trend, it is not the main catalyst. The rising cost of healthcare is forcing consumers to take a much more active role in their healthcare spending decisions. Total out of pocket healthcare costs for a family of four (including premiums, deductibles and co-pays) has risen from $3,509 to $10,473 since 2002. This financial burden is forcing a new level of healthcare consumerism.

Lack of Transparency Continues to Stall Democratization

While the internet has put much more medical information at our fingertips, it still doesn’t provide the information consumers need to make smart healthcare decisions. Since the early 2000s, employers have migrated many employees to high-deductible health plans to encourage more engagement in healthcare purchase decisions. Unfortunately, the bulk of the cost reductions experienced due to that migration have come from healthcare avoidance vs. selecting lower cost alternatives. There is simply not enough data available yet on price and quality for consumers to truly take charge of their healthcare. Rather than shop around, most consumers still rely on their doctors for recommendations on where to go for specialist care, lab work and other ancillary medical services despite the fact that prices for these services can vary greatly. For example, a Washington Post exposé revealed pricing ranging from $400 to $2,183 in the D.C. area for a standard MRI on an ankle.

New Incentives and the Democratization of Health Information

Dave Chase and Leonard Kish have suggested that healthcare is on the verge of radical change in their work, “95 Theses for a New Health Ecosystem.” This revolution is being fueled by new incentives and payment structures for providers combined with better access to information for consumers. They have created their 95 theses as a set of guiding principles to break the cycle of misaligned incentives and design a more effective health delivery system. Examples of a few of these theses include:

  • Cross-discipline collaboration and sharing will be a requirement
  • Individuals have the right to make choices and control their health destiny with the best information available
  • Health is not the limited time individuals spend in clinics. What happens in the other 99+% of their life has the greater impact on an individual’s overall well-being

The Democratization of Healthcare is a real phenomenon, but lack of transparency and the persistence of our fee-for-service incentive structure remain impediments to this transition. Employers who want to encourage greater employee engagement in their healthcare decisions should provide transparency tools and provider models that support smarter healthcare decision-making. For more information on how to speed the democratization curve for your employees, contact Paladina Health.

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