Environmental Assessment Provides Guidance for a Consumer-Centric Approach to Health Care

Two very different trends—increased patient cost sharing at the point of service and a shift to outcomes-based payment—have converged to catalyze a movement toward consumerism in the healthcare industry. Understanding what drives consumers and patients will be key to future success for all types of healthcare organizations. Those are the conclusions of Health Care 2020: Consumerism, a new report published by the Healthcare Financial Management Association (HFMA).

“With many priorities competing for attention and resources, consumerism isn’t always on the short list of key priorities for healthcare organizations,” says HFMA President and CEO Joseph J. Fifer, FHFMA, CPA. “That must change. It’s not enough to try to serve consumers; we must truly listen to them and put ourselves in their shoes when we design our processes and our conversations.”

This is the second in a series of four reports that comprise an environmental assessment designed to guide healthcare organizations in their strategic planning efforts over the next several years.

To download Health Care 2020: Consumerism, visit hfma.org/healthcare2020.

Key takeaways in the 14-page report include the following:

• Appealing to consumers is important for population health management and value-oriented payments. Meeting consumers’ needs and expectations is key to keeping them in a health system, which in turn is essential for optimal care management and patient engagement.
   
• Health plans and providers both will be increasingly responsible for providing the education, information, and tools that consumers need to take ownership of their health.
   
• Consumers are not monolithic. Health plans and providers that thrive will be those that understand the wants and needs of various segments of their consumer base and act on that knowledge.
   
• Consumerism in health care will not truly gain traction until organizations make a point of genuinely listening to consumers.
   
• Consumerism can improve health care only if those with expertise—including providers and health plans—support consumers with the information they need to make good decisions.

In addition to providing background and context for these key messages, the report also identifies six organizations/programs to watch for their innovative consumerism strategies, including Seattle-based Providence Health & Services, UnitedHealthcare’s Diabetes Health Plan, Memorial Hermann Medical Group (Houston), Mount Sinai Health System (New York), INTEGRIS Health (Oklahoma), and the Centers for Medicare & Medicaid Services’ five-year demonstration of value-based insurance design in Medicare Advantage plans.

Twelve healthcare policy experts working in a variety of settings were interviewed in the development of this report, including Jean-François Beaule, executive vice president, design and innovation, UnitedHealth Group; Roger Holstein, CEO, Healthgrades; David Hopkins, PhD, senior adviser, Pacific Business Group on Health; David James, MD, JD, CEO, Memorial Hermann Medical Group; Pat Mastors, president, The Patients’ View Institute; and Craig Richmond, senior vice president and CFO, MetroHealth System.

HFMA’s HEALTHCARE DOLLARS & SENSE® initiative offers extensive resources to guide healthcare organizations in adopting a consumer-centered approach to the financial aspects of health care.

The remaining two reports in the Health Care 2020 series, focusing on consolidation and innovation, will be released later this year. The first report, on the healthcare industry’s transition to value, was released earlier this month. All will be accessible at hfma.org/healthcare2020. 

Karen Thomas
Healthcare Financial Management Association
(708) 492-3377
kthomas@hfma.org

About HFMA

With more than 40,000 members, the Healthcare Financial Management Association (HFMA) is the nation's premier membership organization for healthcare finance leaders. HFMA builds and supports coalitions with other healthcare associations and industry groups to achieve consensus on solutions for the challenges the U.S. healthcare system faces today. Working with a broad cross-section of stakeholders, HFMA identifies gaps throughout the healthcare delivery system and bridges them through the establishment and sharing of knowledge and best practices. It helps healthcare stakeholders achieve optimal results by creating and providing education, analysis, and practical tools and solutions. The association's mission is to lead the financial management of health care. 

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