Absent a sea change in national politics, competition in healthcare appears to be here to stay, at least for the foreseeable future. So, if we are to improve on the country’s healthcare performance relative to other OECD nations, consumer empowerment must be part of the solution. This article explores the confluence of two significant, inter-related trends:

• increasing consumer use of the internet to choose providers and
• growing availability of hospital and surgical outcomes to consumers. 

By examining these two trends, the author finds substantial unrealized opportunity based on the central premise that empowering consumers to choose providers based on outcomes will improve the overall quality of care in the U.S. and will likely reduce healthcare and related costs. At the very least, individual consumers can benefit from choosing providers with better outcomes.

https://www.linkedin.com/pulse/healthcare-consumerism-outcomes-opportunities-peter-a-wadsworth

Executive Summary

Research and analysis by McKinsey & Company, Consumer Reports, the Boston Consulting Group, the University of Michigan and other organizations reveal the need for better internet-based consumer information and consumer awareness:

• Consumers consider quality by far the most important aspect of choosing a primary care physician (PCP), but there aren’t any good measures of individual PCP quality.
• Consumers often rely on patient surveys to choose a PCP, but those surveys don’t measure quality and remain of questionable value even after 10 years of compilation.
• Many recently hospitalized patients are unaware of the existence of other local hospitals.
• Consumers barely mention hospital or medical group affiliation as a basis for choosing doctors.

Outcomes offer Opportunities for Improvement

This article finds opportunities for improvement in the current state of outcomes information, which could help further the goal of consumer empowerment:

• Variations in hospital and surgeons’ outcomes possibly greater than 6 to 1 represent a major opportunity for consumers to lower risks (and costs) through provider choice.
• While the best-known hospital rating services don’t agree on which hospitals are safest or adequately disclose outcomes performance, less well-known solutions currently exist.
• Medical group quality ratings and the national outcomes database need improvement.

And, of course, none of the above would change consumer behavior without consumer education

Industry Action Needed to Realize Results

As a consequence of these findings, the author recommends that the healthcare industry:

• Self-regulate to improve the quality and availability of safety information to consumers and eliminate deceptive practices.
• Educate consumers to use available outcomes data to choose providers.
• Support a nation-wide effort to rate the quality of care provided by physician groups;
• Continue to work toward an integrated all-payer database of risk adjusted outcomes.

The author believes that a strong nationwide healthcare consumerism movement coupled with better information can lead to a safer, more cost-effective healthcare system in the United States.