Consumers are taking the reins of their healthcare, whether they like it or not.
The healthcare industry is characterized by a series of business-to-business transactions between major stakeholder groups: manufacturers, distributors, providers, insurers and employers. The business relationships between these players are the foundational links in the healthcare supply chain—but what about the patients who ultimately receive the products and services that these stakeholders provide?
Historically, patients have been passive consumers of healthcare, paying into whatever health plans their employers sponsor and receiving whatever care the physicians in their networks provide.
However, healthcare costs continue to rise,1 which increases the pressure on stakeholders in the healthcare system to reduce unnecessary costs. As a result, many healthcare stakeholders are pushing more financial risk onto patients in the form of increased out-of-pocket costs. In fact, a recently released study said that out-of-pocket costs for patients rose by 11% in 2014 to $2,491 per patient, up from $2,245 per patient in 2013.2 This increased cost has incentivized patients to play a more active role as healthcare consumers and to make more deliberate decisions about the care they receive, such as:
- How they access healthcare through plan and network choices (e.g., high-deductible, narrow-network and health insurance exchange plans)
- How they address overall health management, in terms of lifestyle, fitness and general wellness
- How they manage health concerns, from acute illnesses to chronic conditions
As patients become active managers of their health, big stakeholder groups are repositioning their services and messaging to focus on consumer decision makers, in addition to traditional business-to-business interactions. This shift in strategy is also known as the consumerization of healthcare.
While consumerization is driven by cost, it is enabled by the proliferation of technology that allows consumers to become active participants in their own healthcare choices. Recent advances in technology have made it significantly easier for the average consumer to manage his or her health. For example, mobile apps enable consumers to search for providers with high consumer ratings or low appointment costs, while wearables allow consumers to track their activity and vital signs. Payers, providers and manufacturers are all developing patient engagement models that use online portals, apps and other technology tools to improve health management and medication adherence.
In our future posts about consumerization, we’ll examine how consumers are accessing healthcare and using technology to make informed decisions about the quality and cost of the care that they receive.
2TransUnion Healthcare Report: Q4 2014.