The empowered patient is one change that stands above all others
DRIVING THE CONSUMER MARKET
Empowered individuals are the emerging healthcare decision makers for several reasons:
• New ways to choose health insurance. As the early provisions of the Patient Protection and Affordable Care Act (PPACA) roll out, individuals seeking healthcare plans will access state-by-state information on available plans, which will soon include rates, network specifics, quality scores and possibly even consumer ratings. As the exchanges become reality in 2014, individuals and small employers, followed by large employers (this will be an option in 2017), will begin selecting their health plans by comparing a wealth of online information about each.
• New managed care populations. The budget crises will force states to move long-term care-the largest portion of their Medicaid budget-into managed care programs. Not only will this result in savings but it will provide heath plan choices for eligibles who previously had no choice. In addition to the long-term care populations, Medicaid eligibility expansions will add new groups of individuals who will select their health plans for the first time.
• New purchasing tools. The Internet has brought new opportunities for individuals to network and exchange information about products and services. Facebook alone is regularly used by 120 million Americans, with people age 26 and older accounting for 60% of daily users. Twitter is adding 300,000 new users and processing over 600 million information searches every day. Increasingly, Americans are relying on their social networks for information. The largest segment of today's uninsured market (25- to 34-year olds) is the most Internet-savvy, and they will be selecting their health plan based on different criteria than purchasers in the past.
• Loss of trust in institutions. The investment banking debacle, Toyota's recall and the British Petroleum oil leak have contributed to a significant decline in Americans' trust in institutions, including the government, the media and the healthcare industry. As a result, there has been a significant rise in grassroots activities that attempt to move institutional power to the individual.
The scope of these changes will impact every aspect of healthcare as the system further evolves. Smart organizations will recognize this change and reinvent themselves. The smartest organizations will tell this new market: "Have it your way."
Don Hall, MPH, is principal, Delta Sigma LLC, in Littleton, Colo.