Survey reveals great divide between patients, payers, providers

Patient engagement is central to improving health outcomes and reducing the cost of care. This is a well-known fact. Yet, there continues to be a huge disconnect between patients, payers, and physicians.

A recent survey of 761 U.S. adults who are healthcare decision makers for their households and 204 healthcare payers and providers found that 95% of payers and providers believe patients are delaying treatment due to cost concerns, but only 42% of consumers said this is true.

Additionally, the survey, which was commissioned by Xerox, found that 90% of healthcare professionals say patients need encouragement from their doctor to lead a healthy lifestyle, but only 55% of consumers say they need such encouragement.

This points to a critical disconnect between patients and providers, and lack of an understanding among patients of the resources and value providers offer them.

The future of healthcare will be proactive, not reactive

During open enrollment this fall, patients will decide whether to switch or stick with their health plan-and if they shop for health insurance on a state or federal healthcare exchange, they may also be deciding whether to stick with their current health insurance provider.

This is an opportunity for payers to start a dialogue with their members to enhance the payer/member relationship and ensure patients recognize how regular primary care is accessible and beneficial to them.

This conversation may include questions like:  

• How satisfied were you with your plan last year?

• How satisfied were you with your customer service last year?

• How can we help you with your health and health-related expenses?

• How can we help you understand your benefits better and make an educated decision for 2017?

During the conversation, payers may find that the member did not have an annual appointment with their primary care physician (PCP)-perhaps they didn’t have time or didn’t know it was completely covered by insurance. Or, they might learn that the member wasn’t satisfied with the plan or that they had trouble understanding their healthcare benefits.

The service representative, in either of these cases, should help the member coordinate with their PCP and set up the appointment, or explain their family plan benefits and options-to ensure that the desired outcome is achieved.

The service rep should then follow up to ensure that the member is satisfied with their service experience and that their immediate care needs are met-or coordinate follow up if necessary.

Next: Opportunity for providers

Providers also have an opportunity to build better relationships with their patients and deliver a better healthcare experience. But it will require providers to spend more time talking to the patient-not at them. And it will require providers to take a close look at how they deliver service and leverage technology in an efficient and impactful manner.

The first point of contact between a provider and his/her patient should begin shortly after the patient schedules an appointment. This conversation can be initiated by a clinician or nurse from the physician’s office and it may cover things like:

• Have there been any changes to your personal, medical or insurance information since your last visit?

• Is this a routine check-up appointment or is there a health concern that you would like to speak to your physician about?

• If we offered telemedicine, would you prefer to use that vs. coming in to the office?

• Do you use any wearables and if so what do you use them for?

• Other information that would be useful for the physician.

In this scenario, when the patient arrives to the office for the visit, their wait time will be shorter because they won’t have to fill out any forms and the physician can dedicate their limited face-to-face time talking to the patient, addressing their care concerns and discussing treatment options.

A few days following the appointment, the provider has another opportunity connect with the patient and ensure health outcomes are achieved. This conversation may sound like:

• How are you feeling after visiting with us?

• Is your treatment plan meeting your healthcare needs?

• Are you taking your medication as prescribed? If so, have you noticed any undesirable side effects?

• Are you satisfied with the level of service we provided?

This enhances the patient/provider relationship and enables the provider to put more focus on health outcomes.

The good news is new technology such as telehealth and population health management can help automate the front-office functions so payers and providers can refocus resources on time needed to see patients. For consumers, technology can also increase access to care and improve the quality of service they receive.

Xerox’s survey results indicate that there is a huge disconnect between consumers and healthcare professionals, especially as it relates to patient empowerment and control. This is not new news, but the results suggest that improved communication could lead to improved patient satisfaction and ultimately, care outcomes-allowing healthcare professionals to be better partners in care.

What will happen if payers and providers don’t make these adjustments? Will millennials who are beginning to consume healthcare accept where we are? Or will the market forces of health consumers leverage globalization and drive a parallel health system?