As the dust settles on the 2012 election, one conclusion remains as inevitable now as before: The healthcare industry is in line for major changes, especially over the next two years. Industry and consumer factors are pushing the transformation to a patient-centered approach in care delivery, which will open new opportunities in connected-home technologies.
Patient-centered care is the culmination of 20 years of experiments with the disease management (DM) practice. When DM services were launched in early 1990s, they had their share of detractors, who questioned its ROI and patient stratification methodology, among other things. However, the DM model has survived and thrived by adapting operational and business models to meet client needs.
The DM industry has done the following:
- taught health insurers how to manage high-cost/high-risk patients;
- showed self-insured employers that population health programs can cut employee absenteeism and reduce claim costs; and
- demonstrated to Medicare Advantage administrators that senior fitness and wellness services offer both health benefits to seniors and fiscal benefits to the government.
Today third-party DM vendors are actually victims of their own success. They have lost their dominant position in an industry they helped create as all large health insurers now have their own internal DM service divisions. The practice has also spread to other countries, indicating the DM practice is accepted by the healthcare community, no matter what label or branding it has.
The Next Phase
The next phase in DM evolution is the patient-centered care model, which the Affordable Care Act — Obamacare — calls the “accountable care organization” (ACO) model. But this model, whatever the name, would have persisted regardless. The market is moving toward a patient-centered care approach, treating patients not as passive recipients but active participants in their own personal care management.
At the core of the patient-centered care approach is patient engagement, which involves patient interaction during and after care episodes. Caregivers interact with their patients to promote long-term behavioral changes that lead to better health outcomes. Motivation for patient engagement is partly due to compliance with government requirements (such as avoiding readmission penalties), but the industry also realizes the potential in this model to deliver more personalized care and cut wasteful spending is huge.
Parks Associates is bullish about patient-centered care because, simply put, the healthcare industry has nearly run out of time and options to rein in escalating healthcare costs. The patient-centered care is the best option on the table, and it is a truly bipartisan solution to a national problem.
Leaders in Healthcare Evolution
Healthcare providers and health insurers will lead this new phase. They have grown comfortable with a more proactive approach to patient care, and over time, they have become more willing to collaborate in order to provide care when, where, and how patients prefer instead of limiting patients’ options based on their own resources.
The coverage they provide will ultimately be more comprehensive, and they will design their approach to address needs across the continuum of care instead of targeting a single disease or offering a standalone procedure.
To implement this care model, healthcare providers and insurers will seek help from third-party DM companies and other non-acute care providers, including home health agencies and retail clinics. Such a collaborative approach will be the signature feature of the patient-centered care model. Driven further by technological innovations, the growing ubiquity of connected devices and services, and government incentives and penalties, this model will explode in popularity in the next 10 years.
Do consumers want patient-centered care? Comprehensive data are scarce, but Parks Associates has been researching the digital health area for several years. Consumer trends show a growing interest in personalized solutions to healthcare — and the use of technologies to enhance these offerings:
- In 2010, about 10 percent of U.S. health consumers interacted with their doctor in a virtual way — email, online chat, or videoconferencing. With more virtual care options offered from health insurers and health networks, this percentage is rising in 2012 and 2013.
- Also in 2010, about one-fourth of consumers who visited health websites expressed strong interest in communicating with an online physician other than their primary care doctor. In 2012, this percentage jumped to 30 percent.
- In 2011, among health consumers with at least one chronic health problem, 27 percent wanted a personalized action plan from their healthcare providers to address their health management challenges.
These data point to growing interest among consumers in receiving care with convenient access and personalized options. They are also open to new provider types as part of the care-management experience.
This push toward patient-centered care will redefine delivery of healthcare, moving it out of traditional institutional settings and more into the connected home and mobile space. This shift will also alter the allocation process of healthcare dollars.
Consumerization of health IT improves consumer care access and changes care providers’ approach to engagement with current and future patients. It also creates a new need for technologies that can leverage today’s connectivity to improve and enhance healthcare delivery.
It will be a difficult space in which to succeed, with often stringent requirements for security and uptime, but there will be ample market, and partnership, opportunities for connected-home technologies.