HCI3 Update from the Field – Newtown, CT
There's an interesting contrast between what most of us think is right and what consumers want – Atul Gawande's recent commencement address to the graduating class of the Harvard Medical School perfectly encapsulates what most of us know to be true: that practicing medicine the right way is a team sport. The number of known treatments corresponding to the number of known diagnoses has grown so significantly in the past decades, that no single clinician can hold the information in their heads. Nor should they be expected. However, most consumers have not yet caught up to this notion, perhaps still basking in the nostalgia of the sitcoms most of us grew up with. A recent series of focus groups conducted by GYMR for a RWJF project provides important insights on how plans and employers should communicate with consumers when it comes to payment reform and the importance of "teams". The upshot is that most consumer-patients don't want to be treated by teams. They still want to rely on their physician, the one they have a relationship with. Of interest, while the price-sensitivity related to physician choice is low for women, it's relatively high for men. As such, men might be a good initial target for moving market share to high-value providers – for screening colonoscopies for example.
What this means to you – We forget to be patient-centric at our own peril. And that means putting that patient not simply at the center of the delivery system and payment incentives, but also at the center of our communications. Markets work only when consumers make them work. So as much as we like to focus on provider-centric approaches to reform (think about ACOs and PCMHs), we really need to change that thinking to being patient-centered if we want to be successful. To help you in communicating new payment concepts to consumers, we've put together a couple of simple videos, one on diabetes care and another on an elective knee replacement surgery. We refer to teams, but only as a support mechanism to the physician with whom the patient has a relationship. It's always humbling to read through focus group reports because it reminds us of how far Main Street is from the Ivory Tower. Here's hoping the Ivory Tower dwellers read the RWJF's Main Street report.
Francois de Brantes
Health Care Incentives Improvement Institute, Inc.