Dr Ray Fabius
Chief Medical Officer, Thomson Reuters
Consumer Activism & Transparency is one of the five successful strategies explored by Dr Ray Fabius and Bob Kelley in their white paper “A Path to Eliminating $3.6 Trillion in Wasteful Healthcare Spending.” Download the paper here>
Studies show that those patients taking an active and interested involvement in their care are more likely to follow through with treatment recommendations and get good results from care, costing the system substantially less as a result. Dr Ray Fabius, Chief Medical Officer at Thomson Reuters, co-author of the white paper “A Path to Eliminating $3.6 Trillion in Wasteful Healthcare Spending,” examines one of the five suggested strategies: Consumer Activism and (Information) Transparency.
“The average American spends more time deciding which car to buy from which dealer than they do evaluating important treatment decisions such as invasive surgery,” says Dr Fabius. “In fairness to the consumer, it has been difficult to find pricing information and even more difficult to obtain credible outcome data to enable decision on a treatment choice .” So how can we bridge the information gap?
Fabius identifies four categories of healthcare consumer, with widely differing levels of consumer activism:
• The Independent Healthcare Consumer – an individual taking active interest and involvement in their care, accessing information on the internet and reading literature and books available on their health or specific ailment.
• The Educated Physician-Dependent – who undertakes an investigation of their health issues but only acts after conferring with their trusted clinician.
• The Less-educated Physician-Dependent – a passive consumer, entirely reliant upon their doctor’s advice, and taking little to no active role in their own decisions.
• The ‘Immortal’ – an individual who does not access Healthcare services unless their condition becomes serious (generally men between the ages of 25 and 40 – who focus on specific problems rather than general prevention – the result being periodic crisis management ending in the emergency room and hospital, rather than sustainable preventive care). It is the Educated, Physician-Dependent consumer, who actively seeks help in combination with and support of a professional’s advice, who is the most receptive and productive consumer of better information transparency. Mutual trust and collaboration between care providers and their patients is more likely to yield the correct treatment decisions and positive outcomes.
Hand-in-hand with Consumer Activism is the need to increase information transparency – where these co-exist, Dr Fabius says, “the patient will more likely receive the right treatment at the right time and at potentially the right price,” costing the system less money. Greater transparency in the form of accredited websites with clear certification denoting validated content, encourages greater understanding, and with a trusted care provider on board to help interpret this information, a patient is clearly more likely to arrive at the appropriate course of action.
Fabius also groups the population into four categories in terms of their levels of health:
• 10-15% ‘Well’ population – not suffering from any major ailments and with few risk factors
• 60-70% ‘At Risk’ – who have multiple risk factors (e.g. smoking, overweight)
• 10-25% Chronically ill (e.g. diabetes, heart disease, high blood pressure)
• 1-3% catastrophically ill – costly patients requiring $50-100k in medical resources
One aim is to keep the well population well for as long as possible. A second aim should be to eliminate risk factors among the at risk cohort before they contract a chronic illness. Dr Fabius says, “Healthplan and employer-based incentive schemes are garnering a lot of attention. For example, a recent study carried out by General Electric, offered $500 to smokers who undertook a smoking cessation program, demonstrated a noticeable increase in successful cessation. It is now up to the employer to develop even more robust programs, with higher uptake.”
Such examples show that it is behavioral change that must be achieved not just participation and engagement. Ultimately, it is not only incentives that drive behavior change but also the environment and culture health consumers live and work within. Not only will costs be cut, but overall productivity and commercial profits will increase as a result of these active, healthy more productive individuals.
Consumer Activism & Transparency is just one of the five suggested strategies Dr Ray Fabius and Bob Kelley explore in their white paper. Read the others, by downloading the full paper here>