News & Insights
News & Insights
You’ve heard it a million times: consumerism is upending healthcare! Just like every other industry, empowered consumers will finally take charge, demanding better experiences, greater transparency, and of course, lower costs.
But guess what… it ain’t happening. At least, not like we thought it would.
Sure, there’s an urgent care clinic on every corner, consumers can (kind of) compare prices online, and virtual visits from your sofa are more common. But the reality is, consumerism is getting constricted, squeezed from all sides by forces that limit its impact.
Healthcare isn’t retail. Consumers don’t get to fully choose where they go for care, when they get it, or how much they pay.
Why? Because payers gonna play. They control where the care happens. They control the time, place, and price. And… they control whether care happens at all (prior authorization, anyone?).
Here’s how:
· Who is the consumer, really? The patient isn't the primary consumer. Not really. Unlike other industries, the real power in healthcare lies with those footing the bill – employers and insurance companies. They're the ones calling the shots, dictating what's covered, by whom, and at what cost. As healthcare costs continue to skyrocket, employers are looking for ways to shift more financial burden onto employees, further diminishing the individual's power to make choices based on their needs and preferences.
· Choice overload and information gaps, galore: Let's face it, healthcare is complicated. Navigating insurance plans, deciphering medical jargon, and evaluating quality metrics is enough to make anyone's head spin. Even with more information available online, most consumers lack the time, expertise, and frankly, the desire, to become experts in their own care. The result? They often default to what's easiest or most familiar, regardless of cost or quality.
· Less choice than ever before: Think you have a plethora of options when it comes to healthcare? Think again. Narrow networks, provider shortages, and geographic limitations often restrict choice, especially for specialized care. And while price transparency initiatives are gaining traction, the reality is, most consumers still don't have a clear understanding of what they'll pay for services, making it difficult to comparison shop effectively.
We want your take…
· Is true consumerism possible in healthcare?
· Who has the most influence in healthcare: providers, payors, pharma, the federal government, consumers, or investors?
· Providers are being attacked about rising healthcare costs. Who is really to blame?
· How can healthcare organizations effectively communicate the value of their services to consumers, in a landscape increasingly dominated by cost considerations?
· One issue new entrants face when entering healthcare is complex reimbursement models. Who do you believe is poised to get this right?
· What reimbursement strategies have you seen work well?
· Is price transparency ever really possible?
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