Health Care Consumerism Research Articles

Healthcare consumerism is a threat for health

Healthcare consumerism is a threat for health

My Child Is Sick; Don't Call Her A 'Consumer'.

The mother of a chronically ill child discusses why the terminology and goals of consumerism won't resonate with all patients.

How Transparency Efforts Helped One System's Financial Turnaround.

Healthcare consumerism, costs, and price transparency are garnering unprecedented attention from hospitals and health systems in the United States. To many observers of the US healthcare delivery system, the inability to provide accurate pricing information and the variability in prices for comparable services are utter failures of the administrative infrastructure that supports patient care processes.Price transparency and the affordability of healthcare have also become top concerns for professional and trade organizations, which are devoting significant resources to assist member institutions in facing these issues. In many states, elected officials have passed legislation requiring pricing support for consumers. When the value equation (cost divided by quality) is considered, comparisons of healthcare providers can become even more confusing.Price transparency and demonstration of cost-effective, high-quality service to patients have become strategic imperatives at Maricopa Integrated Health System (MIHS). A safety-net system and one of Arizona's largest providers of graduate medical education and other teaching programs, MIHS faced an operating deficit of more than $74 million in fiscal year 2014. In 2015, financial concerns prompted the CEO and board to hold weekly meetings to appraise cash availability and management interventions. Over the next four years, MIHS achieved a cumulative improvement in net income of more than $150 million. Today, MIHS is reinventing itself through a major capital campaign made possible in part by a $935 million public bond referendum passed by the voters of Maricopa County. Ultimately, our ability to better serve the community involves connecting with our patients and addressing their need for price transparency.

Improving Value for Patients with Eczema

ObjectiveChronic diseases now represent a cost majority in the United States health care system. Contributing factors to rising costs include expensive novel and emerging therapies, under-treatment of disease, under-management of comorbidities, and patient dissatisfaction with care results. Critical to identifying replicable improvement methods is a reliable model to measure value. Study DesignIf we understand value within healthcare consumerism to be equal to a patient’s health outcome improvement over costs associated with care (Value=Outcomes/Costs), we can use this equation to measure the improvement of value. MethodsResearch and literature show that patient activation—the skills and confidence that equip patients to become actively engaged in their health care—impact health outcomes, costs, and patient experience. Reaching patient activation through engagement methods including shared decision-making (SDM) lead to improved value of care received. The National Eczema Association (NEA) Shared Decision-Making Resource Center can be a transformative strategy to measure and evaluate value of health care interventions for eczema patients to advance a value-driven health care system in the United States. ResultsThrough this Resource Center, NEA will measure patient value through their own perceptions using validated PRO instruments and other patient-generated health data. ConclusionsAssessment of this data will reveal findings that can assist researchers in evaluating the impact this care framework on patient-perceived value across other chronic diseases.

Disruption in the diabetic device care market.

As diabetes mellitus (DM) has approached pandemic proportions, the pressure for effective glycemic management is mounting. The starting point for managing and living well with DM involves early diagnosis and monitoring blood glucose levels. Therefore, self-monitoring of blood glucose (SMBG) can help patients maintain their blood glucose levels within the appropriate range. The general principle behind the current SMBG method involves a finger prick test to obtain a blood drop, which is applied onto a reagent strip and read by an automated device. Novel techniques are currently under evaluation to create the next generation of painless and accurate glucose monitoring for DM. We began by outlining how the emerging technology of the noninvasive glucose monitoring devices (NIGMDs) provides both economic and clinical benefits for health systems and patients. We further explored the engineering and techniques behind these upcoming devices. Finally, we evaluated how the NIGMDs disrupt the diabetic device care market and drive health care consumerism. We postulated that the NIGMDs play a pivotal role in the implementation of next generation of diabetes prevention strategies.

Can Consumers Be Smarter Health Care Shoppers in the Quest for Cost Containment?

Lawmakers, health plans, and employers are increasingly shifting a greater portion of health care costs onto consumers in hopes that increased price sensitivity will make them become better health care shoppers. However, health care consumerism offers limited potential for system-wide cost containment and presents significant pitfalls for patients.

Consumer-Centric Care: Latest Buzzword or New Reality?

With the industry in flux as federal healthcare reform legislation debates continue, leaders are preparing for what the post-Affordable Care Act world might look like. Predictions include patients assuming more responsibility for healthcare costs and therefore behaving like consumers, including choosing providers based on perceived value. What actions should chief nurse executives take to ensure the nursing enterprise responds to rising consumerism in healthcare?

Patient-centredness and consumerism in healthcare: an ideological mess.

Patient-centredness and consumerism in healthcare: an ideological mess.

The “Medicinal Cannabis Question”: How Actors Legitimate Vote Choice on Medical Marijuana Policy

ABSTRACTWhile there has been much analysis of how policymakers shape criminal justice policy in the United States, the role of voters in legitimating such policy has been largely overlooked. This is important because of the growing use of ballot measures by states to determine criminal justice policy, such as the legal status of medical cannabis. What are the collective narratives that voters draw upon to legitimate their vote choices on these measures and how does their usage vary? Patterns of individual-level legitimation that use collective narratives matter because they provide evidence of actors’ internalization of such narratives, which suggests the presence and activation of corresponding automatic processes that have been linked to judgment and decision-making. For this study I analyzed respondent legitimations of vote choice on a 2010 ballot measure that sought to legalize medicinal cannabis for a case set of 91 white male voters. Surprisingly, I found the use of a liberal political narrative that spanned party lines for those who voted to approve the measure. Furthermore, I found evidence of a neoliberal narrative of individual responsibility for patient care that reaffirms scholarship on the intersection of neoliberalism and consumerism in healthcare.

Incentives Misaligned

Incentives Misaligned

Patient- and Family-Centered Care: A Primer

Patient- and family-centered care is a model of providing care in which the patient and family are partners with the provider and care team. A resurgence of interest in patient- and family-centered care is due, in part, to increasing consumerism in health care and the linking of reimbursement to the patient experience. Individual radiologists, practices, enterprises, and radiology professional societies have been engaged with patient- and family-centered care in varying degrees for many years. Understanding the roots and evolution of this care model will encourage further application of these principles in radiology.

Paradoxes of Personal Responsibility in Mental Health Care

Personal responsibility is widely considered important in mental health recovery as well as in popular models of alcohol and drug treatment. Neo-liberal socio-political rhetoric around consumerism in health care often assumes that people are informed and responsible for their own choices and behaviour. In the mental health care context and especially in emergency or crisis settings, personal responsibility often raises particular paradoxes. People often present whose behaviour does not conform to the ideals of the responsible consumer; they may seek and/or be granted absolution from irresponsible behaviour. This paradox is explored and clinicians are urged to consider the context-bound nature of personal responsibility and how attributions of personal responsibility may conflict with policy and their own professional responsibilities to intervene to protect others.

Transparency in healthcare: Where does it stand?

In a typical free market, consumer behaviour stays true to core economic principles related to supply and demand; however, in the US healthcare industry, certain economic principles apply, which influence consumers in a unique manner. Given the complexity of healthcare pricing and consumption, consumers are often ‘left in the dark’ when dealing with the true monetary cost of receiving treatment from a healthcare provider – whether it be for preventive reasons, an illness or injury or the delivery of a newborn child. To add another layer of complexity, there are also varying levels of price elasticity, depending on the condition, which also influence consumer behaviour. In fact, healthcare in the US is the only industry in which the ‘cost of care’ from the three main stakeholders – payers, providers and patients – is almost always different. The purpose of this paper is to explain how price and quality transparency affects consumer decision-making in the healthcare setting, to provide a background on various initiatives (state/federal/third party) that have taken place (or will take place) related to transparency, and ultimately provide recommendations to healthcare leaders on steps that can be taken to succeed in an increasingly transparent environment. By understanding healthcare consumerism and decision-making, healthcare providers can better prepare for value-based care, and understand and align healthcare charges to the true cost of care with the goal of more closely aligning with key stakeholders (patients and payers).

The evolving role of the nurse during the cancer treatment decision-making process: a literature review

Many models of patient-physician relationships have been described since a paternalistic model was postulated in the early 1950s. Among them are the informative model, doctor-as-agent model, shared model of care, family-centered model, and Degner and Beaton's Patterns of Decision Making. This article aims to examine the contemporary role of the nurse during the cancer treatment decision-making process. This article reviews the current and evidence-based role of the nurse during cancer treatment decision making, and implications for practice and research are discussed. Because of external forces, such as rising cost of health care, increasing healthcare consumerism, and increased emphasis on patient-centered care, the shared model of care is taking hold, particularly in the cancer setting. The evolution of these models has caused a shift in the dialogue related to cancer treatment decision making between patients and physicians, as well as oncology nurses. These events contribute to the evolving role of the nurse during the cancer treatment decision-making process.

Phoning in sick--telehealth in the iPhone age: As mobile devices become ubiquitous, can health care finally be delivered effectively over the Internet?

Phoning in sick--telehealth in the iPhone age: As mobile devices become ubiquitous, can health care finally be delivered effectively over the Internet?

Overcoming technophobia in poorly-educated elderly – the HELPS-seniors service learning program

Aging populations, increased incidence of chronic disease, technological advances, health-care consumerism, and rapidly escalating health care costs are driving health care into the home. Advances in the miniaturization and portability of diagnostic technologies, information technologies, remote monitoring, and long-distance care have increased the viability of home-based care. The ability of older adults to use e-health tools is a critical issue, because such tools could effectively enhance medical care for this population. However, fear of technology is more prevalent among older generations who did not grow up with computers, complicated acronyms or digital games. This paper introduces the Health Education Learning Program with Science for seniors (HELPS-seniors) program, which encourages subjects to use new self-management tools for technophobic elderly people. We then explain how to integrate HELPS-senior into a health professional service learning program, and how to train students to become empathetic and smart health promoters. The present findings support the development of service-learning projects within medical education to overcome the technophobia among the elderly.

Framing choice: The origins and impact of consumer rhetoric in US health care debates

This paper examines the origins of consumerist discourse in health care from a communication perspective via a historical textual analysis of health writing in popular magazines from 1930 to 1949. The focus is on Consumers Union's Consumer Reports and the American Medical Association's lay health magazine, Hygeia. Findings from Consumer Reports show that the consumer movement of the 1930s–40s staunchly advocated for universal health insurance. Whereas consumer rights language nowadays tends towards individual choice and personal responsibility, consumerism in health care during that era articulated ideas about consumer citizenship, framing choice and responsibility in collectivist terms and health care as a social good. This paper also illuminates the limits and weaknesses of a central tenet in consumerism—freedom of choice—by analyzing stories in Hygeia about the doctor–patient relationship. A textual analysis finds that the AMA's justification in the 1930s–40s against socialized medicine, i.e., the freedom to choose a doctor, was in practice highly controlled by the medical profession. Findings show that long before the rhetoric of the “empowered consumer” became popular, some patients exercised some choice even in an era when physicians achieved total professional dominance. But these patients were few and tend to occupy the upper socioeconomic strata of US society. In reality choice was an illusion in a fee-for-service era when most American families could not afford the costs of medical care.

On the adoption of personal health records: some problematic issues for patient empowerment

The development of electronic personal health records by independent vendors and national health systems is understood to empower patients and create a new kind of consumerism in healthcare. With more personal health information (PHI) at hand, active participation in the management of health and rational purchasing of healthcare services will be possible. Healthcare systems will also be able to contain costs and achieve sustainability. Based on a careful examination of the literature, we argue that many of the declared benefits of this technology are rather unattainable. As the boundaries between the public and private healthcare sectors become blurred and as employers struggle to reduce health insurance expenses, this proclaimed `consumer empowerment in healthcare' is an attempt to introduce a technology and a business model for centralising all relevant PHI to render them economic. We reflect on the consequences for the `empowered' user and we suggest that this new market device has to separate and individually address sufficiently issues of privacy, confidentiality and security before it can claim a place in the digital healthcare ecosystem.

Choice in Public Health Services: A Multilevel Analysis of Perceived Primary Care Doctor Choice in 22 Countries

The introduction of choice in public services, and in health services more specifically, is part of a wider movement to introduce consumerism in health care. We analyze how citizens perceive the availability of choice of primary care doctors in 22 European countries and the factors that influence their opinions using multilevel analyses and data from the European Social Survey (Round 2, 2004; 22 countries, N = 33,375). We distinguish between individual factors and structural or country-level factors. We find that perceptions of having enough choice are not influenced by the opportunity to freely choose primary care doctors, the density of doctors in a country, or the level of health expenditure. Instead, these perceptions are influenced by individual attributes, such as personal health circumstances, age, sex, location of residence (rural or urban), and level of satisfaction with the health system.

Virtua and CVS Health: Partnering Within a Population Health Delivery Model

The CHANGES ONE observes in healthcare delivery today are the result of convergence of many factors, including the rise of healthcare consumerism, with its attributes of choice, convenience, and perceived value; the dramatic increase of costly coinsurance in government-mandated insurance coverage; the adoption of new technologies, especially those for the sharing of health data and enablement of virtual patient-provider encounters; and work ethic for healthcare professionals that emphasizes work-life balance. As Denise B. Prince and Thomas Graf, MD, illustrate in Geisinger Health System's innovation journey, collaboration with business partners was needed to adapt to this convergence. Other organizations may determine that innovating on one's own is the appropriate route.Additional variables of change in healthcare delivery include a broader definition of location and segmentation into submarkets, as Scott A. Mason, DPA, FACHE, notes. Another way of saying it is that healthcare must be provided when and where the patient wants it: in retail settings, at employer worksites, and almost anywhere imaginable using virtual, telehealth technologies. Geisinger's innovation journey illustrates the honored adage that all healthcare is with the best chance for successful change occuring first in local, familiar settings before expanding it to adjacent or discontiguous settings.It is with the aid of insights from industry leaders, such as Geisinger, that Virtua, leading community-based, integrated delivery network in southern New Jersey, embarked several years ago on its retail innovation journey. The process featured hybrid model that now includes urgent care centers, which are staffed by physicians who are members of Virtua's employed, multispecialty physician group, and partnership with CVS Health, in which provides medical oversight of seven local MinuteClinic® locations. In this commentary, I highlight how the Virtua-CV S Health and MinuteClinic partnership, initially supportive of each other's retail medicine strategy, has expanded to be supportive of population health in the region.A Partnership Rooted in Values and VisionIn the fall of 2012, while attending an industry conference, an executive of CVS Health provided an overview of MinuteClinic, the retail medical clinic of CVS Health. What immediately captured Vir-tua's attention was CVS Health's willingness to partner with healthcare systems, essentially complementing-not competing with-the broad scope of services that healthcare system typically provides. These observations led to partnership agreement in mid-2013 that envisioned numerous ways for CVS Health and to work together in Virtua's threecounty market.When members of Virtua's executive team first visited CVS Health's headquarters in Rhode Island, they immediately noticed wall placard in the main lobby that listed CVS Health's corporate values: Innovation, Collaboration, Caring, Integrity, and Accountability. That list signaled to them that collaborative partnership might be possible, considering that embraces similar corporate values-Caring and Integrity, as well as Respect, Commitment, Teamwork, and Excellence. Virtua's executives also observed similarities between CVS Health's and Virtua's corporate statements on mission and purpose. CVS Health's purpose is Helping people on their path to better health, which resonates well with in terms of our mission: Virtua helps you be well, get well and stay well. The similarities between the organizations' values and missions serve as the guiding principles for working together in six major opportunities in retail medicine, bedside medication delivery, insurance product development, medication reconciliation, home infusion therapy services, and pharmacy benefits management.Retail Medicine via the MinuteClinicThe first opportunity to work together entailed Virtua's provision of medical oversight for seven local MinuteClinics, which are staffed by MinuteClinic nurse practitioners. …