Patients Lowering Health Care Costs

For the past decade, health care has been in the forefront of economists and policy-makers. In a system that currently spends 17% of GDP on health care, and projected to increase by 5.8% yearly until 2020, it’s no secret to the average American that health care is going through major changes, both at state and federal levels. Meaningful Use, a set of policies intended to increase #HealthIT adoption, initially focused on ensuring adoption by practitioners and health care providers across the nation. With MU Stage 2 on the horizon, the ONC has now added a focus on the patient, giving patients the ability to gain timely access to their data. I have confidence that future stages (3, 4, etc), will only build on this framework to include the patient as a principal actor in the heath care process.

From a health policy standpoint, the patient has been largely ignored in the health care equation. Since the financial contribution of most patients is minimal, the role of the health care consumer has fallen out of sight. Most new proposed laws and reforms attempt to fix problems by reducing reimbursements and increasing adoption of technology to improve processes and lower costs. Yet none of these regulations include the patient in the cost-reduction program. This post promotes the patient as an important player and decision-maker in the health care process. So how can the patient help decrease health care spending?

1. Patients have the ability to choose wisely

Contrary to what Dr. Jon Cohen (CMO of Quest Diagnostics) mentioned during his TEDMED speech, my belief is that patients have the ability, time and desire to find the best quality at the best price. While agreeing that quality cannot necessarily be quantified via cost, quality does not always reflect in cost. Perhaps the greatest example of patients taking the lead in cost reduction is this recent post in ePatient Dave’s blog about his search for a CT follow up exam. Cost reductions at an individual level (over 50%?!) could potentially have impacts at state/federal levels. Now this obviously does not apply to pre-negotiated rates that insurance companies/medicare/medicaid have already. On this point, I’m more referring to high deductible plans and INDIVIDUAL savings.

2. Patients are the source of health care spending

It amazes me how few times the patient is mentioned in regulations when it is the PATIENT who consumes health care services, and it is the PATIENT who brings about spending. Yet the patient has little power at determining what their INDIVIDUAL contribution to spending is. For the patient, it’s all a big secret.

3. Preventing disease helps reduce health care spending

Is this beating a dead horse? Well, even if it is, I have to mention it again. Preventing disease leads to preventing health care costs. Not a hard concept to understand, yet a hard concept to implement. When was the last time that the average American accessed a health journal to gain knowledge on disease prevention? I’m willing to put money on never. We’ll search for cures for our ailments, but we won’t search for ways to prevent illness.

The blame doesn’t necessarily sit only with the patient (or pre-patient). There aren’t a lot of resources available to the population at large to start making good decisions. Of those resources in existence, most are not intuitive, hard to use, and even harder to understand. Just check out choosemyplate.gov…the last time I checked out that website, I went cross-eyed and started getting motion sickness.

4. Empowering patients with access to their data helps reduce medical errors, improving outcomes and decreasing costs

Medical erros cost billions of dollars a year (check here). For the minor medical errors (like incorrectly documented allergies, demographics, physical features etc), patients are the #1 source for correction and patient interventions (or patients taking control of their data) have been documented many-a-times. In these cases, patients can not only reduce costs of health care, but can also reduce the chance of injury for themselves…now that’s a 2-fer.

The talk of the town now seems to be the Accountable Care Organizations (ACOs) that are now sprouting due to health care regulations (again, taking the patient out of the equation). What if there were Accountable Patient Organizations (APOs)? Much like the ePatient movement, what if we had organizations dedicated to educating patients and keeping patients accountable for their health? Moreover, what if we engaged the population and encouraged individual heath accountability, even before spending/disease occurs?

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