In continuing to discuss the cost of healthcare and its sustainability, we must analyze consumer behaviors and dissect the role they play. For many reasons, healthcare will never be a legitimate market-driven business, nor should it be because it involves important social dynamics. However, there are several aspects of a consumer-based market that are applicable.
Shared decision making implies that providers and patients (consumers) are partnering together for the best interest of the healthcare recipient. These conversations, containing multiple levels of complexity, require comprehending and understanding the risks and benefits of all treatment options.
The value of shared decision making would be remiss without also discussing the cost of treatment. It is paramount that the consumer have appropriate voice in this conversation. Typically, outside of healthcare, it is common to ask about a price or obtain a cost estimate when shopping for a service or product. Gathering these answers alerts the consumer to the financial expenditure of the product or service and plays a part in the eventual decision of whether to purchase the item. When posed with an unexpected cost event such as a car repair, I want to know the estimated cost and my options before deciding on what I will ultimately do. In making my decision, I ask questions and discuss options with the mechanic before proceeding with the suggested plan of action. During this interaction, I am actively participating and contemplating my choices and the impact of the unexpected cost and how I will manage the situation. I understand that I am not the subject matter expert, but I none the less feel the importance of the conversation.
Similarly, we also know that at some point, we will have a medical expenditure. How we economically prepare should be within our financial planning. When one looks at the recent literature on consumer behaviors, 40% of those studied had saved for future health services. Whereas, only 25% of those surveyed discussed the cost of treatment with their provider. Of those surveyed, 14% compared prices, 14% compared quality and 6% stated they attempted to negotiate a price. These discussions occurred more often for prescription and outpatient services than any other healthcare service.
In discussing shared decision making, the statistics on the lack of conversation regarding cost is most fascinating. Without such conversations, the patient/consumer is unprepared to make decisions or to prepare themselves for the impending financial implications. The consumer plays an incredibly important role in driving these conversations. Exchanges regarding the cost of services enhance the healthcare ecosystem’s focus on providing such information. If people do not ask, the problem of delivering this information will remain unsolved. Demand for pricing information will allow transparency in communications and better partnerships in shared decision making.
Responsibility for our present healthcare dilemma falls into the hands of both the providers and those they serve. Financial conversations are a component that is needed by both parties. We must embrace these dialogues and help our constituents understand the importance of this consumer behavior. Progress towards improvement in quality and cost will require many adjustments, including the financial situations of those we serve.