When it Comes to Improving Healthcare, Consumers are Accountable Too!

By | February 12, 2020

Overall, we focus a considerable amount of time and energy on physician accountability for delivering value to those we serve. However, with consistently increasing costs to the consumer, there is less conversation concerning their responsibility. Currently, there is a societal debate asking what exactly, are the duties of individuals involving their own health and well-being. Undeniably, patients’ behavior is an essential factor in their outcomes, whether that be medical adherence, dietary interventions, or engaging in risky behaviors.

Punishment occurs when patients become ill; however, that in and of itself is not enough of an incentive for behavioral modification. Financially, regardless of one’s level of health, everyone is paying the high costs in their premiums and a proportion of their taxes.

As we consider incentivizing accountability, innovation must occur concerning the behavioral dynamics of those that pay for healthcare. Although high deductible plans are an attempt to have “more skin in the game,” unfortunately, these higher costs lead to consumers avoiding care altogether. If we step back and reorient ourselves, we may design a different model.

Let’s examine the total cost of care for a given situation, including physician payments, patient costs, and other expenses related to care. This may lead us to decide to incentivize proportionately based on reducing expenditures. For example, incentivizing for medication adherence may be a combination of the physician prescribing a less costly option, where both the clinician and patient receives remuneration for an outcome based on a disease state outcome measure and compliance.

This level of accountability will require partnership efforts between physician and patient, employer and employee, and employer and provider. If our attention only falls in one category, results will be suboptimal. Provider and consumer behaviors need to align. Furthermore, it is not all about the dollars, although they do play a crucial role. Other incentives also exist, such as the vocational component for physicians and other activating factors for consumers. Unfortunately, the risk of an actual illness itself is not a strong enough motivator, since no one wakes up worrying about it. Currently, our existing payment models create a disconnect between the consumer and the purchasing of a product.

Since the present model of payment distributes the risk of inappropriate accountability across a population, society has a role in solving our current dilemma. We must have discussions at both the micro-level, but also engage in macro dynamics and interact with each other in a manner that redefines a more rational model. Regrettably we continue to look at the outer edges without examining the foundational elements. To find a better solution, let us continue to peel back the onion and embrace the root issues as we design enhanced accountability for all.