Top Trends in Consumer-Driven Healthcare

How familiar are your practice’s strategic thinkers with these five emerging trends?

Medical tourism

As the price of elective procedures soars, and as employer contributions to healthcare coverage drop in the United States, increasing numbers of U.S. citizens are seeking medical care in foreign lands.

Popular destinations include Thailand, India, Costa Rica, Malaysia and South Africa. Typical procedures include cosmetic surgeries, joint replacements, elective coronary artery bypass grafts and heart valve replacements.

According to Wikipedia, the average cost of rhinoplasty in the United States is $6,000; the same procedure in Costa Rica costs $1,500. A $200,000 heart-valve replacement in the United States costs about $10,000 in India, and a $20,000 facelift in the United States runs for about $1,250 in South Africa.

With savings like these, the recuperating patient can well afford a destination vacation!

Critics complain that there is no quality oversight, although proponents quickly counter that many foreign hospitals are achieving accreditation through Joint Commission International (JCI) — the international arm of the Joint Commission. Proponents also say that many foreign physicians have received postgraduate training in U.S. academic medical centers.

Several large U.S. insurers are now looking into providing coverage for these procedures under certain circumstances.

Retail clinics

Check out your nearest Wal-Mart or CVS pharmacy. You may be surprised to discover a clean, shiny, brand-new retail clinic. Not for nothing are these known as “convenience clinics.” Providing handy access to shoppers who need a little tune-up and serving as excellent feeders to the well-stocked shelves of the pharmacy or supermarket, these clinics are booming.

They are typically staffed with mid-level providers under the more remote supervision of physicians, and provide care using well-defined guidelines for uncomplicated, common illnesses.

What is particularly attractive to consumers is that prices are prominently displayed and the consumer can calculate exactly what the visit is likely to cost.

These retail clinics have also caught the eye of large insurers, who are beginning to cover these visits.

Corporate Wellness Programs

Big business is waking up to the fact that the health of their employees matters! Companies and larger organizations are making substantial investments in wellness programs designed to positively impact employee health behavior, thereby reducing overall costs.

Be they weekly or monthly clinics, an on-site physician or nurse practitioner office, brownbag educational luncheons or online health portals, it appears that corporate wellness programs are here to stay.

e-Health

Health and wellness blogs, communities and forums, content-rich sites, social networks — you name it! The Internet plays a significant role in the daily lives of the U.S. population.

It’s been estimated by the Pew Internet and American Life Project that 73 percent of adults use the Internet on a daily basis (May 2008) and of those, three quarters used it for health-related purposes.

One issue of concern is the quality of information, so several initiatives are underway to improve it:

According to a July 2008 Los Angeles Times article, “Internet entrepreneurs are teaming with doctors, researchers, and other medical professionals to create the Web’s largest body of health information. Modeled on the online encyclopedia Wikipedia, but written and edited only by trained professionals, the Medpedia Project will gather knowledge usually confined to academic circles but make it understandable and available to consumers.”

Consumer Driven Health Plans and HSAs

Consumer-directed health plans (CDHPs) are a type of health insurance that gives consumers more responsibility for managing their healthcare spending. Health savings accounts (HSAs) allow individuals to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis.

The idea behind CDHPs and HSAs is to increase consumer engagement in making health-related decisions. According to a 2005 report from McKinsey & Company, they seem to be working:

“In comparison with the traditionally insured, the CDHP consumers were:

• 25 percent more likely to engage in healthy behaviors

• Over 20 percent more likely to say they would participate in company sponsored wellness programs

• Over 30 percent more likely to get an annual check-up because they thought it would save them money in the long run.

• Over 20 percent more likely to follow treatment regimens for chronic conditions very carefully

• Twice as likely to inquire about drug costs.”

The creative business owner is already thinking about the implications of these trends for their company. How does your organization plan to respond?

Philippa Kennealy, MD, MPH, CPCC, PCC, is a certified physician business coach with The Entrepreneurial MD. She helps physician entrepreneurs thrive in business, and can be reached at www.entrepreneurialMD.com or philippa@entrepreneurialMD.com.

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