Healthcare consumerism is a topic which has been discussed for years. It is defined as putting economic purchasing power and decision-making in the hands of participants – you – and supplying information and tools to make informed decisions which encourage engagement in altering health and healthcare behaviors.
In simpler terms, the intent of healthcare consumerism is for each of us to have the information and tools to make informed decisions about our own healthcare. To accomplish this, consumers need to have a choice in healthcare networks, providers, services, etc.
The rise of narrow networks – employer health plans which offer individuals fewer choices – has prevented consumerism from occurring. If you only have one healthcare network to choose from in your health plan and/or your benefits plan strongly de-incentives you from using a particular network, you have just lost your freedom to choose (i.e. you don’t have healthcare consumerism).
While these types of narrow networks are good for employers because employers are continuously seeking methods to control healthcare expenses, they remove choice for you – the consumer. On top of this, we all know that healthcare costs rise virtually every year. They increase for employers, individuals, everyone; which is unfortunate.
One example is maternity care. Moms build relationships with providers over years of care as their families grow. When health plan’s change and exclude these trusted providers or networks, new providers must be found. This can be stressful for expectant moms to find new maternity care mid-pregnancy and for children to switch from trusted pediatricians.
Fortunately, through extensive efforts and collaboration, Holy Family Memorial is now a preferred plus tier provider in the Manitowoc County health plan. This means Manitowoc County employees and families can now achieve healthcare consumerism. The County provides a great example of an organization seeking to achieve healthcare consumerism, and providing tools and information to its employees so they can make informed healthcare decisions.
The result of consumerism should be more choices for individuals/families, improved health and healthcare for individuals/families, and ultimately lower healthcare for both individuals/families and organizations.
When comparing Manitowoc County to other counties in Northeast Wisconsin, narrow networks have been more prevalent in Manitowoc County for some reason. Despite the continued rise in healthcare costs, employers in other counties have been reluctant to go this route. They have continued to offer choice to employees, promoting healthcare consumerism. As an employer, Manitowoc County is leading efforts in our community to bring back healthcare consumerism.
We all know how complex healthcare is. Efforts to collaborate among healthcare network such as Holy Family Memorial and other networks in Manitowoc County, along with employers, health plans, government entities, and consumers is much needed. Vision 2022 in Manitowoc County presents a great example of collaboration; and healthcare is sure to be an important part of this given the costs and effect on everyone.
We look forward to continued collaboration among our community and continued leadership among healthcare networks, employers, and other entities on healthcare consumerism and other vital topics facing our County.
About the author.
David Yeghiaian is the interim vice president of strategy at Holy Family Memorial. Reach him at firstname.lastname@example.org.