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Scott Shreeve, MD

Hey there!

I'm the CEO of Crossover Health, a patient-centered, membership-based medical group that is redesigning the practice, delivery, and experience of health care. We offer urgent, primary, and online care to our members who can access our technology platform, practice model, and provider network from anywhere and anytime to optimize their health. Email Me



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Who’s Driving?: Consumer Empowered Healthcare

Empower (ĕm-pou’ər)
  1. To invest with power, especially legal power or official authority.
  2. To equip or supply with an ability; to enable.

I am attending The Consumer Driven Health Care Conference this week in Las Vegas (I also stopped by for a few minutes at the Healthcare Blogging Conference as well). It is great to see that an entire industry is springing up around how to help consumers more fully engage in the healthcare process. I look forward to an immersive experience.

As you are aware from my blog, I believe that words are important. I believe that words can efficiently communicate or effectively obfuscate (ie, Bill Clinton wordplay). While I am excited to see the “consumer driven” movement taking off, I believe that the term is inaccurate and does not correctly relay what I believe is the essence of the movement.

Consumerism is a natural response to the heavy handed financial tactics and decades of disempowerment of the “third party payer-physician knows bestmedicoindustrial complex. However, the ability for consumers to “drive” healthcare is an oversimplification of the potential impact. Consumers can and should be actively involved in their healthcare, but there ability to decipher the latest medical literature, treatment protocols, or long term implications of medical decision making is limited (but still important!). A crisp delineation of these limitations from RHC:

How can we expect consumers to navigate the system when the doctors can’t do it? Consumers cannot offset or counteract the dysfunctional competition in the current system. They cannot direct their own care in a system with fractured care cycles, constrained networks, and prices that depend on who is paying rather than on what care is being delivered. Without results information and competition centered on improving results at the medical condition level over the care cycle, consumers will not be able to identify good value or make good choices about necessary services. Shifting more of the financial burden to the consumers (through higher co-pays or HSA’s) will not transform the system. Instead, they run the risk of cost-shifting in the guise of “empowering the consumer,” and skimping on “discretionary” preventive or disease management services but not acute care.

Because of these challenges, the consumers ability to “drive” healthcare change is limited. However, as you begin to think about consumers as “partners” or “catalysts” of change, I think we can more appropriately begin to see the consumers role in the reform process. Again from RHC::

Health care is a service in which physicians and patients are co-producers. Consumers need to participate actively in managing their health through lifestyle choices, obtaining routine care and testing, seeking excellent providers, complying with treatments, and active participation in disease management and prevention. Consumers need to be the front-line participants in their health and health care. Even in today’s flawed system, studies show that informed and involved patients tend to choose less invasive (and thus less expensive) treatments, have better results, and better compliance with medical instructions. These observations underscore the potential for all participants to benefit from a value-based positive sum competition.

As a result, I believe describing the consumer movement as one of “Consumer Empowerment” is much more descriptive, appropriate, and accurate. As you read the above description of a recommended role for Consumers, you clearly see words like “management”, “choice”, “seeking”, “front-line”, “informed”, and “active participation”. Consumers need to be given information in order to make rationale healthcare decisions. The information that is required to make rational healthcare decisions includes pricing comparisons, outcomes results, quality indicators, and patient satisfaction. While this information is often available, it is often incredibly difficult to find, may be unreliable, and is not in a consumable format.

Hence, the opportunity for companies to leverage technology and information to aggregate, analyze and advise consumers on how to make rational healthcare decisions. I believe that THIS is a role for companies who operate within the Health 2.0 paradigm (companies that use enabling Web 2.0 technologies to leverage business opportunities afforded by the current healthcare reform initiatives). I believe a primary objective of these companies is to equip or supply (ie, “empower“) the consumer with value added information that helps them make better choices regarding their health.

Empowering consumers with the information required to make rational healthcare decisions is an enobling, enabling, and an enlightening pursuit. Companies who empower consumers in this way will be able to continue to drive the reform conversation.

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