How High-Deductible Insurance Fuels Momentous Healthcare Shifts

By Stewart Gandolf
Chief Executive Officer

affordable healthcare warning signAlthough the Affordable Care Act (ACA), in its final, amended version, has been the law of the land for slightly more than five years, the industry-shaking consequence of “healthcare reform,” continue to emerge almost daily.

There have probably been more significant changes in the nation’s healthcare delivery system—for providers, hospitals, employers and health insurance—between 2010 and today, than in the preceding decade or two. And about the only certainty going forward is that little is settled, and change will continue to be the order of the day.

That said, highly significant trends have emerged, and they are changing how we do things in medicine and marketing. Further changes notwithstanding, hospital and health care administrators and communications professionals need to monitor these shifts closely.

High deductibles are reducing patient compliance. In the rollout of ACA (also known as Obamacare), the individual consumer (previously referred to as the patient), is expected to shoulder more of the costs for medical services. And many consumers opt for high-deductible coverage as a tradeoff for lower premiums.

What’s more, this trend among consumers with high deductible plans emerged ahead of the ACA. According to a RAND Corporation study, “while such plans significantly cut health spending, they also prompt patients to cut back on preventive health care.

“Among those with high-deductible health plans, spending was lower on both inpatient and outpatient medical services, as well as prescription drugs.”

Middle class patients are cost-conscious and reluctant buyers. Handing a greater share of cost to patients has caused a tightening of both the purse strings and care. “[Healthcare] costs are crippling the middle class,” reports USA Today in an in-depth report. “Rather than pay so much out-of-pocket, many skip checkups and scrimp on care.”

The publication cited a Commonwealth Fund survey that found “four in 10 working-age adults skipped some kind of care because of cost, and other surveys have found much the same.”

One such previous study by Thomson Reuters, reported in ManagedCare, found that “an increasing number of patients are postponing medical care because of cost, and that includes people with high deductibles. Among those that postponed or canceled care, 24.1 percent cited cost as the primary reason.

“One in five US households postponed or canceled medical care during the prior year, up from 15.9 percent in 2006, when the survey last addressed this problem. The majority of postponed services (54.7 percent) were for physician visits, followed by imaging (8 percent), non-elective procedures (6.3 percent), and lab or diagnostic tests (5.7 percent).

The bottom line for health care providers…

Market forces, including the ACA and the less-than-robust economy, are applying downward pressure on middle class and high deductible coverage patients. And informed patients who do seek care are increasingly questioning costs and seeking the greatest value in their healthcare spending.

There’s no simple solution, and change will continue. In the face of these trends, however, marketing, advertising and other outreach efforts are still reliable tools to engage prospective patients, open communications channels, and reinforce the preventive care and compliance.

In addition, physicians increasingly need to shape expectations and to communicate patient benefits, affordability and good value in healthy decisions for themselves and their family members.

For more on this topic, see related reading:

Stewart Gandolf, MBA

Stewart Gandolf
Chief Executive Officer at Healthcare Success
Stewart Gandolf, MBA, is Chief Executive Officer of Healthcare Success, one of the nation's leading healthcare and digital marketing agencies. Over the past 20 years, Stewart has marketed and consulted for over 1,000 healthcare clients, ranging from practices and hospitals to multi-billion dollar corporations. A frequent speaker, Stewart has shared his expertise at over 200 venues nationwide. As an author and expert resource, Stewart has also written for many leading industry publications, including the 21,000 subscriber Healthcare Success Insight blog. Stewart also co-authored, "Cash-Pay Healthcare: Start, Grow & Perfect Your Cash-Pay Healthcare Business." Stewart began his career with leading advertising agencies, including J. Walter Thompson, where he marketed Fortune 500 clients such as Wells Fargo and Bally's Total Fitness.



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