What If Consumer Choice Came To Be?

About half of all patients are gathered up into groups and offered, so to speak, to providers. By buying in bulk, the theory goes, providers will discount prices in return for patient (and cash) flow.

It’s kind of worked. Patients with private insurance are going to be assigned to some sort of network of providers from which to choose. The patient can leave, but there is a high “switching cost” for doing so.

For physician practices, the first priority is to be in the right networks – or enough networks – to generate the patient flow. For new practices or for physicians joining a practice, there can be a delay in getting into a network, or even a wait list.

In the current model, employers choose the networks, through their choice of health insurance option(s) offered to employees (if any, but we digress). But what if this changed – what is the consumer had a voucher, and they could choose from a selection of plans (networks), the way federal employees and some large company employees can choose?

I am not alone in the belief that the US will move to universal coverage in the next 4-5 years. It is likely to be a choice of plans, starting with a “basic” plan, which will be the default for those who don’t select one or who are covered, in whole or in part, through the government system.

Most consumers, then, would be in a position to choose a plan and a network. My wife works for an employer where we have a choice of plans. When she first went to work for them, we had to sit down and compare which of our physicians were in which plans, and then decide: which physicians will be drop in order to stay with another physician? Change pediatricians or internists?

Which is where you come in. Your attention for marketing purposes will be as much, if not more, targeted to the consumer than to the insurance plans. Your goal is to be a “practice of choice” when patients make decisions on health plans, and at the second stage when they call for an appointment.

Consumer choice is likely to be part of the universal coverage system that will be enacted in the US. This will mark a shift in the dynamic, where the patient will be more open to a marketing approach from physician practices. This is a time to be creative, perhaps working with other groups on patient education and prevention programs that will benefit. Every fall, I climb up on my bandwagon to promote “vaccine day” – if the local drug store can do it, so can (and should) you. In short – look for ways to engage your patients and community and build relationships.

The evolution of healthcare in the US is evolving in some interesting ways, and we will certain major changes in the coming few years. The shift to truly portable health insurance, even where employers step in, will put more decision making in the hands of consumers. From a business perspective, position yourself front and center to the patients.