Health care as you've known it will never be the same.
It goes without saying that the health care environment is going to change. Unless you are coming out of a coma for the past few years, you know that much of the debate around what the U.S. health care system should be like stems from political philosophies, individual experiences and the reality that the historical model was not suitable from a financial perspective. Physicians, insurers, investors, elected officials and other insiders have known for decades that the model would at some point in time experience a paradigm shift.
The fact that no one seems to like the current model may actually turn out to be a good thing in the long run. However, this presents a huge problem for the immediate future. The saving grace to all of this is that before physicians start practicing medicine they take the Hippocratic Oath. The one thing that should never change in our health care system is putting the patients' needs first by the caregivers.
Philosophically, "putting the patient first" seems like a no-brainer. Unfortunately, the current and future reality of heath care makes this harder and harder to accomplish through today's care delivery channels. The future of health care is greatly dependent on balancing financial resources, continuous improvement, a highly skilled workforce and humanitarian compassion.
For decades the primary stakeholders who are involved in the delivery of health care have been able to mask much of the complexity from the most important person in the process, the patient. Unfortunately, the future of the industry is so complex now that even those within it struggle to meet all of the requirements being imposed on them. The result of this means that the majority of patients are going to struggle to navigate the system and will have less and less direct interface with the physician who wants nothing more than help the patient.
Within Acadiana, we are fortunate to have amazing health care leadership that continues to play a significant proactive role in addressing new challenges. Health care consumers are going to experience these changes - many of them driven by financial and regulatory obligations for caregivers.
In the immediate future, consumers of health services are going to experience what seems to be mass chaos. This is because forward thinking health care providers, commercial insurers, Medicaid and Medicare are all in "survival mode."
From a business perspective, they have to find a way to absorb millions of new patients into the system, migrate to electronic documentation systems and provide more information to government regulators. And all of this, along with the desire to improve patient outcomes, has to be done with fewer dollars per patient.
Anyone who has gone through a major change realizes that change is not easy and that it often takes a psychological and physical toll on individuals going through the process. Making matters more complex is much of the country remains divided on how and at what pace this incredible transformation should occur, resulting in non-productive political posturing by elected officials (from all political parties) who have ill-conceived perceptions of the health care system.
Caught in the middle of this is the health care consumer, who in all likelihood will at some point in time become a patient. As the industry continues to respond to new regulations and lower financial reimbursement, we will see older physicians opt to shutter their practice and retire earlier. The health care community already knows that there is a shortage of physicians and is increasingly embedding physician assistants and nurse practitioners into patient treatment plans.
This means that when a patient goes to a hospital or doctor's office, depending on the severity of their visit, they may not have a face-to-face conversation with their physician. Many patients may be taken back and have concerns about this, however it is important to understand that these individuals have advanced training in particular medical specialties and that their treatment plan is reviewed by a physician.
Patients who get admitted into the hospital might also be surprised to learn that their primary care physician (the doctor they go to on a regular basis) will not be "hands-on" with the treatment plan. Instead, a hospitalist will be assigned to them. The hospitalist will oversee the patient's treatment plan and coordinate with other physicians with the goal of improving coordination of care and helping to expedite when patients can be discharged from the hospital.
Obviously, shorter hospital stays should result in lower expenses for the entity responsible for paying the bill. Additionally, most patients would much rather continue their recovery process in the comfort of their own home.
Many physicians recognize that patients do not like to sit in their waiting room for hours waiting to be seen. However, due to the shortage of physicians, there is a greater demand than supply. In response to this, physician practices across the country are turning to a "premium" service offering known as concierge medicine.
In this model, patients will pay an annual or monthly fee to the physician practice to be seen within a guaranteed time and for increased time with the physician. Obviously, this model will cater to those who can afford the premium service.
With all of the changes occurring within the health care system, entrepreneurs are looking to introduce new, innovative ways to address challenges presented by these changes.
Uber, a San Francisco-based company that has completely disrupted the taxi and "black car" service in metropolitan areas, announced recently that it is going to take on health care service delivery. Uber drastically altered the taxi industry by leveraging a mobile app that connects a passenger with a car in the area at a discounted cost using a stored credit card.
Here is how it works: A person looking for a ride selects his current location in the app, all of the cars in the area see the request coming in, the first driver accepts the request and Uber uses GPS services to show the car en route to the pick-up location. Once the ride is complete, the passenger's credit card is automatically charged.
Uber plans to leverage its technology to create a "house call" service. It will build a marketplace of licensed physicians who will do house calls. Again, this will come at a premium.
The most unfortunate component of health care is the lack of coordination in billing processes. Patients will continue to see bills from multiple physician practices and will become responsible for even more out-of-pocket expenses because insurance companies will deny services they think were unnecessary. Many times patients do not have a choice in the matter, and are left with the financial obligation.
As health care consumers continue to experience these changes, they need to recognize that it is OK to question what is happening and ask who is who throughout their treatment plan. They also need to recognize that things are changing quickly, which means the people, processes and technology in place today may not be the same next week.