Consumer-driven health plans (CDHP)

The healthcare industry isn't exactly known for its attention to customer service, but with the advent of consumer-driven healthcare, providers can't afford to run a practice that doesn't impress patients. That's why some physicians have turned to "mystery shoppers"--paid employees who pose as patients and evaluate the quality of the service they received. Mystery shoppers are commonly used in the retail and hotel industries, but using their services in the healthcare industry is a fairly …

Retail clinics--nurse practitioner-staffed medical centers that are less expensive than regular doctor visits--began popping up five years ago in such stores as CVS, Wal-Mart and Walgreens. Now traditional medical providers are taking notice of retail health clinics and even throwing their hats in the ring in order to protect themselves from competition. Some health systems have staffed their own clinics, signed contracts to oversee clinic staff or set up referral systems with the …

Payers want good outcomes at low cost, but what do patients want, asks Kaveh Safavi, M.D., chief medical officer of consulting firm Solucient. In this article, which originally ran in the Journal of Healthcare Management, Safavi observes that patients expect good outcomes the way they expect safe plane travel, and they measure "good" performance in terms of doctor-patient communication and responsive nurses. In consumer-driven healthcare, non-technical criteria will take a front seat--but you have to have good outcomes, too. Article

One major symptom of consumer-driven healthcare's emergence: No-wait clinics in drugstores and other retail settings are drawing the attention of the mainstream business press. This BusinessWeek piece focuses on the recent acquisition of MinuteClinic, the largest provider of such services, by pharmacy chain CVS. Wal-Mart, Rite-Aid, Walgreens and Osco are also getting into the act with other clinic providers. Waiting 15 minutes for a flu shot--instead of days or weeks--sounds good to an increasing number of consumers. Article

In Working Knowledge, an online publication of the Harvard Business School, faculty member and consumer-driven healthcare crusader Regina Herzlinger makes a case for consumer-driven Medicaid, using a proposed plan from South Carolina as a model. She argues that a consumer-driven Medicaid plan would improve service to beneficiaries who may otherwise face long waits and indifferent treatment thanks to low Medicaid reimbursement rates. Article

At some point, most doctors to deal with know-it-all patients who actively seek to inform themselves about their health issues and aren't afraid to question their physician's decisions. When physicians are willing to open a dialogue with patients, patients often experience better doctor-patient communication. But despite some people's willingness to do what it takes to learn about their health (an encouraging sign for supporters of CDHP), it's important to note that the information …

In a move that fits the growing trend toward consumer-driven healthcare, Maryland has expanded its state guide to hospitals to include price comparisons on many procedures. Officials hope that by allowing consumers to compare procedure prices, they will make more cost-effective decisions. They also hope to include more information on hospital quality. For example, the new guide lists often each hospital used antibiotics to prevent infections among hip, knee and colon surgery patients. …

Press Ganey released a patient satisfaction study that finds that the gap between the best performing hospitals and the worst performers in many measures of patient satisfaction is growing. At a time when many consumers are joining the consumer-driven healthcare revolution--or at least thinking more about their healthcare choices--this is, of course, noteworthy.

Here are a few interesting details drawn from the executive summary. Smaller facilities with 50 beds or less tend to have …

> Watts Health Foundation has decided to sell its bankrupt UHP Healthcare HMO for $30 million to Care 1st Health Plan, an Alhambra-based HMO, for $30 million. The plan's 80,000 members would keep their coverage and should see little change. Article

> Stanford's Lucile Packard Children's Hospital is introducing promising new telemedicine program from Clarity systems that allows …

As the focus of the insurance market begins to shift from employers to individual consumers, insurers are changing the way they have traditionally interacted with customers. Humana is an example of a company that has been forced to "start worrying about what consumers think," according to The Wall Street Journal. But that hasn't necessarily been bad for business. Au contraire, after actually looking at how consumers interact with health plans and the information they …