Implications for Consumer
Engagement in National Health
Reform: Cautionary Tales and New
Opport nities
Opportunities
Marilyn
y Moon, Ph.D.
Vice President and Director, Health Program
June 29, 2010
Health Reform – A Movement
T
Toward
dV
Value-Driven
l
D i
Health
H lth C
Care



Reforms insurance system


Requires quality reporting and advancement
Promotes innovations
Funds research and establishes knowledge
centers
Fortifies patients’ roles as partners in care
Health Reform Will Require Consumer
Engagement to be Successful



Choose among health plan options




Hold providers accountable
Respond
p
to “value based” p
purchasing
g and p
plans
Understand evidence-based findings and
implications for changes in care
Monitor security of personal health information
Seek p
preventive care
Practice healthy behaviors
H lth C
Health
Care C
Consumer Needs
N d








Access
Meaningful
g information
Resources to act
Social and emotional support
Confidence
Time
Assurances of privacy and security
Transparency
Challenges to Consumer
E
Engagement
t


System complexity


Communication barriers

Changes to traditional employer-employee
relationship

New concepts
p to consumers
Proliferation of information and information
sources
Changes to traditional provider-patient
relationship
Effect of Health Reform on
C
Consumers
Will Vary
V

Differential impacts on consumers based on

Education

Income

Culture

Skills

Familiarity with system

Confidence

Advocacy
Patients Have Beliefs That Challenge
Key Goals of Evidence-based Health
Care
Patients believe:
 More care is better
 Newer care is better
 More costlyy care is better
 Their physicians know best
 Treatment
ea e dec
decisions
so sa
and
d
health care quality should
not be discussed in terms
of costs
““I don’t
’ see how extra
care can be harmful to
your health
health. Care would
only benefit you.”
“Because if you’re
“B
’ going
i
to have a doctor that’s
better he
better,
he’llll charge
more.”
Patients Are Unfamiliar With Key
Tenets of Evidence-based Health Care
 Unfamiliar
U f ili with
ith th
the tterms

8
“medical evidence,”
quality guidelines
guidelines,” and
“quality
“quality standards”
Only 49% said they had
heard about medical
research and only 34%
had ever had a physician
discuss the topic with
them
“Of
Of course my doctor uses
evidence-based medicine.
He makes decisions based
on the available evidence—
things like my test results
and medical history
history.”
Facilitators for Consumer
E
Engagement
t

Tools




State Health Insurance Exchanges
State websites to aid consumer decision-making
Quality reporting
Innovations




Demonstration
D
t ti projects
j t
Health Home innovations
Meaningful use
Telehealth
e e ea t
Use Approaches and Venues
A
Appropriate
i t to
t Audience
A di
 Need
N d tto fifind
d outt where
h
people
l gett
information
 Develop user-centric materials
 Adapt materials to site
 Be aware of cultural sensitivity
 Use multiple contacts
 Incorporate perspective of friends and
family