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2018年3月
医疗保健 markets have been extraordinarily dynamic over the past year, with significant public policy changes implemented—or at least contemplated—at both State and Federal levels. Employers, 保险公司, and providers are trying out new ways to contain costs and improve services. 为了可持续和有效, it is essential for public policy and private innovation to be designed with the consumers of healthcare at the focus.
2018年1月，12bet官方研究所发布 递延医疗:退税如何促进医疗支出 highlighting the powerful role that cash flow dynamics play in determining when consumers get healthcare. The report focused on one of the most important cash flow events of the year—tax refunds—and found that consumers delayed care in the months before receiving their refund and immediately increased their out-of-pocket healthcare spending by 60 percent as soon as the tax refund arrived. 此外, 62 percent of the tax refund-triggered additional healthcare spending was paid for in person and represented deferred care (just 37 percent represented deferred bill payment).
关键的外卖
汇集雇主的观点, 医疗服务提供者, 保险公司, and an innovator reinforced three key takeaways for how to reduce total healthcare costs and help consumers receive the care they need 当他们需要的时候 and not just when they have the cash to pay for it.
- 关键结论1: We should focus on achieving medical adherence and behavioral change, rather than merely applying price pressures on consumers to drive behavior change.
- 关键结论2: 医疗保健 providers need to be incentivized by paying them more for better health outcomes.
- 关键结论3: 我们需要应用官僚主义程序, data, and technologies to bring down disproportionately high administrative costs in the healthcare system.
Coinciding with the report release, JPMC 研究所 President & 首席执行官, 法雷尔, led a panel discussion on the implications of these findings for 保险公司, 医疗保健服务提供商, 市场的创新者, 在第36届年度J.P. 摩根医疗保健会议. 代表这些观点的是布鲁斯·布鲁萨德, 首席执行官 of Humana; Toby Cosgrove, the former 首席执行官 of the Cleveland Clinic; 鲍勃Kocher, a Partner at Venrock; and 贝灵, the Global Head of Compensation and Benefits at 12bet官方.
J.P. 摩根医疗保健会议 Panel from left: 法雷尔, 鲍勃Kocher, 贝灵, 布鲁斯·布鲁萨德, 托比·科斯格罗夫. 2018年1月8日.
These top-of-the-line practitioners validated the report findings that affordability plays a role in healthcare utilization. 当医疗补助计划在俄亥俄州扩大时, Cleveland Clinic saw a 60 percent increase in the number of Medicaid patients and an 86 percent increase in outpatient visit but only a 20 percent increase in inpatient visits.
They also highlighted potential links between the growth of high deductible plans and consumers’ healthcare utilization patterns. As an 保险公司, Humana sees evidence of care being delayed but also care being skipped entirely. In addition to the cash flow problems identified in our study, out-of-pocket costs appear to drive consumers to skip even “high value” care, 比如预防保健和药物依从性. 不幸的是, it appears that giving consumers more "skin in the game" causes them to defer “high value” care.
As the degree of coinsurance in standard plans has expanded, the Cleveland Clinic has seen a shift in demand for outpatient and diagnostic services toward the last quarter of the year, when patients are more likely to have reached their deductibles (but no shift in the timing of demand for inpatient care).
But these outpatient services almost always reduce complications and bring down the total cost of care. High levels of coinsurance encouraged consumers to avoid using all healthcare services, 不仅仅是高成本的医疗. 这不是控制医疗成本的有效方法.
然而,, reducing total cost is crucial for ensuring that consumers get the care they need, 当他们需要的时候. Across government, employers, providers, charities, and patients—someone has to cover these costs. Shifting the burden back and forth among these players will not address the fundamental problem of affordability. 汇集雇主的观点, 医疗服务提供者, 保险公司, 和创新者, the panel reinforced a few key takeaways for how the healthcare system can reduce total healthcare costs in order to help consumers receive the care they need 当他们需要的时候 and not just when they have the cash to pay for it. We highlight three key takeaways that deserve continued attention and focus at a time when 医疗成本正在上升 and too many families do not have enough cash to weather extraordinary medical payments.