As a result hardly anyone knows much about what is actually in the reform bill but that does not prevent them from having strong opinions about it. Sadly, the reforms, whatever their merits, will make the system even more complicated, the administration more Byzantine and the regulatory burden more onerous. The American healthcare system is already by far the most complex and bureaucratic in the world. We were once asked to spend ninety minutes explaining American health care to a group of foreign health care executives.
Yet the impact in hard dollars on payers is news. Not only are people frustrated, but money is being wasted. In fact, more than half of US consumers do not understand how to navigate the current healthcare landscape because it is so complex, reveals Accenture research. Health plans can save billions by helping patients navigate the system Instead of forcing people to continue to battle complexity, payers can invest in simplifying the ways consumers interact and engage with healthcare.
Literacy is not a given Accenture developed a Healthcare System Literacy Index to understand the healthcare competency levels of US consumers. This analysis reveals that 52 percent of them have low healthcare system literacy—including 33 percent with no experience and 19 percent who are novices.
Of the 48 percent of Americans who have high healthcare system literacy, only 16 percent qualify as experts. A big surprise is that many consumers with low healthcare system literacy are well educated. Forty-eight percent of low healthcare system literacy consumers completed college or hold a graduate degree.
And 97 percent of them have at least a high school diploma. Accenture analysis reveals that they contact customer service 13 percent more often than high literacy consumers do.
Consumers with low healthcare system literacy may struggle to make key decisions These interactions create a big administrative cost burden for payers. It is especially detrimental to the 26 percent of US consumers who have both low healthcare system literacy and a high need for intervention.
These are people who are more likely to have serious health conditions, including high-cost and pervasive conditions such as cancer, congestive heart failure or renal failure among others.
They also have a higher need for weekly and monthly interactions with customer service. Shift the burden off consumers. Orchestrate service options and experiences across physical, digital and emerging channels to reach low literacy consumers on their terms.
Use data insight from advanced analytics and artificial intelligence to deliver easy-to-follow programs and relevant products. Look beyond the four walls. Incentivize healthcare providers to help consumers understand and navigate their health insurance options and questions.
Integrate the use of lay navigators. Engage community members who are trained to help people manage non-clinical challenges—financial, logistical, emotional, cultural and communications.
Payers can direct the cost savings from these initiatives to new product concepts that actually make the system simpler. With iterative, test-learn-tweak development, health payers can experiment and scale the best concepts faster.6 Complexity in health. Consequences for research & evaluation Page | 6 Introduction User fee exemption for delivery and emergency obstetric care (EmOC) is a policy that has recently.
Jul 16, · The New Health Care The Astonishingly High Administrative Costs of U.S. Health Care Hidden from view: The complexity of the system comes with costs that aren’t obvious but that we all pay.
When we disassemble care into its components, translate the elements into an unbreakable code, then dribble out pieces of the encoded message bit by bit, it’s no wonder the general public sees the complexity of health care finance as some type of water torture.
The administrative costs of providing health insurance in the US are very high, but their determinants are poorly understood.
We advance the nascent literature in this field by developing new. Considering complexity in healthcare systems. In short, the distributed and fairly structured organization of health care settings makes the functional decomposition approach viable.
As with any research approach, there are potential disadvantages to functional decomposition. the challenge of complexity in health care. BMJ, ( Drawing from a literature largely from outside health care, the authors discuss the roles of self-adjusting and interactive systems to manage the interdependence between clinical practice, information management, research, education, and professional development.