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The Reimagined Healthcare Consumer Can Democratize Healthcare

democratize-healthcare (Demo)

Insight by: Debbie Lin

The pandemic has shifted the motivations and expectations of consumers more rapidly than ever before. Consumers today are reimagining how they choose products. Today, the reimagined consumer makes purchasing decisions based on factors beyond price and quality. Importantly, features such as ease and convenience, health and safety, demonstrated product origin, service and personal care, and trust and reputation, weigh heavily on purchasing decisions.

In healthcare, consumers (patients, healthy individuals and caregivers), barely have choice. Lack of transparency, complexity and convoluted pricing of healthcare products limit educated decision-making. Consumers are not able to choose based on basic criteria of price and quality much less, other features. The recent increase in digital health product development and utilization and changes in regulations is giving healthcare consumers more power to make real purchasing decisions.

A vast shift occurred during the pandemic. Healthcare consumers adopted and embraced the use of Telehealth services. Prepandemic, consumer use of Telehealth services was 11%. Now, Telehealth utilization has increased across specialties. Utilization is upwards of 27% in both Medicaid and Medicare populations. Consumers are demonstrating the power they have to transform healthcare through sheer motivation, demand, and changing expectations. Furthermore, on the regulatory side of things, starting July 1 2022, as part of a Trump-era price transparency rule, most insurers must post price information for covered items and services. Similarly, the hospital price transparency rule went into effect January 1, 2021.

As a result, innovators in areas besides Telehealth are stepping up to the plate to give consumers more choice through added service options and pricing data transparency. There is  growth in digital front doors for discount pharmacy (i.e. GoodRx), women and men’s health (hims & hers), and fertility services (i.e. Maven and Ro’s acquisition of Modern Fertility). Startup companies such as Turquoise Health and Ribbon Health are not only ingesting pricing data into their platforms to generate insight but also translating it for consumer use. Consumers are responding with increased demand. As an example, large employers are responding to the demand by increasing coverage for fertility benefits by 8% year over year.

We, as individuals, patients, and caregivers, are inching closer at having a range of choice and full information transparency to make healthcare purchases. Our recent appetite for innovation for healthcare products and services coupled with changes in regulations gives me hope that we can push the industry further to create a marketplace that is truly competitive at the consumer level.

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