In a health care landscape that is struggling to catch up to how information technology, comparison shopping, and rising expectations are injecting consumerism into health care, these researchers shed light on how different populations of consumers are navigating the resources available, benefiting from the information, and revealing new gaps in the system.

Dr. Linda Weiss, Director, Center for Evaluation and Applied Research, The New York Academy of Medicine (the Academy), spoke about the Academy’s New York State-funded report, “Consumer Perspectives on Health Care Decision-Making Quality, Cost and Access to Information.” The report was based on a series of statewide focus groups of commercially insured patients conducted to inform the State’s transparency efforts. Regarding cost information, she shared that, in general, these patients were interested in finding out whether their provider was in-network or out-of-network, whether a service was covered, and what their bill might be, but that they were less likely to use the information to comparison shop. When asked about health care quality, consumers responded more to the experience, such as office environment, rather than the type of process measures on which providers are often evaluated. Consumers also cited the importance of information to help assess whether they would be treated with respect. For example, focus group participants of diverse racial or ethnic backgrounds expressed a shared interest in seeing a photograph of the physician when seeking a new provider as a way to gather information that would help them avoid past experiences of disrespect or discrimination. The Academy plans to do similar research on populations with specific health care needs.






Dr. Parie Garg of Oliver Wyman talked about a Robert

Wood Johnson Foundation-funded study, conducted by Oliver Wyman and the Altarum Institute, which looks at how health care information is accessed and used by vulnerable populations. The study examined whether the resources and tools currently available are responsive to the needs of vulnerable populations. Similar to the Academy’s research, the study found that the interpersonal connection and protection from potential discrimination were the most important factors in choosing a health care provider for vulnerable populations. For example, the research also found that vulnerable population seek out photos of a potential provider as an indicator of warmth, bedside manner, and likelihood of patient respect. Vulnerable populations, especially the Spanish-speaking population, rely heavily on referrals from friends and family to choose a provider and to assess the quality and trustworthiness of that provider. Facilities that hired people from the community were often deemed of higher quality by the low-income populations living in those communities. Finding ways to objectively measure a provider’s communication skills and respect for diverse patients were echoed throughout Dr. Weiss’ and Dr. Garg’s presentations. Both researchers highlighted that current sources of information on patient experience and treatment are not at the individual physician level. The Oliver Wyman research also included interviews with hundreds of health care stakeholders (payers, providers, technology innovators, employers, and state government representatives) to understand how these decision-makers are thinking about health care information and the needs of the marketplace.

Dr. Paul Howard, Director and Senior Fellow for Health Policy, Manhattan Institute for Policy Research, opened his presentation with the following question: what do we want consumers to do with information? That answer should drive the type of information being made available. He suggested that injecting more consumerism into the system has the potential to induce more market competition and drive use of higher-value networks. He highlighted how patients already have “skin in the game,” as they are the ones who bear the cost of medical errors and complications, regardless of what they pay out of pocket. Dr. Howard then discussed a current NYHealth-funded project related to patient-generated reviews of health care providers on sites such as YELP. Dr. Howard is looking at Yelp reviews and ratings of New York State providers and analyzing how patient experiences may align with objective clinical quality metrics.

Questions and comments from audience members noted that it is very hard for people to find price and quality information, and that many consumers (and doctors) do not know such information exists, so more needs to be done to market and promote these resources to consumers, as well as to educate providers.

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