Unbiased Analysis of Today's Healthcare Issues

What does “value” mean to patients?

Written By: Jason Shafrin - Jun• 05•17

There are numerous value frameworks being developed by an alphabet soup of organizations including ACC/AHA, ASCO, ICER, MSKCC, NCCN, and others.  These organizations generally represent providers or payer perspective on value.  But what does “value” mean to patients?

The National Patient Advocate Foundation (PAF) provides their thoughts in a recent white paper titled “The Roadmap to Consumer Clarity in Health Care Decision Making: Making Person-Centered Care a Reality.” PAF conducted a series of focus groups as well as a survey of over 1,600 patients on the topic of what value means to patients. The report’s key findings are below.

  • “Value” means having a patient/provider relationship in which the physician shows respect, interest, care and compassion, and is accessible and responsive. This “value” definition holds true across patient groups, regardless of age, disease type, cultural and ethnic background, health literacy and insurance status.
  • Patients attach great importance to the provider-patient relationship. They want physicians who acknowledge them as individuals, are open and honest and are good listeners. They also respond to truthful and empathic communications, even on difficult topics.
  • While the physician remains at the center of the relationship, patients value relationships with their entire treatment team. Many members of this team play key roles in providing person-centered care. Their contributions, demeanor, and knowledge are very important.
  • The provider-patient relationship has an important impact on health care outcomes, affecting key areas such as adherence and decisions about treatment options.
  • Both direct and indirect costs play a key role in decision making and need to be incorporated into communications between providers and patients

Some additional excerpts from the report on patient-centered care are below.

Patient centered care and utilization

Physicians who are not patient-centered (i.e., have poor relationships or communication, or lack empathy) order more tests, hospitalizations, prescriptions and referrals.

Patient-physician communication.

Fewer than half of patients believe their clinicians understand their goals and concerns, and many people who are seriously ill say their medical care is not aligned with their preferences. Nearly half of the time when doctors say they discussed prognosis and likely outcomes with patients, their patients say there was no such conversation.

Economists on patient centered care

While basic consumer theory asserts that paying for value requires measuring what actually matters to patients, most current quality metrics refer only to professional standards without reflecting what individuals want. As the well-known economist Michael Porter noted: “Value should always be defined around the customer, and in a well-functioning health care system, the creation of value for patients should determine the rewards for all other actors in the system.”

Use of a “navigator” in health care and other markets

A navigator who represents the consumer’s best interest is a common feature in other markets with similar complexity like real estate, law, investments, and even mountaineering; however, a robust health IT platform that facilitates and automates the care coordination activity is the most likely means by which to scale the coordination of care efficiently and effectively

Do read the entire thing, interesting throughout.

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