- TEDMED #GreatChallenges :? Can consumers trade Change of health insurance
Panel Participants
- Vinay Gidwaney is co-founder and product manager at Maxwell Health, Health creator as platform services, system operating for benefits. Before Maxwell Health, he was the CTO and co-founder of Control-F1, an IT support automation software maker.
- Dr. Tal Gross is assistant professor of politics and health management at the Mailman School of Public Health at Columbia University, as well a researcher of the faculty at the National Bureau of Economic Research. It focuses on the intersection of health insurance and consumer credit.
- consumer advocate and former litigator Jennifer Sclar is CEO of Clear Health Analytics. His software company, which recently won Developer Challenge Choice plan Robert Wood Johnson Foundation, helps consumers make smarter and faster decisions about their health care purchases.
- Abir Sen is the CEO and co-founder climbed, a consumer market for health care services. His new startup help individuals and businesses to comparison-shop health care in the private market. Before founding climbed, he founded four start-up health care and worked as advisor to Fidelity Investments Health and wellness businesses.
- The panel was moderated by journalist, podcaster, author and TV contributor Jayne O'Donnell. A journalist of the policy of health care for the United States today, his area of expertise is the Affordable Care Act and other health problems focused on the consumer. The Association of Health Care Journalists and the Commonwealth Fund recently awarded Jayne a scholarship to study the inner workings of Medicaid on the state level.
Key Takeaways
For many years, health insurance sponsored by employers was business-to-business (B2B). Most health insurance was purchased and sold between employers and insurers, and patients were essentially withdrew from negotiations for the price and services. Recently, however, the Affordable Care Act (ACA) has forced the industry to become more consumer-oriented. This change allows more of what experts call "insurance independence" in which consumers make their own choices and are released headaches that often accompany complex health care decisions.
In a consumer-driven market, the patient can choose to use an application or service that best meets their needs. For example, Vinay Gidwany addressed many of concierge services available to consumers, where a patient pays an annual fee or retainer for the services of a primary care physician, and the opportunity to receive a higher level of interaction personal. This option may be attractive to those who now believe that the quantity of patients see a provider replaces the quality of care received.
"[A concierge service] will actually be an advocate for you, they will get on the phone with your doctor, your payer health care, your insurance company, and talk about the best way to solve it problem, "he said.
This example consumerization can be beneficial in many ways, but it also has disadvantages, in particular regarding data quality and technology available to the consumer. Jennifer Sclar warns that taking care of health in their own hands, consumers could waive the continuity or quality of care.
"Without good tools and good information, it will be very difficult for consumers to wade into the market and evaluate the tradeoffs in terms of price, quality and results," at- she said. "It will have a real impact on the price of health care as well, with routine care is much cheaper, and the most catastrophic care increasingly expensive." Customer demographics are changing. with ACA, the so-called "young invincible" seeking a consumer-oriented plans with high deductibles.
"There are many people who are relatively young, very healthy and forced to buy insurance, "said Tal Gross." they respect the ACA mandate and they want a type of insurance that generally was not that common because they were not on the market. "
How high deductible plan affect the cost of health care down the road? the score points to a small group of consumers, mostly the elderly and those with chronic diseases, who are injured by high deductibles.
"We want to ensure that people who are vulnerable should not quit going to the pharmacy to save money," he said. "But then, for people who are in good health, we must ensure that we do not provide too much care, or unnecessary care. "
ultimately, the panelists agreed that while the ACA comes with challenges, it is proving to be an exciting time in health care. They hope consumers will be inspired to think about their health and the delivery of their health care in a new way. with the right tools and a better access to data, consumers will be able to create their own roadmap to better health, while helping to change the health care delivery business in this country.
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