Healthcare direct is a great option for employers seeking affordable, high-quality health coverage. Most employers want a robust health plan at a low price point, and many are willing to buy direct. Health systems should offer direct products before competitors do so to take advantage of this trend. But, there are some important things to consider before buying directly from a health system.
For consumers, healthcare direct convenience means less paperwork and faster access to doctors. Unlike traditional medical insurance, healthcare direct convenience allows patients to pay their bills with a single, low monthly payment. It can also include same-day appointments, longer office visits, and unlimited email and cell phone communication with the doctor. The service contracts with medical services directly, so there are no middlemen to deal with.
Convenience is a leading criterion that patients use to evaluate the value of healthcare services. Today, patients no longer consider significant time commitments for a single doctor’s visit as acceptable. This trend is fueled by digital services, which have accustomed consumers to on-demand experiences. As a result, healthcare delivery needs to evolve to fit this on-demand model. For example, primary care delivery is moving away from traditional doctor’s offices and toward telehealth.
Direct care, or “doctor-pay” health insurance, eliminates the influence of insurance companies and lets patients pay directly for healthcare. Direct care patients pay a fixed monthly fee to the provider for most primary health care services. This model has many benefits, including transparent prices, shorter wait times, and longer doctor’s appointments. It also provides better health outcomes for patients.
Direct costs include the actual costs associated with the delivery of an intervention, such as inpatient and outpatient services, pharmaceuticals, and additional care. While these costs can be difficult to determine, many people use administrative databases or hospital chargemasters to estimate them. Another method is time-driven activity-based costing.
When measuring healthcare costs, the health system must consider both indirect and direct costs. Indirect costs result from a reduction in productivity. These costs come from the loss of economic productivity. For example, a pregnant woman who rides the city bus to appointments can rack up a bill of nearly $2,000 over a few months. In some cases, high costs may discourage patients from seeking care.
Developing a clear understanding of indirect costs is essential for developing communication between patients and providers. It will help providers better understand the needs of their patients and address their needs. Similarly, it will help patients better understand the costs of indirect care. However, it is difficult to collect accurate costs data due to the wide variation in prices and proprietary nature of economic data. Furthermore, different elements of health care costs are borne by different entities.
Healthcare direct quality improves patient outcomes and experiences. With an emphasis on patient-provider relationship and evidence-based best practices, direct healthcare providers are incentivized to provide high-quality care. This means less time on hold, face-to-face time with a healthcare provider, and a seamless healthcare experience.
The definition of healthcare quality is complex, but it can be captured in a mosaic of four dimensions and their interrelationships. A systems approach is important to avoid silos and to make sure that all perspectives are being considered. Specifically, quality includes improvement over time. The interrelationships between these dimensions are critical for achieving true quality in healthcare.
Quality is the likelihood of achieving the health outcomes the patient group wants. The Institute of Medicine defines quality in healthcare as a “probability of achieving desired outcomes consistent with professional knowledge.” The institute defines six sentinel attributes for healthcare. When evaluating a practice, look for performance metrics that reflect these attributes.
Direct contracting can reduce costs for employers while improving quality. It also improves accountability. A recent Business Group on Health survey found that almost a quarter of employers are considering contracting directly with an integrated delivery system. This approach allows healthcare providers to provide better care at lower prices. It also helps improve patient relationships. It also enables health system leaders to monitor patient care from start to finish, resulting in improved patient outcomes and a better patient experience.
AHRQ’s teamSTEPPS training program promotes communication and teamwork skills among healthcare providers. Over the years, the training program has been used by more than 1,500 organizations across the country. The curriculum was created in partnership with the Centers for Medicare & Medicaid Services and is distributed throughout the nation by the Nation’s Quality Improvement Organizations. In addition to providing training, the Institute also produces data that is used by policymakers and healthcare providers.
Direct care practices use a monthly fee to provide health care to their patients. The model is most common in primary care, but it can be used in a variety of health fields, including dental and behavioral health. In the United States, there are approximately 1,200 direct care practices. Massachusetts has at least 16 of these practices. This model is expected to reduce costs and improve patient satisfaction.
This type of programmatic approach involves communication with patients, appointment scheduling and time slots, and medical staff treatment. It also includes training, standards for testing, and system-wide coordination. In addition, healthcare providers should have cultural competency when providing healthcare. The goal of programmatic accessibility is to make healthcare services accessible to all.
Accessibility is a crucial element of quality healthcare. Direct care providers strive to create a seamless experience for patients. This means same-day appointments, short wait times, secure messaging, and virtual health visits. Those benefits result in better health outcomes. Moreover, direct healthcare is a valuable financial investment.
Geographic coverage of health services is important for countries moving towards Universal Health Coverage. The availability of healthcare services in a country’s region determines health outcomes within the country. Therefore, measuring accessibility is crucial for the development of evidence-based health policies. It also helps in understanding how health systems are performing.
Partnerships with providers
Partnerships between payers and providers in healthcare direct have the potential to improve care delivery, improve population health analytics, and reduce administrative burdens. However, they require capital commitment and open communication between the two parties. Nonetheless, they may be an attractive option for both parties. If a partnership works well, it may be a game changer.
Successful partnerships involve open communication and integration of information. Both parties should be involved in the process, and regular face-to-face meetings are necessary for success. Regular communication with key stakeholders is also vital for external support. Partnerships should provide both insight and innovation to both parties. Several key stakeholders must be involved in the process, including payers and providers.
Many employers are increasingly interested in partnerships with healthcare providers. Rising healthcare costs and dissatisfaction with traditional fee-for-service payment arrangements are driving this trend. These employers want more control over healthcare costs and the patient experience. Forward-thinking health systems are responding to this trend by partnering with employers through innovative pay-for-value arrangements. Early successes with these partnerships have inspired other healthcare organizations to explore this promising option.
Direct provider-employer partnerships can provide employees with comprehensive, affordable, and convenient care. However, these partnerships require clear communication between employers and providers, and mutual agreement on financial incentives, quality metrics, and service offerings. Cockrell draws on her experience in managing partnerships with local physician groups for a local health system. In these partnerships, she has reduced costs by introducing one premium increase for employees while increasing primary care engagement, employee satisfaction, and medical outcomes.
Partnerships between healthcare players are key to unlocking greater value for all patients. In addition to improving patient outcomes, they also improve care coordination and technology integration. Regardless of the size of an organization, it can be beneficial to partner with a provider of the same specialty.