DURING 2003, THERE WAS SURPRISING PROGRESS IN THE MOVEMENT to improve patient safety. Closely-connected to the patient safety trend are efforts to measure and make public the healthcare outcomes achieved by hospitals, physicians, laboratories, and other providers.
One reason why this movement is important is that it begins the process of restoring the consumer as the major decision-maker. Employers and payers want consumers to have ready access to information which shows which hospitals and physicians get better outcomes. As our clients and regular readers know, one big trend in health benefits is the move to consumer-directed health plans, with larger deductibles and out-of-pocket requirements.
I would think laboratory administrators and pathologists would welcome this development. For most of the 1990s, they had to deal with the gatekeeper HMO, which denied both the physician and the patient the ability to choose which clinical laboratory would serve them. Restoring consumer choice in laboratory services is a positive step for the laboratory industry.
So watch out for consumers! They will be back. Slowly at first, but in growing numbers as each year passes. Aging baby boomers are well-educated, like to control their healthcare decisions, and have plenty of money to spend for healthcare which they perceive best meets their needs.
What makes this consumer-driven powerful is that it has the support of the nation’s largest employers. Many were sued by their employees when gatekeeper HMOs denied access to care. To avoid this legal liability, and to maintain a neutral role in providing health benefits, major employers are designing health benefit programs which give consumers more choice than at any time when fee-for-service medicine dominated the American healthcare scene.
Laboratories and pathology group practices should keep a close eye on the patient-choice trend and direct-access testing (DAT). Along with requirements to document improvements in patient safety and outcomes will come the need to provide consumers with laboratory testing services customized to their needs. I think labs will do much better when patients (and physicians) are encouraged to shop for laboratories and make their own decisions about who does their laboratory testing.