Time to Teach Consumers What "Patient-Centered" Means

For years now, experts in Medicare, to academia, to hospitals have been talking about “patient-centered” care. After decades of rewarding those who ordered the most tests or performed the most procedures, health plans must now pay doctors to keep people out of the hospital, by preventing illness instead.

In New Jersey, a group of stakeholders thought it was time everyone understood—especially the patients.

Last week, they launched “Better Choices, Better Care NJ,” a public education effort led by a steering committee of business and labor leaders, a physician, and a representative from the state’s largest health plan (Horizon Blue Cross Blue Shield of New Jersey). Horizon is funding the project through a grant.

Christine Stearns, an attorney with more than 20 years’ experience on healthcare issues in New Jersey’s state capital, will serve as the group’s executive director and general counsel. In an interview with The American Journal of Managed Care, Stearns said that the need for something like “Better Choices Better Care” emerged earlier this year in conversations with business and labor groups, who she said are more active in healthcare policy than ever.

“There are lots of great organizations that do great work,” Stearns said, but with healthcare evolving so rapidly, the average consumer was being left behind. Reaching that person will require multiple formats—and she anticipates the group will try a little of everything, from a website that gathers consumer “stories,” to social media and public events.

Stearns didn’t rule out the possibility of a town hall meeting, a white paper, or academic research projects, but she said the public’s response will guide the steering committee.

“The goal is to take in all the information, and to bring it back out,” Stearns said. “We will be driven by what we hear.”

The committee isn’t starting from scratch. “Better Choices Better Care NJ” benefits from polling and work with focus groups, which Stearns said show that patients see a growing financial burden as they purchase healthcare. “There’s interest in a high-quality, patient-centered healthcare system,” she said.

A key feature of “Better Choices Better Care NJ,” Stearns said, is that the communication will flow both ways—the effort will simultaneously teach the public about terms such as patient-centered care, and why this should benefit the consumer, while taking feedback on what parts of the health system frustrate or baffle people.

The initiative has some skeptics. A spokeswoman for a consumer group, NJ Citizen Action, asked whether a health insurer was the appropriate party to lead a discussion about high costs. A policy analyst for a left-leaning group said it would better if the state led the public education effort, but that was unlikely in the current administration.

Much of the groundwork for “Better Choices Better Care NJ” took place before Donald J. Trump became the president-elect. It’s unclear what the end of the Affordable Care Act would mean for New Jersey’s individual and small group insurance markets. Horizon spent much of the past year fighting court challenges to its OMNIA health plans, which were well designed for consumers shopping on the exchange. OMNIA’s bronze and silver plans, which were priced to complement a population health initiative with select hospitals, had comparably low rate hikes for 2017—a welcome shift from the state’s historically high premiums.

“Certainly, we are all very aware there was a presidential election, and we are aware of the potential change in healthcare policy coming out of Washington,” Stearns said. “At this point, no one has a clear picture of how things may or may not change in 2017 and beyond.”