Economic analysts estimate that health care spending will likely grow at an annual rate of more than 5 percent over the next decade, leading more employers and insurance providers to shift costs to individual consumers.
While access to health care is the highest priority, these increasing costs (and fear of uncertain and unexpected expenses) continue to put pressure on employers, individuals and other purchasers to seek better value for their health care dollar. This “value” includes outstanding quality combined with service, convenience and tools to manage both health and costs at an improved price. Today’s health care leaders are tasked with thinking differently to address rising cost concerns and help ensure the focus remains on a high quality patient experience with the best possible health outcomes.
While there are many challenges facing today’s health care industry, there are also many innovations being developed to help meet those challenges. In the past, the health care industry primarily focused on selling insurance and providing products and access to care. We are now seeing an exciting shift toward focusing on the consumer experience. As health care leaders, we are asking ourselves, “How can we better serve the consumers of health care, helping them meaningfully engage with their providers and health plans?”
In the San Francisco Bay Area, upward pressure on the costs of delivering quality health care comes from many factors — including positive advances in technology, safety and seismic protection, as well as inflationary practices of regional health systems leveraging their market position to demand higher payments.
Additionally, the Bay Area cost of living exacerbates the scarcity of an available clinical workforce — including primary care physicians, nurses and support personnel. Working together as independent medical practices, community hospitals, health systems and academic medical centers, and alongside insurers, purchasers and individuals, the Canopy Health alliance works to mitigate costs, reduce inefficiencies, and ensure savings are passed to individuals and purchasers while investing in patient safety, service and training to improve value and experience.
At Canopy Health, we’ve created an integrated health care experience where quality care and coverage are provided by an alliance of top caregivers across the Bay Area. Canopy Health’s 5,000 physicians and 18 hospitals are working together to refer patients to the best possible care in the most efficient way. This means consumers have access to all the providers in the Canopy Health alliance, not just those in their primary care physician’s medical group or being directed to limited choice of specialized service locations. The result is better access and more affordable care from some of the Bay Area’s top physicians and hospitals.
Today’s consumers also want more control and accountability for their health and wellness. Calls for price transparency have led to price- and cost-estimation tools from insurers. While most cost-estimation tools are generic estimations, at Canopy Health, we have developed personalized and accurate cost transparency tools to provide clarity at every point in the care continuum. We believe consumers should be able to determine the most appropriate treatment options and understand how treatments may affect their budgets.
To maximize the impact of these tools, they need to be used effectively in a shared decision-making context. Costs should be weighed with consumer preferences and clinical evidence so that patients obtain care that they consider “valuable.” It’s critical that patients are supported in these decisions by care teams that are ideally situated to not only help patients understand and navigate their options, but also to adapt care plans to patients’ individual goals and life circumstances.
Joel Criste is the CEO of Canopy Health.