Since the patient’s cost is effectively zero in the Medicaid population, getting patients engaged in their care often requires some ingenuity to figure out what the patient needs in order to be motivated in their own health, said Matt Salo.
“Is child care your biggest issue?” Salo asked. “Well let’s figure out: if you can go to the highest quality, lowest price provider, maybe we can kick in some child care subsidy or something like that. You can be creative.”
Figuring those things out is complicated, but can be done, and it aligns with the way insurance is changing to embrace social determinants of health, he added.
Leah Binder agreed that it is important to create incentives to creatively build benefits designs based on what the patients actually value. “But our healthcare system has no tradition at all of caring at all about what patients think,” she said.
And when the system does try to define quality, it’s usually in a scientific way that considers what is high quality or what the most people think. But the industry needs to start understanding the nuances between how different people view value, Binder said.
In the end, this will all come down to research, Austin Frakt, PhD, said. The data on these innovative models need to be available and accessible in order for independent researchers to know the effects of these programs.
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