Finding Affordable Care: Asking the Right Question is Key

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NQF Releases Guidance for Consumers.

What information do patients need to find affordable care? The National Quality Forum (NQF) released a report (http://bit.ly/1DwekE9), consumer fact sheet (http://www.qualityforum.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=77687), and an infographic (http://bit.ly/1tX3lzA) resulting from an in-depth look at the rising cost of healthcare, how patients define affordability, and what information and changes are needed for consumers to get the best possible healthcare at the lowest possible cost.

Rising healthcare costs have become a significant burden for the nation, its businesses and American families. Families have seen their health insurance premiums increase by almost 130 percent in the past decade while their out-of-pocket spending has risen by almost 80 percent. Because of these increases, families’ real income has been essentially flat for the past decade as growing healthcare costs have consumed increases in people’s wages and income (http://bit.ly/1nxyBnM).

To understand the impact of healthcare costs on patients and consumers, NQF, with support from the Robert Wood Johnson Foundation, organized a two-day meeting in March that brought together key stakeholders including patients and families, consumers, health plans, researchers, clinicians, and community health experts. To date, affordable health care has been examined mostly through the lens of payers.

The discussion revealed that while patients and consumers primarily judge whether care is affordable based on how much of their household budget they spend on healthcare, a host of other factors that influence their perspective, such as whether the care was high quality, the options available for their healthcare needs, and how they were able to balance the other demands of their daily lives with their healthcare. These factors change depending on the particular type of decision patients are making, including buying insurance, selecting preventive screenings to stay healthy, seeking treatment for an urgent ailment, managing chronic illness, or dealing with end-of-life issues. Each situation introduces complexities and too often, lack of information can be a barrier to making informed choices.

“Consumers and patients are often unsure of what questions to ask to get the answers they need to find affordable care,” said Christine K. Cassel, M.D., president and CEO, National Quality Forum. “This new work adds to NQF’s growing portfolio on affordability by providing consumers with key questions and resources they can use to help them find the best care at the best price.”

The report concludes with recommended actions for clinicians, insurers, federal and state agencies, hospitals, patients, and other educational and non-profit organizations could take to ensure that affordable health care is available and accessible.

“Affecting sustainable change in healthcare affordability will require a concerted effort from all sectors of society,” said Dr. Cassel. “There is promise that coordinated action should help ensure that healthcare is affordable for patients and the nation.”

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Erin Reese