Marah Short, associate director of the Center for Health and Biosciences at Rice University’s Baker Institute for Public Policy, started out doing research for cancer care policies, but since the Affordable Care Act (ACA), her focus has predominately been on studying the effects of the ACA and how health care can be managed more effectively.
“There is so much to learn from what it is changing,” Short recently told Patient Daily. “It is a hot topic because it affects more people in general.”
She explained that trends consumers should be looking for in health care are how doctors and patients are choosing medical tests, treatments and procedures more wisely to avoid extra costs and waste, as well as higher deductibles and new, promising Medicare programs for lower-income patients.
Short said she has been looking into the Choosing Wisely program, which asks different societies of medical professionals to provide short lists of tests and procedures that could be overused. Choosing Wisely’s goal is to advance a national dialogue on avoiding wasteful or unnecessary medical tests, treatments and procedures.
“More than 70 specialty society partners have released recommendations with the intention of facilitating wise decisions about the most appropriate care based on a patients’ individual situation,” a Choosing Wisely representative said. “Consumer Reports is a partner in this effort and works with specialty societies to create patient-friendly materials to educate patients about what care is best for them and the right questions to ask their physicians. Through a coalition of consumer groups like AARP and the National Partnership for Women and Families, Consumer Reports is ensuring patients get the information they need just when they need it.”
Short went on to explain that there are more consumer-driven, high-deductible programs with lower premiums, where consumers could be more responsive to health care prices.
“Higher deductibles have possible negative and positive effects,” she said. “With higher deductibles, people may be more sensitive to the care they are receiving -- and in some cases overusing. On the other hand, higher deductibles could be a deterrent for people seeking the care they need because the deductibles are too high.”
There isn't enough data yet to see what direction this new trend will take, Short said. What is clear, though, is that there are still people who are left out.
“In Texas, there is no Medicaid expansion, so about one million residents either make too much for subsidies, or too little to pay for any type of insurance coverage,” Short said. “Medicaid expansion in Texas would help a lot, but it is not currently an option.”
Short explained that there are a couple of promising programs in Medicare, such as the Accountable Care Organizations (ACO) and shared savings programs, which both attempt to provide quality, affordable care to patients.
“One that doesn’t seem to be working as well is bundle payments,” she said. “It may be a good idea, but there are mixed results in the data, so it does not look as good as the data is coming in.”
Another trend in health care is that it seems as if insurance companies are trying to get their information to consumers in a simpler manner, breaking down what their plans provide so they are better understood.
“Employers will also hopefully help their employees through the process of understanding what their insurance does and does not provide, but ultimately consumers still need to pay close attention to what they are signing up for and make choices that would best fit their situation,” Short said.
In terms of “value” in the health care industry, Short believes that it is difficult to find a consistent, quality measure.
Finally, Short stated, it is likely that quality and value can measure a patient’s satisfaction, but that could also be tricky because of the patient’s mood on the day of applying -- or thinking the procedure is too expensive.
“It is hard to measure the important things regarding value,” she said. “Measuring quality is also difficult because of factors like income and housing, which is sometimes hard to determine. To put it simply, the data is hard to measure because providers have no control over the data.”
Rice University public policy director details effects of Obamacare