Healthcare Consumerism: Pros, Cons, and Needs

Updated on March 4, 2024

Healthcare consumerism took a massive leap forward during the pandemic. Millions of Americans received care online through telehealth services for the first time, either from their provider or from a digital health company. This meant, also for the first time, many people shopped for care similar to the way they research and purchase a new appliance for their home: checking prices, service offerings, reviews and availability. 

In general, care delivery has shifted back toward in-person visits since the pandemic’s peak days, but telehealth care delivery holds at 900% above pre pre pandemic levels. As such, new direct-to-consumer, out-of-pocket, or insurance-covered telehealth services continue to emerge. Giant retailers such as Amazon, CVS, and Wal-Mart are expanding their healthcare services to more primary and specialty care, leveraging their scale, marketing dollars, and expertise in consumer behavior to succeed in a changing market.

This shift toward viewing the patient as a healthcare consumer is increasing the accessibility and affordability of care. Greater convenience and lower out-of-pocket spending are driving more patients to receive the types of preventive care and chronic condition management that are associated with longer, healthier, and happier lives.

A long journey with no map or guide 

For younger, generally healthy patients, consumer-centric healthcare offers the convenience and choice they want. They can quickly receive on-demand care for occasional illnesses or injuries in a way that fits their lifestyle and their budget. 

For patients with more complex and chronic issues, however, accessing care isn’t as easy or as simple as finding the best auto repair business in their neighborhood. Leaving this population of patients to fend for themselves in a disconnected, consumer-oriented market risks their health and well-being when the choices are overwhelming and care is ineffective or even potentially harmful. Costs tend to increase due to redundant services and worsening medical conditions resulting from ineffective care. 

All of this shines further light on the potential inequities in our healthcare system. 

How unguided care journeys unravel

Another driver of consumerism is the significant consolidation that has occurred among healthcare provider organizations. Hospital and health system merger and acquisition activity has held steady since 2012 at roughly 90 to 110 transactions per year until the pandemic. Ideally, the result of these mergers is that the larger health system can help guide patients through the many providers, facilities and services to manage their conditions, procedures and other needed care. Yet, in some instances, merged health systems continue to operate as autonomous collectives. 

Consider this common scenario, which, incidentally, happened recently in my family. A family member was having symptoms of a heart attack, so he was rushed to the emergency room. After spending the entire night there receiving multiple tests, physicians ruled out more serious causes, and referred him for outpatient follow-up. 

While we were relieved, he left the hospital with a stack of documents and recommendations to schedule additional tests and appointments with specialists. He called me, and I walked him through what all of it meant, and how to best approach the next phase of his care. I even made a couple of phone calls in his behalf. I’ve worked in healthcare my entire career and even I felt overwhelmed by all of this. It caused me to reflect on what I ask my own patients to do when they are discharged from the hospital. 

A situation like our family faced happens daily across the country. If a patient’s condition doesn’t improve or worsens, they often end up where they know they will receive the time and attention they need: the emergency room. The ER’s staff, however, may not have adequate information to safely let the patient go, so they end up admitting the patient. More invasive and expensive tests are ordered, all because they lack a consolidated, trusted source of data and communication tools to answer some simple questions, change medications or schedule an appointment for the most appropriate outpatient follow-up.

Orchestrating the noise

Every complex care journey requires a clinician to guide the patient, help overcome concerns, answer questions, and manage next steps. In most cases a patient could not envision nor be equipped with the knowledge and judgment to make safe and informed decisions. 

Receiving this kind of care assistance, however, does not mean patients lose their rights or options. If they are not experiencing the results they reasonably expect or feel their concerns are ignored, then patients should certainly seek guidance and services from other providers.

Regardless of where they receive care, an orchestrator guiding and coordinating the journey is needed. Equipped with a complete, trusted data source and technology to connect disparate organizations, the care orchestrator can communicate with patients and providers and manage a care journey, including selecting and scheduling different ancillary services, such as transportation or medication assistance. As a guide, manager and advocate, the care orchestrator will prevent them from becoming lost and forgotten in the growing, changing world of healthcare consumerism.  

Darin Vercillo 4 2022 web
Dr. Darin Vercillo

Darin Vercillo co-founded ABOUT, drawing upon his expertise in developing and implementing medical information systems specifically designed to manage complex patient needs, medical education, and faculty and staff logistics. A board-certified hospitalist practicing in the Salt Lake City area, Darin also served as a clinical advisor and technical developer at the University of Utah Health Sciences Center. Prior to his work at ABOUT, he served as a physician knowledge engineer and interim Chief Medical Officer at TheraDoc.