The healthcare system is not meeting the needs of the people who need it most, according to a new focus group study.
Based on nine focus groups of low-income consumers with complex health and social needs, “In Their Words: Consumers’ Vision for a Person-Centered Primary Care System,” from the Center for Consumer Engagement In Health Innovation (the Center) at Community Catalyst, also reported:
Poll participants reported:
• The primary care system is not meeting the needs of the people who need it most because they do not have the ability to form meaningful primary care relationships and the system does not address the impact that problems like transportation, housing insecurity, mental health issues, and more have on their overall health. “Consumers expressed the desire for a primary care relationship that is not necessarily tied to a credential [e.g., an MD], but rather one that is rooted in empathy for the significant challenges and barriers this population faces in their day to day life,” says Ann Hwang, MD, director of the Center for Consumer Engagement in Health Innovation, a national, non-profit consumer health advocacy organization based in Boston. “These consumers don’t feel that doctors have the time to listen to them, that their stuck on a profit-driven treadmill, regardless of if the institution is for- or not-for-profit.”
• Unhappiness at a system they see as profit-driven.
• Strong desire for supportive services they do not get now, such as:
- An ongoing relationship with a trusted provider;
- Help navigating the complex health and social services system;
- Providers with greater cultural sensitivity and empathy; and
- A centralized place which would include mental healthcare and supportive services in addition to primary care (a “one-stop shop”).
“The healthcare system has been going through major changes that are too often designed without meaningful input from the very people it exists to serve,” Hwang says. “Because primary care is often the first point of entry for a consumer into the larger healthcare system, these focus groups were conducted to capture the perspective of consumers with complex health and social needs about what they need and want from their primary care relationship.”
This reflects the mission of the Center for Consumer Engagement in Health Innovation which is to bring the consumer experience to the forefront of health system transformation to deliver better care, better value, and better health for every community, particularly vulnerable and historically underserved populations, according to Hwang.
“The voices in this report belong to people with complex health and social needs—a group that tends to include some of the highest-need and highest-cost patients.,” she says. “As systems shift toward value-based payment and try to understand and address non-medical drivers of good health (i.e., social determinants of health), this kind of insight is critical to designing and delivering care that actually meets the needs of the people it serves.”
Based on the poll, there are five takeaways for healthcare executives, according to Hwang:
- Consumers want a long-term, trusting relationship with their primary care provider.
- Consumers value a coordinator or navigator who can help them manage their care, connect them to social services and advocate for them when needed.
- Consumers welcome a broader conversation with their primary care provider, not just focused on their medical treatment, but exploring the needs of the whole person.
- Consumers want a “one-stop shop” where they could receive a wide variety of services under one roof, including medical services, mental health treatment and counseling, and social services.
- Consumers hope for a provider who is culturally sensitive, able to relate to their life experience and struggle, and who uses language they can understand.
Tracey Walker is managing editor of Managed Healthcare Executive.