February 08, 2018
Social media and its reach across communities and commerce has not ignored healthcare. In fact, thousands of mobile healthcare applications have come online over the past decade. But, how useful are they for today's patients, providers and payers? For example, apps that synthesize user-entered vital signs, physical activities (e.g., exercise routines) and meals to make recommendations are a dime a dozen, despite minimal evidence they improve health outcomes, according to the Financial Times.
To grasp the potential of social media in healthcare, we need to look instead at tools like ZocDoc and reviews aggregators such as Yelp. These services have revolutionized how patients select and interact with physicians. They have also improved the quality of care in some locations, while reshaping how doctors present themselves on social media and television advertisements.
ZocDoc is a web-based service providing streamlined appointment scheduling, insurance verification and review aggregation for doctors. Its success should be understood as the product of two larger trends sweeping through healthcare:
While ZocDoc has significant utility for patients, it could also become an important asset for providers and payers. The app now features AI-driven processes for simplifying insurance plan administration, which is a common sticking point when patients connect with new providers on ZocDoc or elsewhere.
According to the 2016 CAQH Index, manual administrative activities related to insurance consume more than 1 million man-hours weekly and exact $9.4 billion in unnecessary expenses from health providers and payers. Similarly, ZocDoc itself has estimated that office managers spend one-quarter of their time dealing with insurance.
ZocDoc has also promoted the notion of "five-star doctors" with stellar reviews and large online followings. Its public rating system is a powerful incentive for doctors to offer high-quality care that aligns with new value-based reimbursement (VBR) models and creates positive impressions among would-be reviewers.
Both ZocDoc and Yelp can determine which physician a patient sees. Yelp's influence was even once the subject of a federal court case about the company's responsibility for negative reviews. It is worth noting how Yelp is used by providers: business owners or managers can set up a free Yelp account and pay for advertisements; however, businesses are forbidden from soliciting Yelp reviews and can never change or re-order reviews.
But there are ways to optimize your image on these platforms. One example is some doctors have paid for ads on the Yelp pages of nearby offices. Ads help the Yelp user see alternate options for the services they seek, but they do not influence reviews. In fact, an independent academic study found that advertising plays no role in how reviews are recommended on Yelp. Per an in-depth profile of Yelp in BuzzFeed, "Harvard Business School professor Michael Luca has co-authored a new study that effectively debunks the extortion theory." Another way to optimize your image is to become an influencer (i.e., prominent media personalities offering highly shareable expert advice).
Doctor-influencers are still relatively new phenomena. In fact, Wired identified medicine as one of the last frontiers for the types of social media influencers now ubiquitous in finance, music and sports. Despite the potential for the aggressive commercialism sometimes associated with influencer marketing, there are key benefits to heightened engagement between providers and patients, if intermediated by credible ratings/reviews systems.
A Manhattan Institute study revealed that Yelp reviews of hospitals in New York were correlated with quality measures (e.g., criteria for determining VBR payments) at those same institutions. Accordingly, patients who filter providers by Yelp scores might be making well-informed decisions. Moreover, the overall simplicity and ease-of-use of Yelp, ZocDoc et al. is important in light of the complexity of government healthcare data. These platforms provide a good base for healthcare consumerism, an often-touted but still nascent practice for finding lower-cost care.
The Health Care Cost Institute once estimated that 43 percent of all healthcare spending by people with employer-based insurance was shoppable, meaning that it could have been attained at lower cost after reviewing all possible options. The problem is in actually finding actionable information about prices and costs. Yelp and ZocDoc offer some insight into a traditionally opaque industry.
In addition to the readily available (and, crucially, free) services we have discussed so far, many workers also have access to cost transparency tools from their employers. However, an Alegeus survey found that 69 percent of respondents felt that their familiarity with medical terminology hindered decision-making about which plan to select or provider to see.
Going forward, it is important for patients to have more options in the mold of ZocDoc and Yelp to know which doctor-influencers to trust. On the other side, providers and payers have a number of ways in which they can be held accountable for delivering appropriate and quality healthcare. One such partnership is between insurance plans and independent review organizations.
Advanced Medical Reviews (AMR), an IRO that works closely with insurance plans, hospitals and more, provides unbiased, third-party, physician-level reviews for claims appeals to ensure that the care an individual is seeking or receiving is medically necessary and/or consistent with plan language or appropriate jurisdictional guidelines. As Leah Williams, Physician Recruitment and Credentialing Manager at AMR, explains, "The physicians in our nationwide network are held to a high standard of qualifications that includes appropriate credentialing and licensing and, in many cases, being in active-practice. This allows us to provide our clients with state- and specialty-matched physician reviewers whose expertise, coupled with evidence-based guidelines, ensure their reviews are accurate."
Indeed, reviews aggregators are just the start of a more democratized healthcare experience. The combined effects of easier access to healthcare information and better evaluated treatments will be superior outcomes, lower costs and a more sustainable health system.
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