- We measure utilization
- Make utilization projections
- And analyze the heck out of utilization
For all our numbers-crunching, health care utilization is much more than a numbers game.
Health Care Utilization Defined
There are various definitions. Because I prefer simple, let’s use the following.
The type and frequency of health care services we access.
So we have two categories.
- The type of services we use − office visits, prescriptions, surgery, etc.
- The frequency of those services − X number of doctor visits per year
Analysts gone wild dissect those two categories a million different ways. Oops, there’s that numbers game again.
In the battle of health care costs, the rallying cry is often, How can we reduce utilization?
As a favorite wellness mentor of mine counters −
Our focus shouldn’t be on reducing utilization.
Our focus should be on creating the right kind of utilization.
Is This Right?
Health reform promotes the concept of a better health care consumer. Employer sponsors of health benefits, burdened by decades of rising costs, push employees into taking responsibility for their own health.
All that is good. Some would say it’s working.
- Decline In Utilization Rates Signals A Change In The Inpatient Business Model − Health Affairs blog
- 5% decrease in use of Emergency Room (ER) services − Summary of Key Findings: April 2014: 8th Annual Cigna Choice Fund Experience Study
My concern comes with the celebration of reduced utilization in those of us with high-deductible, health savings account-type plans.
- Reduced health care utilization
- But is it better utilization?
Promoting the right kind of utilization takes many forms.
- The individual with high blood pressure who regularly takes his or her medication
- The person who consistently receives recommended preventive services
- Follow-up visits to our doctor’s office to review test results and plan treatment
Or are we skipping those because we haven’t met our deductible or don’t know preventive care incurs no out-of-pocket cost?
So before we jump for joy at lower health care utilization, ask if it means eliminating the right kind of utilization.
To quote one of my dad’s favorite southernism −
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Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.