High-quality medical care is available in the United States, but many Americans are unable to access the care they need. Patients across our country are still facing complex situations—some caused by unexpected changes in care or coverage, others by bad, out-of-date information—often resolved only after laborious exceptions and appeals. With more Americans than ever before now covered by health insurance and expecting to receive quality care at a reasonable cost, patient-centered reforms must be the focus of the health care agenda moving forward.
Ensuring that all patients receive such quality, patient-centered care is the mission of Partners for Better Care (PBC), a coalition of patients and their allies advocating for the next generation of health care. Powered by the strong backbone of our nonpartisan Patient Charter, PBC’s members have banded together to fight for improved health care for all Americans. At the top of our agenda, the Patient Charter clearly states that all patients must have an active and formal voice in these health reform conversations.
Drawing from our Patient Charter’s call-to-action, one of PBC’s first charges has been to improve the medical billing system in the U.S., which is too often a source of frustration and confusion for patients. Today, we see that nearly 25 percent of patients receive multiple bills from several different providers for a single episode of care and 13 percent of patients pay their medical bills even if they believe the bill is incorrect. These bills typically vary in content, presentation and clarity, placing the burden on the patient to understand what their out-of-pocket expenses will be and what their insurance plans will cover.
PBC and the Department of Health and Human Services (HHS), in partnership with AARP and Mad*Pow, are paving the way to develop solutions to the challenges presented by current medical bills through the "A Bill You Can Understand" design and innovation challenge. In this challenge, health care organizations and designers brainstormed and proposed new medical bills that are easier for patients to navigate. Our coalition was tapped by HHS to help review the proposals and ensure that the patient perspective remained at the heart of this project.
To help advise the federal judges, PBC’s member organizations contributed six professional experts to the HHS Challenge’s advisory panel that reviewed each submission. Our members also recruited patients and caregivers from their communities to participate in a focus group, which provided critical real-world feedback on the submission finalists and first-hand accounts of experiences in navigating the health system and billing process. We are thankful that HHS and the Challenge partners remained committed to understanding today’s patient landscape and engaging patient advocacy organizations and the communities they represent throughout this project.
Ultimately, PBC and its member organizations were committed to ensuring that the outcome of this Challenge resulted in a more patient-centered approach to the medical billing system. We’re eager to see how the Challenge’s pilot partners, Cambia, Geisinger, INTEGRIS, MetroHealth, Providence and University of Utah Health Care, will test or implement the winning bill designs and continue to improve the patient experience over the coming months.
As health care costs continue to rise and patients play an increasing role in shouldering the cost burden, Partners and its members believe that we must work with policymakers and industry leaders to create more predictability and clarity in medical expenses. Patients have a stake in addressing both individual and health system costs, and should be at the table when these issues and potential solutions are being discussed. Containing health care costs without jeopardizing access to care and quality of care is complex, and all stakeholders, including patients, should be part of designing solutions.
These reforms are what patients around the country both demand and deserve. As our charter dictates, we believe that the patient voice must be the force that continues to drive these changes forward.