Over the past few months, much of the national health care discussion has focused on a single element of the Affordable Care Act: the online shopping experience for patients seeking insurance. That was a natural conversation for us to have at the time, because it was our first tangible glimpse of the changes to our health care system.
But let us now be clear that the performance of healthcare.gov is not a valid indicator of the ACA's overall success or failure. The ACA wasn't created to deliver a fantastic online shopping experience. It was created to deliver meaningful access to health care.
That's why conversation among the ACA's early adopters will be a critical component of the legislation's success. Patients have begun to put the ACA's new health care plans to use for the first time. What kind of experiences are they having? What are they telling their friends and families?
The recommendation of a single patient -- like that of any consumer -- is worth its weight in gold. If the first wave of Obamacare patients has a positive experience, word will spread quickly and more uninsured patients will sign up. The crucial "young invincibles" demographic may be swayed as part of a larger shift toward health care responsibility. On the other hand, if this first wave of patients has a negative experience, word will spread just as quickly -- and the "undecided uninsured" will remain unengaged.
Why might patients have a positive or negative experience with these new insurance policies? It boils down to basic issues of performance:
- Many of the ACA's new plans are "narrow network" type, meaning relatively few healthcare providers will participate in them, limiting patient choice and access. Will they be so narrow that patients cannot find care when they need it?
- Many patients will end up in health plans with low monthly premiums and high deductibles. When the time comes to pay major out-of-pocket costs, will they choose to get the care they need? And will patients who do feel that their policy was worth the price?
- How easy and convenient will insurers make it for patients to find doctors and book appointments?
- How helpful will insurers' (frequently poor) customer service be for ACA patients?
These questions aren't rocket science; they are the same metrics of consumer satisfaction we'd look for in any new health plan. It's reasonable to expect that healthcare.gov will continue to improve, and that more patients will use this remaining time to enroll for 2014. But that website won't make or break the Affordable Care Act -- patient experiences will.
As a leader of an organization which has been built on a positive patient experience, I recognize this as a hugely significant distinction. That's why, when people regularly ask us about Obamacare's survival prospects, we can only turn the question around: What do newly insured patients have to say about it?
The ACA has created new health plans with new rules, and people are finally using them to get healthcare. If we want to tell the future, those patients' opinions are the ones we should listen to.