The Best Place to Die, and Affordable Healthcare


If we are to treat healthcare services the same way we treat other services in terms of assessing and evaluating affordability, then many existing paradigms in our healthcare system will need to change.  For one thing, we must know the price of services before making the decision to purchase – this will apply both to selecting a plan as well as selecting where to get health services.  Yes, many dynamics are at work with transparency of healthcare service charges, and to be sure life-or-death decisions are not like any other service we purchase.  Nonetheless, no consumer can determine if something is affordable, unless he/she knows the cost of a particular treatment.

As consumerism takes hold across healthcare services, patients (consumers of services) need to have access to as much accurate information as possible in order to make the best, most appropriate decisions regarding their healthcare and quality of life.  Consider La Crosse, Wisconsin, which has been dubbed “The Best Place to Die.”  About 96% of the adults who have died in La Crosse had an end-of-life care plan.  These plans, which include advance directives, not only allow people to carefully consider various services and outcomes well in advance, they have greatly reduced healthcare costs.  According to a report on National Public Radio, on a per patient basis, La Crosse-based Gundersen Health System spends less in the last two years of life than any other place in the U.S., about $18,000 compared to the national average of $26,000.

Individuals creating an advance directive answer a set of questions regarding what treatment they want (or don’t want) in a crisis situation. While none of the choices presented have a price associated with it, the choices people make most often result overwhelmingly in a less costly last two years of life. In other words, end-of-life decisions are motivated not by affordability but by quality of life for the patient and their loved ones.  The fact that many people choose to decline treatment (healthcare services) that would have otherwise been performed absent a directive, means that quality of life choices can also result in a positive financial outcome.

Ultimately, decisions based on affordability can’t be separated from choices based on quality of life Hospital systems and affordable care organizations need to recognize this and position their consumer-facing efforts and investments accordingly.  Electronic health records for patients are amassing big data volumes.  Hospital information systems are capturing a growing list of data attributes including patients’ advance directive choices.  Mobility applications are allowing consumers to access and update all of this data via anywhere, anytime, and any device convenience.

While government regulation continues to drive healthcare organizations to comply with statutory laws, the real business differentiator for payers, providers and healthcare supply chain companies is how they improve the overall experience for their customers in terms of visibility into costs and clarity of options.  To stay viable, healthcare companies must make sure their customers can answer the question, “is healthcare affordable?”

About the author

Mr. Chang is a Director, within the Energy, Life Sciences, and Healthcare (ELH) vertical. Richard brings nearly 30 years of experience within the advisory services and strategic sourcing industry. He has broad and extensive expertise across the entire Information Technology and Business Process outsourcing life-cycle, from assessment and strategy to contract negotiations and operational governance. He is responsible for client relationship development and advisory services delivery for ISG’s Healthcare clients.