Most would agree that cutting health care costs requires more active participation of the consumer in medical decision making.It’s a cost driver the Affordable Care Act (ACA) fails to address.Sadly, as I reported on this blog a month ago, researchers found that consumers felt little responsibility for helping to solve the problem of rising costs.  Moreover, they were unlikely to accept a less expensive, equally effective treatment option.  That study also revealed that consumers do not want physicians to consider patient finances when they make treatment decisions. And if they have insurance, they not only feel entitled to the more expensive care, they see it as an opportunity to “stick it” to their insurance company.

A new study reported this week in the  Annals of Internal Medicine looked at another aspect of consumer engagement affecting the cost of their health care, their medical outcomes and health status.  Researchers identified repeatedly missed appointments and failure to fill prescriptions or to follow treatment plans as “contextual factors” or “contextual red flags” (CRFs) in the care and treatment of patients.  Also included were socioeconomic and life issues such as the inability to pay for medications, a change in work hours, lack of transportation and competing responsibilities—such as taking care of a chronically ill family member.  In all, 208 contextual factors were determined relevant by the researchers.

Doctors and other caregivers need to address their patients’ CRFs as part of their treatment plans.  Here’s why.  The study found that health care outcomes improved in 71 percent of the cases where CRFs were addressed compared to 46 percent where they were not.  

To put it plainly, clinical outcomes can improve when the contextual factors, or circumstances, behind patients’ non-adherence to treatment plans are addressed by their doctors. It’s in their best interest medically and financially.

Gives a whole new meaning to what delivering high-quality patient care involves, doesn’t it?  The only problem is, how does a doctor make time to address these issues in the 15 minutes he or she can afford to spend with each patient in the current practice paradigm?

Your thoughts?