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The Virtue and Value of Patient Empowerment and Health Literacy amidst Healthcare Reform

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Patient empowerment and health literacy are valuable attributes for both patients and healthcare providers in today’s healthcare system. Both are key requirements for accomplishing many of the goals and intents of the Affordable Care Act (ACA). Those goals include better well-being, favorable treatment outcomes and reduced medical costs.

Patient empowerment is the process by which patients develop the ability to become involved in their medical care in meaningful and beneficial ways. Its virtue is borne out by patient empowermentthe fact that the age of the passive patient is rapidly vanishing. The new and evolving healthcare system requires greater responsibility on the part of patients in various aspects of their medical care. One of those aspects is familiarity with their medical histories. Patients have conveniently and comfortably answered “I don’t know” or “the doctor didn’t tell me” when questioned about certain diagnoses or the reasons for various tests, surgeries or medications in times past. But in today’s changing healthcare system that type of passive behavior is neither desirable nor beneficial.

It is the responsibility of patients to know and understand the reasons for the care they are provided. If there is a lack of understanding it is appropriate to ask questions and take notes if necessary. If circumstances or timing don’t allow the asking of questions other sources of medical information such as articles on the Internet or written publications oftentimes provide answers. In addition to obtaining answers, presenting questions to doctors and using available sources of medical information helps to establish and increase health literacy. It is understandable that many patients are not able to understand and utilize information pertaining to their health, but family members or other caregivers can serve as substitutes.

Empowerment of patients to become engaged in their medical care is valuable because of the health literacy associated with it. After all, patients’ ability to obtain, process and utilize health information and services to make quality decisions pertaining to their health leads to improved well-being, better treatment results and reduced medical expenses.

The economic value of health literacy to patients is more evident in today’s changing healthcare system because they no longer have a blank check for medical care. In general, out-of-pocket expenses are greater in the ACA insurance plans. Therefore, if patients require more frequent doctor visits, more tests, or hospitalizations because of poor decisions on their parts, poor adherence to treatment instructions, or the inability to provide key information for their care, they are faced with greater expenses.

Patient empowerment and health literacy are also beneficial and valuable to physicians and other providers because of ongoing changes pertaining to reimbursement. Those changes are part of the transition from a system in which services are paid on the basis of volume to one in which reimbursement is based on the value of the care provided.

The traditional volume-based fee-for-service reimbursement system pays physicians and other providers according to the number of patients they treat and a fixed fee schedule. A value-based reimbursement system on the other hand, reimburses based on quality standards, treatment outcomes, and the cost of the care provided. Therefore, it is understandable that most providers would prefer to treat patients for whom the perceived value of their treatment is greatest. Since the value-based reimbursement models make allowance for a patient’s degree of illness, factors related to the behavior of providers and the behavior of patients determine the value of the care.

Factors related to providers that affect the quality of healthcare are basically those having to do with diagnostic testing and treatment decisions. They might reflect the level of competence of the provider, but oftentimes the quality and accuracy of the information provided by patients influences them. The value of that information has been borne out by two studies. One study performed in the early 1990s, and the other in 2011, both showed that physicians were able to make correct diagnoses far more often if they relied primarily on verbal information from patients as opposed to findings on physical examinations or diagnostic tests.

Many of the quality standards by which the value of a provider’s care is judged require patient engagement and patient adherence to treatment instructions and recommendations. Although adherence involves willingness to adhere, the ability to understand the treatment, make appropriate decisions in relationship to it and to be successfully engaged in the treatment are all virtues of health literacy which illustrate the value of patient empowerment through it.

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