Health Care Evolution: New Roles for Family and Consumer Professionals
Rider, Mary Ellen, Riportella-Muller, Roberta, Journal of Family and Consumer Sciences
The health care evolution affects families in how they use and pay for health care. Communities face changes in the types of providers available as well as how community members make choices to use the health care system. The purpose of this paper is to describe the current health care evolution through related cost, quality, and access issues. Implications for consumers and the professionals that serve them are drawn. Family and consumer science professionals need to continue and enhance educational programming that affects personal health behaviors, choices for interacting within care systems, and involvement in health care policy decisions. Our field provides an appropriate, interdisciplinary base for meeting rapidly changing consumer and community needs.
HEALTH CARE EVOLUTION: NEW ROLES FOR FAMILY AND CONSUMER PROFESSIONALS
Health care is a complex economic good. Decisions about what services are available, who provides them, what they cost, and the quality of those services are all determined by a variety of sectors. These sectors include health care providers (physicians, hospitals, etc.), government (federal, state, and local), communities, and consumers.
Health care is one of our nation's largest industries. Health care expenditures represent 13.6% of gross domestic product (GDP). In fact, Americans spend over $1 trillion a year on health care (Center for Disease Control, 1998). Because of the size of the health care system and concerns for health care costs, federal discussions of health care reform were held in 1993 (Zelman, 1996). After these discussions failed to produce comprehensive legislation, reform became industry driven and focused on managed care.
Helping consumers successfully understand how our health care system is evolving, making decisions that affect families and communities, and functioning in the changing health care environment are appropriate and important roles for family and consumer sciences professionals. The expectation is that active consumer participation will improve one's health status and reduce health care costs. To achieve these ends, consumers and communities must be effective participants in the economic environment of one of our nation's largest industries.
Health care system changes affect families in how they use and pay for health care. Communities face changes in the types of providers available as well as how community members make choices to use the health care system. The purpose of this paper is to describe the current evolution, related issues, consumer adjustments to the evolution, and implications for family and consumer sciences professionals.
HEALTH CARE'S RECENT EVOLUTION
The Foundation for Accountability (1998) noted that Americans want quality health care in five areas-delivering basics of good care (access, communication, care coordination, and customer service), staying healthy, recovering from ill health, living with illness, and changing family needs. New forms of evaluation data are becoming available to assist systems and consumers in evaluating quality and making choices about treatment protocols and health care plans. Outcomes data are derived from studies that ask what difference a drug, procedure, or other intervention really makes in one's health and well-being (Families USA, 1994) . In addition, provider implementation of customer satisfaction surveys, known as "report cards," is increasing.
Because of the complex nature of health care, the issues of cost, quality, and access are often interwoven. When health care reform became industry driven and focused on managed care, the focus was the control of health care costs and enabling access to care.
Managed care is both a method of managing costs and a method for delivering health care (Kongstvedt, 1996). The concept is translated at the patientcare level by moving from crisis management or acute care (treating only after illnesses or injury occurs) to preventive care. …