The Healthcare Consumer
With increasing high deductible policies and out of pocket expenditures, patients have morphed into consumers who must make consumer-like choices for their healthcare. Understand the profound impact that this consumer-driven healthcare movement will have on how healthcare services must be reformulated and delivered.
Skeptics of healthcare consumerism make many excellent points, including the impossibility of comparing hospital prices while driving to the emergency room. Despite the rising number of people with high-deductible health plans,1 the majority of consumers are confused by what it means to have “skin the game,” or manage their medical-related expenses. According to one survey, 66 percent of respondents said that managing their out-of-pocket costs was the most challenging part of overseeing their health care.2
Yet, despite the challenges of turning health care into a “shoppable” service, it is already happening due, in part, to the emergence of retail health and digital devices. After growing by 445 percent between 2006 and 2014, the number of retail health clinics is expected to nearly double by 2017.3 In addition to mortar-and-brick clinics, online storefronts are emerging, such as the second opinion service Best Doctors, Inc. At the same time, virtual Amazon-like interactions are becoming ubiquitous in almost every area of life, from banking to education.
As more patients embrace retail health and online experiences, many hospitals and physician practices are taking steps to give their patients the type of consumer-oriented experience they’re coming to expect.
As they think about consumerism, providers are embracing three tenets of retailers the world over, convenience, transparency, and customer service.
Convenience. Taking cues from retail, many physician practices are working to extend office hours, reduce office waiting times, and offer same-day appointments. According to a 2015 survey, 53 percent of physicians said that most of their patients could get a same- or next-day appointment on request, compared to 39 percent in 2009.4
Meanwhile, hospitals and health systems are using a variety of strategies to make it easier for patients to access services in a timely manner. Some are opening free-standing urgent care and emergency departments in convenient locations so patients don’t have to drive all the way to the main hospital facility.
SCL Health is adding small community hospitals—or micro-hospitals—in neighborhoods around its urban and suburban service area. These eight-bed hospitals offer a full-range of services but on a small scale. “They’re also priced less than a full-service hospital emergency center or inpatient facility, so it’s sort of a middle price point,” said president and CEO Michael Slubowski.5
A number of health systems are affiliating with retail clinics in hopes of gaining downstream volumes. These partnerships include Trinity Health and Walgreens and Kaiser Permanente and Target.3 Other health systems are building their own retail complexes. For example, Hackensack Meridian Health recently opened a retail health village, called Meridian Health Village, that brings numerous medical and wellness services under one roof, including an urgent care clinic, imaging, a fitness center, a pharmacy, and numerous physician specialties.6
Extending the convenience continuum to patients’ homes, many providers are experimenting with e-visits, telehealth monitoring, and other virtual care. Mercy’s Virtual Care Hospital has taken this concept to the extreme. It is the world’s first bed-less hospital dedicated entirely to care outside its walls. More than 300 clinicians electronically monitor patients at home and in ICUs at the Catholic health system’s traditional hospitals.7
Transparency. Comparing quality and price across healthcare providers is still an evolving science. But many providers are making efforts to be as transparent as possible without confusing patients. For example, patients at Pittsburgh’s St. Clair Hospital can access an online tool that allows them to get an out-of-pocket estimate for 105 different services. The estimate factors in the patient’s specific insurance benefits and deductible status.8
In addition to giving price estimates, Spectrum Health was the first provider in Western Michigan to make its quality data available on its website. The health system currently posts quality reports on nine conditions and procedures, including breast cancer and hip and knee replacement. Each report explains in simple terms how Spectrum Health compares to other providers on important quality metrics.9
Customer service. To identify ways to help im
prove the patient experience, about 40 percent of hospitals have patient and family advisory councils. One study found that hospitals with these councils have a higher percentage of patients giving the organization a high rating (9 out of 10) on patient satisfaction surveys, compared to hospitals without these councils.10
At LifePoint Health, members of these councils advise leaders on areas of improvement. They’ve also helped the health system develop a patient portal, worked on patient education materials, and advised on the layout and design of a new hospital.10 LifePoint has also hired a vendor to carry out secret shopper calls to evaluate the level of customer service in different areas. The information is then used to train staff in customer service protocols.11
McKinsey & Co. research shows that consumers rank “providing great customer service” as important to healthcare experiences as non-healthcare experiences. However, many consumers have a hard time recognizing what satisfies them the most about a healthcare experience. When McKinsey surveyed patients after a hospital stay, the patients said the outcome of their hospital procedure or admission was the most important to them.12
However, when McKinsey researchers analyzed all the factors that patients said influenced their satisfaction, they found that the factor that impacted satisfaction levels the most was the amount of empathy and support they received from clinicians, especially nurses. Another key factor was the information patients received during and after treatment.12
Some providers are investing in training to help clinicians build empathy and communication skills. For instance, Kansas University Medical Center gave physicians emotional intelligence training.13 In another example, Twin Rivers Regional Medical Center saw its patient satisfaction scores increase 33 percent after implementing a program that ensures nurses dedicate time to talk to inpatients about their greatest concerns.14
Different Customers, Different Approaches
Many healthcare providers are still feeling their way around this new retail, consumer-oriented landscape. While the general retail tenets described above are a good place to start, providers will need more detailed information on their patients to design effective and successful strategies. The use of data analytics could be helpful in this exercise. Press Ganey recommends segmenting patients by shared attributes (for example, age, condition, and service line) and then digging deeper into what each of these segments values. This could lead to breakthrough ideas for distinguishing a healthcare provider’s services.15
- Kaiser Family Foundation, Average Annual Workplace Family Health Premiums Rise Modest 3%, September 14, 2016.
Alegeus, New Alegeus Research Explores Consumer Spending & Saving, July 27, 2016.
Accenture, U.S. Retail Health Clinics Expected to Nearly Double by 2017, 2015.
Milne, A. et al., Why Don’t More Doctor’s Offices Offer Same-Day Appointments? Healthy Debate, January 28, 2016.
Stempniak, M., SCL Health Tries Out Microhospitals, H&HN, June 28, 2016.
Meridian Health Village at Jackson, accessed September 16, 2016.
Mercy Opens World’s First Virtual Care Center, October 6, 2016.
Butcher, L., St. Clair Hospital Launches Online Cost Tool, Patient Friendly Billing e-bulletin, May 2016.
Spectrum Health, Quality Reports, accessed September 16, 2016.
Landro. L. Hospitals Form Patient Advisory Councils to Learn How They Can Improve Care, Wall Street Journal, November 29, 2015.
Butcher, L., Secret Shoppers Identify Improvement Opportunities, Patient Friendly Billing e-bulletin, November 2015.
McKinsey & Company, Debunking Common Myths About Healthcare Consumerism, December 2015.
Fojut, R., How to Turn Physicians into Patient Satisfaction Champions, Leadership, September 2015.
Pu, S. and Jackson, S., Humanizing Health Care to Boost Patient Satisfaction, Leadership, May 2013.
Press Ganey, Segmentation: The Power of Data to Reduce Patient Suffering, 2016.