Hospital and healthcare providers are getting real about improving patient and health consumer experience, the latest Kaufman Hall research finds.

The company’s 2018 State of Consumerism in Healthcare report is out, subtitled, “Activity in Search of Strategy.”

Kaufman Hall has developed a Healthcare Consumerism Index for healthcare providers based on four pillars: access to care, consumer experience, pricing, and a strong foundation of consumer insights. Based on their assessment of providers on these components, Kaufman Hall found identified four tiers of performance:

The top-performing group, Tier 1, includes only 8% of providers. These are the early adopters who allocate resources to build and implement a strong consumer focus in their healthcare operations.

Tier 2, 23% of providers, are evolving to become more consumer-centric, in pilot modes.

Tier 3, with just over one-half of providers, have focused on a specific need in their market versus adopting an overall culture of healthcare consumerism.

Tier 4 represents 17% of providers, who are following others to learn from earlier adopters of consumerism in healthcare.

On the first pillar of access, some tactics are better utilized than others to expand accessible touchpoints: urgent care centers and freestanding imaging sites are more widely available to consumers compared with video and e-visits (telehealth) services. Roughly one-in-five providers is planning or developing virtual care services.

Convenience is an integral component to consumer experience, and for healthcare that means same-day appointments, messaging between patients and clinicians, hours of operation, and on-line scheduling. A majority of providers offer these initiatives or are rolling them out.

Providers’ addressing friction points for consumers trying to access healthcare services is key to garnering patients’ loyalty and trust. The most-used tactics for enhancing customer experience friction are providing easy-to-find phone numbers and customer service training for staff. Plans and roll-outs are in progress for facility way finding support, reducing office wait times, and real-time patient feedback loops.

Health care costs are a key issue for patients and healthcare consumers in 2018, for both personal households and as a mid-term election hot-button. This study examines consumers and healthcare costs across several dimensions. First, providers’ addressing consumer-friendly billing statements is a work-in-progress: while 28% of providers have fully implemented “easy-bills,” 20% have them in pilot or roll out stage, and 24% in planning/development.

Pricing methods is another aspect of consumers’ healthcare costs. The most common tools that providers use to set pricing are benchmarking negotiated rates to the market and analyzing price/volume trade-off impacts on revenue and margin. Less-common tactics to address pricing are cost-to-serve analysis based on costs of patient/clinical services, determining relative price risk by service, and consumer research to understand patient demand-elasticity or willingness-to-pay for a service.

Finally, Kaufman Hall analyzed price transparency efforts among providers. The most common approach to transparency is reactive, not proactive: it’s responding to price quote requests by consumers. Only 23% of providers offer an online tool providing estimated patient out-of-pocket costs. Fewer than one-in-five providers offer clinicians and staff with tools to answer patient questions about price. Note that the Aetna Health Ambitions Study, which I wrote about here, found that the majority of consumers wants to ask doctors about the patient-facing cost of services, so the demand side is quite clear (and substantial) on this point-of-friction and -service.

Kaufman Hall interviewed 200 organizations for this study, including health systems, stand-alone hospitals, children’s hospitals, and specialty hospitals.

Health Populi’s Hot Points:  There’s a hard return-on-investment for garnering patients’ satisfaction and HCAHPS scores. First, in terms of experience, customer experience guru Bruce Temkin connected the dots between patients’ emotions during hospital visits and the organization’s net promoter scores based on different feelings: relief, confidence, happiness, versus disappointment, confusion and anger. The bar chart illustrates the impact on NPS by emotion factor: confidence and excitement inspire high scores; disappointment drives the NPS way down, followed by anger.

Deloitte calculated another way to measure the ROI of patient delight by looking at hospitals’ financial performance, finding that those providers who scored more highly on patient experience yielded better financial outcomes — highly correlated to patient-nurse engagement. On the nurse-connection, note that Americans rank nursing the most honest and ethical profession in the nation, the Gallup Poll found in its 2017 annual study on the topic. In fact, nurses have placed at the top of this poll for many years ongoing.

Accenture, too, calculated that the higher the HCAHPS scores a hospital garnered, the better fiscal margin the provider realized.

So the moral of this story is if you delight the patient, you do good and do well. If you highly value and compensate your nursing staff — all the better.

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