The rise in healthcare “consumerism” has been discussed for years, but until now was never an urgent reality. As we head into 2017, that has changed. We finally see the confluence of events that makes a “consumer platform” a necessary competitive priority for healthcare providers.
Consider the following: High deductible health plans (HDHPs) are now the norm for commercial insurance; CMS is leading the industry into unprecedented levels of value-based transparency; retail chains deliver convenient, low-cost care in almost every mid-size to large market; virtual physician visits via mobile devices are now a reality; and the 2016 elections have ushered in an agenda for a resurgence in “free market” healthcare.
Given these realities, it is vital for healthcare providers to develop an effective consumer-based platform, including a focus on five key principles: Accessibility, Convenience, Affordability, Transparency, and Tailored Care.
Accessibility
With convenient access becoming a core expectation, consumers are driving healthcare providers to look outside of traditional care models and settings. Patients value access and the ability to choose the care setting that best fits their needs. To address these needs for accessibility, healthcare organizations need to consider both the number and type of access points they have.
There is no “right” number of access points. When evaluating the number and location of access points, it is necessary to consider population growth patterns, distances, drive times, competition, and economies of scale. There are many forms these access points can take. Outside of the hospital and physician office settings, new access points can include a mix of medical office buildings, immediate and urgent care centers, ambulatory surgery centers, retail clinic partnerships, imaging centers, multipurpose ambulatory centers, home health services, telemedicine sites, and even mobile telemedicine applications.
An organization does not need to own all of the assets or operations of these sites. Partnerships with limited integration, that instead capitalize on shared information, can offer the opportunity to leverage assets while building an effective, and geographically distributed, integrated care model.
Convenience
Our society is always in a hurry – and so are our patients! To stay relevant in a competitive market, organizations must provide care not only where patients want it, but when they want it. For example, primary care and core ancillaries must be available on evenings and weekends. And when consumers arrive for care, they don’t want to spend more time in the waiting room than they spend with their provider. Many times, they also want the flexibility of same-day appointments.
The expectation for convenience extends beyond medical care into the financial transaction. Patients are tired of dealing with the confusion of multiple, unclear bills and want to know their costs before they choose a provider, rather than after the service. Many organizations are investing to simplify and streamline the billing and collections process. Why is convenience in billing so important? Studies have shown that a positive financial experience is important to patient satisfaction, with 82% of patients recommending a hospital if their experience with billing was good.
Patients also are looking for convenience when it comes to accessing their health information. Patient portals continuously demonstrate additional capabilities that make it easy for patients to make appointments, message their physician, and request medication refills. This 24/7 access to health information allows consumers to feel more connected and informed, increasing their overall satisfaction.
Affordability
Over 15.5-million people in the U.S. have HDHPs. This growing patient financial responsibility is leading to higher consumer sensitivity relating to healthcare costs. Historically, hospitals and health systems have benefited from hospital provider-based rates. However, managed care plans and consumers have increasingly steered away from hospital-based emergency, imaging, surgery, and oncology centers to less expensive clinic-based models. Furthermore, CMS is pursuing a site-neutral agenda to eliminate these price differentials. Health systems continually need to create lower-cost platforms to meet patient needs.
This need for affordability ties back to accessibility. When an organization can manage care settings across the continuum, it has the ability to offer services at different price points. Additionally, participation in telehealth services allows physicians and other providers to administer care without the costs associated with additional labor, supplies, and facilities. Virtual visits can even serve as a “gatekeeping” mechanism to prevent patients from utilizing unnecessary or inappropriate services. This type of accessibility greatly reduces the costs to the patient, as well as the costs to the insurer and even the facility.
Transparency
Patients are seeking lower costs and more predictable costs. Many organizations have responded to this need for price predictability by developing out-of-pocket estimator tools specific to patient benefit plans. A recent Public Agenda study found that 56% of Americans have tried to find their out-of-pocket cost before receiving care. By implementing price estimator tools and other transparent pricing structures, organizations can serve their patients and provide them with the information they need to make decisions about their care.
Beyond price transparency, consumers are looking for organizations to be open and honest about their quality and outcomes. With sites like Hospital Compare and Physician Compare, there now is a wealth of readily accessible quality information for patients to access when choosing a provider. A 2014 JAMA study found that 65% of consumers are aware of online physician rating sites and 36% of consumers have used a ratings site at least once. Now that quality and patient satisfaction data is reported publicly, physicians and organizations have no choice but to be transparent. This is why it is vital that providers monitor online reviews, address gaps in the care process, and make patient satisfaction a priority.
Tailored Care
Not all consumers are created equal. Providers need to consider what populations they are serving and how the needs of these populations differ. Consumers want their care to be personalized. A “blanket” strategy will not work.
For example, Medicare patients typically do not have the same values and concerns as their younger counterparts when it comes to the care they receive. They may shy away from virtual visits and place a greater emphasis on established patient-physician relationships and face-to-face communication. Younger patients typically place a greater emphasis on the convenience and accessibility of care and are comfortable with virtual communication and electronic transactions. Older and younger populations also have different healthcare needs. Older populations may need more chronic care management services, while younger populations may seek treatment for acute illnesses, minor injuries, and urgent care needs.
These are all considerations to make when developing a consumer platform. Perhaps the consumer approach for Medicare patients focuses on care navigation services, personalized care plans for chronic disease, and easy-to-understand billing. For younger patient populations, the approach may include the use of smartphone applications and video conferencing with providers to increase accessibility across technology platforms and better fit care time into their schedules.
Durable relationships are built on the ability to anticipate and respond to consumers’ clinical and non-clinical needs. By providing personalization and a feeling of community, organizations can encourage patient loyalty through outstanding experience.
Right now, a patient is looking for care. Will he or she choose your providers? How can you position your organization to be the consumer’s choice today?
For more information about developing effective consumer-based platforms, contact one of our executives below at PYA, (800) 270-9629.
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