US health leaders say that building a better customer experience for patients is a top priority. Yet, despite spending millions of dollars on the administrative aspects of healthcare such as online billing, digital communication tools and facility improvements, a gap remains between where companies need to be and where they are today. The primary reason for this gap is that the US health industry is not able to reap the full potential of data being generated about American health consumers.
In the New Health Economy, patients are consumers first, with the freedom and responsibility that comes with making more decisions and spending more of their own money. The health industry has made strides in shifting from the business-to-business to the business-to-consumer mentality that other service industries such as retail and banking adopted long ago. But health companies still lack a complete view of their customers because they lack data. In an HRI survey, 64 percent of health insurance executives and 88 percent of provider executives said having insufficient information about customers is a barrier to meeting their expectations.
Health companies should start connecting data about not just the patient encounter but also the preferences and social circumstances shaping everyday health and healthcare-related purchasing decisions. They should use that information to provide a more seamless and customized experience and be able to stay connected to customers in the “white space” of health.
Traditionally, providers have built their customer experience efforts around the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and with good reason. According to Press Ganey Associates, a leading patient satisfaction survey firm, US hospitals have, on average, $850,000 at risk every year directly tied to their HCAHPS results. For insurers, a five-star rating from the Centers for Medicare and Medicaid Services serves as a ringing endorsement in an increasingly competitive market.
But the metrics collected in satisfaction surveys fail to capture what healthcare customers value most, what they prioritize and what motivates them toward healthy behaviors and purchasing decisions. The HCAHPS questionnaire, for example, cannot discern that people may have different views on wait times for primary care appointments as compared to visits to the emergency room. A study published in the journal Health Affairs found that the topics most strongly correlated with the sentiment of Yelp hospital reviews—including compassion and kindness of staff, cost of care and billing—were not measured by HCAHPS.
Ninety-seven percent of provider executives surveyed by HRI said that new ways to measure the customer experience will become important in a value-based care environment. Under the Medicare Access and CHIP Reauthorization Act (MACRA), the law governing clinician payments for Medicare services, provider reimbursements will be based, in part, on patient engagement efforts such as promoting self-management and coaching between visits.
In its survey measuring the intensity of consumers' preferences on 47 healthcare experience features, HRI found 12 features that are highly valued across all consumer segments and can be satisfied by using data.
These features fall into five main categories: convenience, quality, support, personalization and communication.
Some health companies are starting to trace how experience correlates with customers’ actions over their lifetime, such as whether they stay in a single provider system for all their care or recommend the company to a friend.
Measuring the experience requires more information than can be gathered from a patient satisfaction survey administered after treatment. The New Health Economy provides the health industry with incentives to gather customer feedback in real time to continuously learn about the customer and cycle that information back to clinicians and other staff.
Masses of data are being collected throughout the health ecosystem, but companies rarely share the data with each other and no single company has a complete view of its customers. Claims and grievances data sit with payers, clinical information remains with providers, while community organizations and retailers own shopping, personal preference and lifestyle data. Drug and device manufacturers and technology companies are beginning to gather drug adherence and real-time biometrics through apps and wearables.
Gaining access to data and analyzing them will be critical for matching patients with the services they want and need. Yet the industry is still in the early days when it comes to using this information to improve the patient experience.
Consumers know what they want. Grasping the nuances of their experience priorities and addressing them can generate a return on investment in the New Health Economy.