What Providers Need to Know About Healthcare Consumerism

Each week brings news of yet another website, tool or app to help consumers make healthcare decisions. Increasingly, patients have access to clinical information, quality data and patient satisfaction ratings. But how do they use that information? And how can understanding their behavior help providers turn consumers into engaged patients?

Consumer Focus Can Reduce Costs

According to “Executive Insights from the 12th Annual World Health Care Congress” (March 22–25, 2015, Washington, D.C.), healthcare “has lagged behind other industries that place consumer need and convenience at the center.” But the landscape is changing. Healthcare providers are not only focusing more on patient experience; they’re also coming to view consumer engagement as an opportunity to improve care and lower costs.

In the same report, Stan Nowak, CEO and co-founder of Silverlink Communications, a healthcare consumer outreach firm, notes that consumer behavior drives 50% to 70% of healthcare costs. His firm’s research has found that if 10% of a million-member health plan behaves optimally, a $100 million bottom-line benefit results.

It’s Not Always About the Ratings

Researchers at Johns Hopkins Medicine have found that consumers rely on a number of factors in deciding where to receive care. Some tips from their findings:

Care decisions are emotional decisions. Patients travel long distances to access care at Johns Hopkins. The organization’s research indicates that just 13% of consumers who travel to receive specialty care conduct factual research during the decision-making process. Instead, emotion drives many care decisions, as do family or friends’ recommendations and magazine rankings.

“Consumers like to have an emotional connection, even before they travel here,” says Dalal Haldeman, PhD, VP of marketing and communications at Johns Hopkins Medicine. “They want to see a photo of the doctor, talk to them and get a feel for their voice, see if it’s a warm tone. We had someone who was coming from California who was looking at two to three institutions tell us they looked at photos of the doctors. This person made the decision based on what the doctors’ photos looked like.”

Generally, Haldeman says, consumers make healthcare decisions based on analysis, emotional reaction and/or peers’ and friends’ recommendations.

Consumers seek connection with their providers. “It’s not enough to have the expertise anymore,” Haldeman says. “Everyone on faculty has to have a small video on the website so people can view, listen and connect with the physician. When facing a life-or-death situation, you are stressed. When you are stressed, you move to the emotional side. People want to be made to feel like a person, not just a number. They want to know the providers genuinely care about them from the very first interaction.”

Consumers want to know the cost—and will need help finding it out. “Consumers want to know what it will cost to come here, what the insurance doesn’t pay,” Haldeman says. “But that varies with each insurance plan. We have financial advisors who help them with that. They help the patients and even talk to the insurance companies for them.”

Ratings are a factor, but not the only one. “There are so many rating agencies and a lot of research patients can do, especially if they don’t have strong guidance from their primary care physicians,” Haldeman says. “The patients who are local to Maryland generally follow their primary care physician’s recommendations. Those who travel from out of state generally try to find the person with the most expertise.”

Consumers value convenience. “Eighty-five percent of people will seek healthcare in a geographically convenient location,” Haldeman says. “What matters most to healthcare consumers is that the facility has what they want at the time and location they want it.”

Take a Page From Health Plans

The shift to value-based payments is driving healthcare providers to put more emphasis on patient engagement, something health plans have focused on for decades. Providers can benefit from what health plans have learned about how to communicate with consumers. Silverlink’s Nowak, whose firm works with health insurers on communications engagement strategies that result in a better consumer experience, shares some insights.

Time communications for when the consumer needs them. Organizations that can capture real-time information about care episodes are in an especially good position to do this. “We’re predicting when the consumer is accessing healthcare,” Nowak said in an interview. For example, “when we can see that you are going for orthopedic consults, we realize you might need an MRI.” The plan or provider might direct the patient to an MRI facility that’s close by and cost-effective. “The health plan has to be directed to me when I am accessing care,” Nowak says. “If I am spoon-fed the right information at the time I need it, and the insurance plan tells me I can save $400, that will get my attention.”

Analyze data to personalize approaches. Silverlink’s technology combines data and analytics to target certain populations, track communications history, and provide strategies to personalize communications and channel preference.

“The data needs to be used smartly and in a way that is relevant and personal,” Nowak says. “And the message—[for example] that it’s time for a mammogram—needs to be delivered in a way the patient wants it delivered. Do they want a reminder sent via mail, a phone call, email, a text message? Also, if we deliver the message on the provider’s schedule rather than the patient’s, it’s not effective. It doesn’t make sense to send a reminder in January if the patient usually has a mammogram in November.”

Look for opportunities to educate. For example, if an insurance plan notices a patient is visiting the ER a lot, it can intervene. “Perhaps [they] really just need a primary care physician,” Nowak says. “The plan can educate and help the individual find a primary care physician.”

Nowak says the shift from employer-based health insurance to more individualized plans also has changed where consumers get their information. “A few years ago, most healthcare was related to employers, so people just went to HR for answers,” he says. “Now, there are a lot more individual plans, so health plan providers are trying to help consumers understand and engage in the process. They are starting to create user-friendly websites, apps, etc. Our business is to engage the unengaged and have everyone involved in the decisions.”

Susan E. Sagarra is a writer, editor and author based in St. Louis, MO.

Take-Home Points

• Care decisions are emotional decisions
• Consumers seek connection with their care providers
• Consumers want to know the cost—and will need help finding it out
• Ratings are a factor, but not the only one
• Consumers value convenience