What Do Consumers Want?

By Monica E. Oss, Chief Executive Officer, OPEN MINDS

Sixty percent of consumers reported having a negative health care experience in the past three months. That summary of the new study, Consumer Perspectives on Patient Experience In The U.S, caught my attention. “Positive” health care experiences declined from 73% in March 2020 (pre-pandemic) to 64% now. With all the new health care organizations and online rating systems, with more focus of CMS and HEDIS on consumer satisfaction, and with all the investment in health care technology, why does consumer experience in health care remain so poor?

I think the answer to that question starts with a basic question—what do consumers want? The survey findings were not surprising. Cost of care was the most important health care issue. Out-of-pocket costs topped the list at 41%, followed by affordable insurance premiums and the costs of drugs and hospital services. Access was important to 25% of respondents. And the consumer experience and quality of care followed.

If you subscribe to the theory that competitive advantage is less about the absolute and more about being “better” than the competition, these data present some great opportunities for entrepreneurial executive teams—in fee models, in access to care, and in consumer experience. After all, the “standard” isn’t great.

First is the cost issue. Executive teams of specialty and primary care provider organizations should consider developing low-cost “package” options—both for health plans and direct-to-consumer options. Walmart is going that direction with their published low prices for health care services. But low-cost options aren’t limited to the giants in the field. Direct primary care models charge consumers a fixed monthly fee for services—typically $100 to $125 per month. Masseurs are creating massage membership models. And any number of mental health provider organizations are moving to subscription services as well.

On the access front, the “front door” of most provider organizations needs an overhaul. My recommended test for any executive team is to create their own consumer profile and try calling their organization to schedule an appointment. This “mini mystery shopping” experience often reveals the difficulties consumers face in getting connected with what they need.  What we have found is that better consumer access is more than just hiring more clinical professionals. It’s the design of the front door function—integrating telephone, web site, email, social media, and text access. It’s employing real-time scheduling, providing options for in-home, in-office, and virtual services. It’s the integration of coaches and peers in the service delivery process. And it’s the leverage of a suite of consumer assessments and self-help tools to extend care delivery capacity.

Finally, there is the issue of how to improve the consumer experience. What the survey data show is that consumers base their experience mainly on how they perceive their communications with the organization. The top factors in shaping perceptions of experience are related to listening, empathy, and clarity of information.

Poor consumer experience has a definitive cost. Health plans are more likely to give preferential referrals and establish partnerships with organizations that provide better consumer experiences. Both Margaret Mayes in her keynote, Where Do We Fit? A Place For Specialty Provider Groups In Beacon Health Options Integrated Model , at The 2022 OPEN MINDS Executive Leadership Retreat, and Indira Paharia in her keynote, Improving Access & Collaboration For Complex Consumer Needs: Centene’s Approach To Integrated Care, at The 2022 OPEN MINDS Performance Management Institute, spoke to the health plan perspectives on the importance of consumer experience to health plans.

In addition, consumers tend not to return to organizations where they’ve had a negative experience. In fact, 33% of consumers with a negative experience report not returning to that provider organization. And consumers are more likely to share their negative experiences than positive ones.  Forty-four percent of consumers tell another person about a positive experience. Fifty-two percent tell others about their negative experiences. Two percent post comments about positive experiences on social media or on a web site compared to 5% for negative experiences.

Understanding what consumers want is a key piece of a sustainability strategy for specialty and primary care provider organizations in the year ahead.  For executive teams, the consumer experience should shape service delivery processes and technology acquisitions—driving the ability to compete for customer referrals.

In planning for 2023, executives would be wise to keep in mind the words of political strategist Lee Atwater: Perception is reality.