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Consumers first, patients second: what healthcare consumers are really looking for

By Aathavan Raviraj, PA healthcare expert

After moving to the US, I had my first American healthcare experience when I went to an orthopedic specialist. As I tried to understand and navigate the complexities of the US healthcare system I had to work my way through a steep learning curve.

As with many decisions today, I started by reading reviews on Yelp. From there I called my chosen specialist and booked an appointment after confirming they were “In Network.” The rational experience was great, quick, and efficient. Overall I received good service. However, the assistant went above her role when she realized I was new to the US and shared advice on managing my bills, etc. She even offered to be available in the future should I need to ask her questions (which I did). She acted as a bit of a healthcare confidant, which is especially important because it led to an emotional connection, committing the experience to memory. Point being, humans remember emotional experiences far more often and better than logical rational ones.

Across the healthcare industry organizations need to start treating consumers like friends and family, focusing on creating an emotionally great experience. As a consistent point of contact, payers are particularly well situated to create a better healthcare environment for consumers.

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To give consumers the proactive engagement they’re craving, healthcare payers need to change their consumer engagement strategy. Here are three ways to go about doing that:

1. Understand that the emotional and not just the rational experience define satisfaction

As companies merge and regulations change, more people feel that doctors and health insurers simply view them as just another “Member ID” rather than customers.

While US providers face increased pressure to get through as many patients as possible and battle to get paid by payers, consumers are becoming more disengaged. Consumers seek consistency, access to information, and a friendly face, something that is essential for healthcare payers to keep in mind. This is especially true as consumers engage specialists for different issues. Since payers cross a large spectrum of providers, they are best suited to enable the consistent, emotional engagement that consumers need.

At a recent NY Healthcare Leaders conference, Mario Schlosser, the CEO and co-founder of health insurance start-up Oscar, spoke about the impact on consumers when healthcare providers simply added a photo next to their name on the provider lookup tool—click rates showed an increase of over 100%. How hard is it to add a face (emotion) to create a link with the rational?

2. Focus on consumer engagement and not patient engagement

Many within healthcare discuss how 5% of the total US population represent more than 50% of healthcare costs (~ $1.3 trillion). The costs are astronomical and are largely impacted by unhealthy habitual and environmental factors. 

At AHIP, Jeff Margolis, CEO of Welltok, spoke on the power of data and highlighted how payers are vigorously analyzing the wrong data. By wrong he meant focusing just on claims data which only shows utilization. There are many factors which influence our health, and clinical care plays just a small part. Health factors include: 

  • Clinical care: 10%
  • Genetics: 20% 
  • Environment: 20%
  • Lifestyle behaviors: 50%.

Notice how lifestyle and environment account for 70% of the factors, yet healthcare payers rarely know much about the social determinants of consumers. Thinking about my specialist visit, they probably know very little about me outside of my utilization information. Payers need to start focusing on analyzing consumers before they become patients!

3. Listen to the Voice of the Customer, and don’t even mention the word “survey

I’ve worked with a number of clients who have varying levels of maturity when it comes to their consumer strategy, but they all lacked a critical function, consumer engagement! Recently, a PA client asked us to help develop their consumer strategy. The first thing we noticed was that there wasn’t anyone engaging, analyzing and/or speaking with their consumers regularly. They were efficient with the rational but again lacked the emotional intelligence gathering they desperately needed. Payers need dedicated teams engaging and testing their consumer market.

Dr. Nirav Shah, COO of Clinical Operations at Kaiser Permanente, also presented at AHIP, describing how they called up 5,000 of their highest cost members and asked the question “How’s it going?” and “How can we help you?”. What they found was habitual and environmental factors played a huge role in their health. For example, all “Linda wanted was a handrail for the steps in her house” so she could stop falling over. KP arranged for a handrail to be installed immediately, going beyond what was expected of a typical healthcare payer.

Linda built an emotional connection with KP the day she received that call, they considered her a consumer rather than a patient and listened to what she needed. Linda’s healthcare costs were significantly less, all from a phone call and a handrail. When people rank items of importance in their life, health rarely comes first. Family, relationships, finance, and career are likely to have a stronger focus. Yet health can be a key influencer in each. By keeping this in mind and shifting their thinking to focus on what members truly need, payers and providers can tap into the emotional connection that individuals crave. The idea of treating consumers like family isn’t new, but forging strong emotional bonds has become increasingly important.

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