Patients are healthcare consumers and are making more informed health care decisions. It is becoming increasingly more cost-effective for healthcare providers to retain patients than spend resources on new patient acquisition. In fact, according to The Advisory Board Company 2015 report “Competing on Consumer Experience,” a new patient retained for three years is worth six times more revenue than new patients who don't return.
The report also shows companies with loyal followings have two times the revenue growth as those without loyal followings, and when organizations commit to the customer experience they typically enjoy a 25 percent increase in consumer retention. In fact, a 5 percent increase in customer retention can lead to greater than 25 percent profit increases.
How can hospitals and health systems meet their patients' needs and inspire loyalty among healthcare consumers?
That’s what participants in an April 12 roundtable hosted by the Johnson & Johnson Medical Devices Companies at Becker's Hospital Review 9th Annual Meeting in Chicago sought to find out. The roundtable included Johnson & Johnson Medical Devices Companies Vice President of Customer Marketing & Solutions Melinda Thiel; Johnson & Johnson Design Senior Director of User Experience & Insights Cordy Swope, and President of Johnson & Johnson Health and Wellness Solutions Len Greer, moderating a discussion with about 25 healthcare executives.
"Loyalty is really essential for population health to be executed well," said Ms. Thiel. "If you don't have consumers for periods of time and you don't have your populations in support of some of those strategies, it is difficult to execute population health without patient loyalty. Loyal customers can help minimize some of the financial challenges associated with reimbursement and other financial implications within your systems. We also know that experience is often driven primarily by what that patient experiences with the provider themselves, more so than the actual cost or quality of care."
The following summarizes key trends and topics discussed during the roundtable and potential solutions to the tough challenges of population health.
Consumerism in healthcare
Many hospitals were not designed around patient experience. However, studies show that patient experience may be more important than quality outcomes in gaining patient loyalty. For example, around 60 percent of the top 10 loyalty drivers for primary care physicians and 66 percent of the top nine loyalty drivers for specialists are experience-related, according to The Advisory Board Company 2015 report “Competing on Consumer Experience.”
Patients search for healthcare facilities online and read reviews to decide where to spend hard-earned healthcare dollars, bringing a consumer mindset into the healthcare space. "We think of consumerism as a cultural transformation which recognizes that people are active consumers of care in search of better experiences and outcomes in an evolving and interactive healthcare environment," said Ms. Thiel.
Patients now have access to retail clinics, urgent care and concierge care in addition to the traditional primary care physician practice model. As a result, a physician's influence over where patients receive care has diminished. Instead, patients take the same consumer mindset and expectations they have when streaming Netflix or purchasing groceries online.
"They want information and access quickly; we all want and have come to expect that and so health systems need to think about service expectations and consumer engagement in the context of that evolving landscape," said Ms. Thiel.
Motivating populations for wellness
Healthcare providers can point patients in the right direction for wellness resources and healthy living, but struggle to influence patients' self-motivation. Some patients are intrinsically motivated to make changes, but others need additional incentives. Healthcare organizations can partner with employers to help motivate individuals, but there isn't a one-size-fits-all solution. (can we provide an example of how this might take shape)
"For a long time, healthcare providers have been telling people you need to do A, B and C to get healthy and stay healthy, and you start to see results, but then compliance falls off," said Mr. Greer. "But what we found is if you can ignite an intrinsic motivation, if you can give people an opportunity to reflect on personal purpose and use that as a motivational factor throughout someone's healthcare journey, they're much more likely to exercise and eat right. With employees, we have been doing this for years in different forms and we're just beginning to take those types of concepts and put them in front of the patient journey for an episode of care."
The principles Mr. Greer describes can be applied to individuals who face lifestyle changes as a result of a new diagnosis. Johnson & Johnson Human Performance Institute (HPI) developed a solution based on a simple Q&A that helps a patient tell his or her story and identify goals for the future. The process triggers intrinsic motivators and can help healthcare providers craft a care plan along with the patient that they both support.
For others, general wellness may already be a core value but they have trouble finding time to exercise, eat right and sleep. Mr. Greer and his team at HPI decided to tackle that problem and developed the Official Johnson & Johnson 7 Minute Workout® App. The workouts were designed to maximize value during a short time period, which is ideal for employees who travel regularly for work.
"As we do develop solutions of any kind, whether they are consumer directed or part of an episode of care, or some other healthcare journey one's on, we always try to put on the very front some element of purpose and vitality to get people fired up," said Mr. Greer.
Addressing at-risk populations
There is a huge opportunity to combine behavioral science principles and technology to develop solutions that address key issues for at-risk populations, including elderly patients with congestive heart failure. In some cases, when patients are discharged home, they face isolation and food insecurity, which leads to readmission.
"I think we have a unique opportunity at this point in time to start to think differently," said the senior vice president of population health for a large North Carolina-based nonprofit health system. "What I fear is that traditional healthcare in the next 20 years is going to be fundamentally destroyed for the people who need it most if all we do is design at the margins. We chase revenue streams without chasing health."
Healthcare providers in many urban and rural settings struggle to engage patients and community members to improve overall health and prevent unnecessary visits. Much of the prevention begins by making investments in individual well-being, which can become part of the patient's journey in care. While companies such as Johnson & Johnson have tremendous resources and reach to scale technology applications for community benefit, solutions must be customizable to adapt to the local markets.
"What if we talked about caring for the communities, and not just people who have revenue streams tied to them, but how do we develop a system that looks at improving the health of the community in a more meaningful way?" the executive posed. "And that's going to take us thinking differently than developing a service or providing a product. What are those basic things we can do in order to support the health and improve the health of our communities? I think if we don't do that somebody is going to do that for us."
Global reach
Johnson & Johnson has experience implementing public health initiatives in impoverished regions around the world. It reaches people through consumer channels with disease awareness campaigns and education to promote healthy habits and lifestyle.
"Independent of the business model under which care is delivered, we at Johnson & Johnson design endeavor to make the experience of care accessible, relevant, and easier to deliver,” said Mr. Swope.
As an example, in impoverished African communities, pregnant women had smartphones but no internet access. Johnson & Johnson spearheaded a campaign to send reminders through the pregnancy journey via text message.
The company is applying similar principles in the U.S. There is huge opportunity for population health, chronic care and pediatric wellness to invigorate healthcare consumers across the nation. Many in the room agreed that childhood wellness is a great place to start.
"When we talk about segmentation of the population and improving the health of communities, a great target audience is pediatrics because we have a much more captive audience in pediatrics," said the director of quality and patient safety for women and children's service line for a 913-bed hospital in Delaware. "While my child is [at his or her visit], I'm there, my husband is there, my other child is there, so you have the opportunity to reach families and if we focus on improving the health of children we create healthier adults."
Roundtable Conclusions
Healthcare providers are responsible for the health of communities and their institutions. Under value-based care, hospitals are tasked with improving quality while reducing costs. Healthcare providers realize they must partner with employers and industry members to motivate healthy lifestyles while creating loyal customers with a transformed patient experience.