Building Brand and Patient Loyalty

HEALTHCARE BANKING Building Brand and Patient Loyalty SUSTAINING BUSINESS SUCCESS IN AN UNCERTAIN HEALTHCARE MARKETPLACE

The patient waits an average of 24 days for an appointment. When she arrives the parking lot is full, the signage confusing. She waits another 20 minutes before the doctor enters the exam room. The patient begins to explain her symptoms and the session ends in about 15 minutes. A consumer decides to shop online while waiting at a coffee shop. Within three minutes he has compared the styles and prices for a halfdozen pairs of shoes his size. He makes his purchase before his latte arrives. This is the average American doctors office experience. This is the average American consumer experience.

HEALTHCARE BANKING 1 Hospitals and health systems competing for those same consumers should aspire to meet those same expectations. And that challenge will only get more daunting with the improving capabilities of digital health devices. The world of virtual health is not only convenient, but relies much less on faceto-face interaction. Without that personal connection, it s easier for patients to switch to other providers, and loyalty becomes much harder to earn. Even now, healthcare loyalty is at a premium. Research by Accenture 1 shows that patient loyalty for healthcare providers falls below that for Wi-Fi service providers. (See Fig. 1) For these reasons, healthcare providers are realizing the importance of a high rating for patient experience and the loyalty that accompanies it. Those systems that downplay the patient experience do so at their financial peril. Hospitals that fail to report or score at or above the quality measures mandated by the Centers for Medicare and Medicaid Services (CMS) including the Hospital Consumer Assessment of Healthcare Providers and Systems survey results will face, according to the New England Journal of Medicine s Catalyst 2, an estimated $1.7 billion in reduced reimbursements in 2017. Healthcare providers have lower Net Promoter Scores than many other industries. Fig. 1: Net Promoter Scores 1 Linda MacCracken and Jean-Pierre Stephan, Patient Engagement: Think Your Patients are Loyal? Think Again, Accenture, September 16, 2016. 2 Paul Rosen, MD, The Patient as Consumer and the Measurement of Bedside Manner. Catalyst, New England Journal of Medicine Blog Post, March 20, 2017.

2 BUILDING BRAND AND PATIENT LOYALTY The Value of Your Brand How to Build Loyalty The quality of your organization s patient experience is an essential part of one of the most important dimensions of your business your brand. In a marketplace with myriad healthcare options, your services can become mere commodities to patients unless they are inextricably linked to your brand. A brand that makes good on its brand promise is one of the only business assets that generates patient loyalty and distinguishes your health system from the competition. A 2015 study by Deloitte 3 revealed that half of patients say brand and reputation are important factors in choosing a healthcare provider. In fact, according to a Global Consumer Pulse Research paper by Accenture 4, 44 percent of patients choose their healthcare provider based on personal recommendations more than any other industry. Health systems that understand the value of their brands monitor them constantly. We do a ton of patient and health plan member focus groups, says Tami Minnier, MSN, FACHE, Chief Quality Officer for the University of Pittsburgh Medical Center (UPMC). How are we doing? What s top of mind? What s your first choice? Where would you go? Why? I think that s pretty atypical of the healthcare industry today. As healthcare becomes more consumer-driven and pivots from providercentric to patient-centric, healthcare organizations can look to leaders in other industries for strategies on how to enhance patient loyalty. Donna Vieira, Chief Marketing Officer for Chase Consumer Banking, oversees branding and marketing for its 5,100 bank branches and 50,000 employees. She says that building loyalty demands a singular focus. We make sure we re driving a customer-obsessed culture, Vieira says. Our customers are really all about convenience and banking on their own terms. They want to bank when, how and where they want. "Our philosophy is: If you truly focus on the customer, everything else will flow. It is at the core of how we think about the business. We start with the customer." - Donna Vieira, Chief Marketing Officer, Chase Consumer Banking That principle resonates at UPMC, the biggest employer in the state of Pennsylvania and the operator of a health insurance plan with more than three million members. The power and direction of control in healthcare is shifting more and more to our patients and families, says Minnier. We need to be at the forefront of that. The UPMC culture is very, very, very focused on the patients and the members that we serve. We are relentlessly focused on seeing the highest performance possible. 3 David Betts, et al, The Value of Patient Experience: Hospitals With Better Patient-Reported Experience Perform Better Financially, Deloitte Center for Health Solutions 4 MacCracken, Patient Engagement: Think Your Patients are Loyal? Think Again.

HEALTHCARE BANKING 3 The Importance of Patient Satisfaction A nearly obsessive attention to the concerns of the patient not only results in higher reimbursement from CMS, but also has a significant impact on both clinical outcomes and your bottom line. Research in 2016 by Deloitte s Center for Health Solutions 5 found that hospitals whose patients reported high experience scores had a net profit margin more than two-and-a-half times that of hospitals with low ratings. (See Fig. 2) The report even suggests that those elements of the patient experience most closely linked to increased care levels, like communication with nurses, also have the strongest correlation with hospital profitability. Hospitals with excellent patient ratings have higher profitability Fig. 2: Average net margin by hospital rating levels MARKETING A PHYSICIAN S PRACTICE Educate your physicians to actively manage their online reputation. Strongly encourage them to respond to online reviews in a timely manner. Initiate extended hours and text and voicemail appointment reminders. Answer the phones in a back office rather than at the receptionist s desk. Patients often are put off by waiting at the desk while staff members process incoming calls. Inform patients about physician delays; have staff offer water or fruit to waiting patients. -Jean Hitchcock, Marketing/Communications Lead, Stamford (CT) Health 8% 6% 4% 2% 2008 2009 2010 2011 2012 2013 2014 Excellent Moderate Low A 2017 Deloitte study 6 reported that hospitals with higher patient experience ratings also had better process of care quality scores, especially regarding readmissions, mortality rates and emergency wait times. At Northwestern Medicine in Chicago, innovators are focusing on four ways to increase patient satisfaction. We re expanding telehealth options, improving workflow efficiency, enhancing value-based care and enriching the digital patient experience, particularly as it pertains to our mobile app, says Lyle Berkowitz, MD, the Director of the Szollosi Innovation Program at Northwestern Memorial HealthCare. The changes are often a combination of new technology and a re-thinking of processes. 5 Betts, et al. The Value of Patient Experience: Hospitals With Better Patient-Reported Experience Perform Better Financially. 6 David Betts and Andreea Balan-Cohen, Value of Patient Experience: Hospitals With Higher Patient Experience Scores Have Higher Clinical Quality, Deloitte Center for Health Solutions, 2017.

4 BUILDING BRAND AND PATIENT LOYALTY What Works: Patient Incentives, Connections, Convenience Financial incentives for patients UPMC s health plan provides financial incentives to its employee members for taking specified steps to improve their health. When a member completes any of nearly 200 activities including a preventative care visit, a flu shot or a health-coaching program funds are deposited into his or her health plan account to offset out-of-pocket healthcare expenses. Employee response has been overwhelmingly positive. The amount of the annual deductible that I can have waived is in the thousands of dollars, says UPMC s Minnier. You can even earn points for simply filling out an online health assessment that helps you identify your healthcare priorities as you age and as your health status and habits change. 24/7 nurse triage services In a 2016 survey by the Health Leaders Media Council, 65 percent of respondents from hospitals, health systems and physician organizations agreed that the emergency department (ED) is a place where a positive patient experience is most important. Round-the-clock nurse triage services that patients can access before they leave for the hospital provide healthcare answers when patients most need them and often result in resolving the emergencies without an in-person visit. That increases patient satisfaction and allows ED staff to focus on patients that need immediate assistance, improving their experiences, too. Reach out and send content Chase s Vieira notes that in this digital age, it s very easy to send relevant content to patients or customers. Health systems can occasionally email general health tips or information specific to a patient s illness as long as it s unobtrusive. These are just ways to make sure the people you serve understand that you value your relationship with them, Vieira says. Chronic disease patient contact Patients with chronic diseases consume 75 percent of the nation s healthcare resources. Using a text message to remind this key patient group about their treatment obligations has been shown to improve compliance, leading to reduced readmissions and increased patient satisfaction. Enhanced mobile apps Mobile phone healthcare apps that can schedule appointments, present lab results or communicate with doctors and nurses are standard by now. They re convenient for patients but not used enough to increase their loyalty to your brand. The content often won t hold their attention or encourage them to spend more time on the app. Now, medical innovators are designing apps that provide another level of information. We ve found that patients want to feel more involved and in control, says Dr. Berkowitz. We re figuring out the right amount and kind of content for patients so that they can make decisions the right decisions on their treatment plan before, during and after they see the doctor. That kind of information will keep patients connected to a healthcare system, give them that sense of control and build loyalty. "We've found that patients want to feel more involved and in control." - Lyle Berkowitz, MD, Northwestern Memorial HealthCare

HEALTHCARE BANKING 5 Making It Work Once hospital system executives agree on an innovation affecting patient experience, the change has to be implemented. That process has its own set of challenges. Dr. Berkowitz, a national thought leader in healthcare innovation, says the implementation process hinges on three steps. You have to remember that the staff who will be impacted by your innovation and the process involved often are more important than the technology, he says. Who has to work a little more? Who has to work a little less? Who has to work differently? Make sure you manage that very well and make it easy to do the right thing. A great lesson number two is that you need a champion who is passionate about doing something and knowledgeable about how to do it. That is critical. Finally, the third lesson would be: Start small and scale up but start. And, as they say in Silicon Valley: Fail fast, fail cheap and fail often! Treat each failure as a gift from which you can learn and you will get better every time. BANKING CUSTOMER EXPERIENCE TIPS THAT APPLY TO PATIENTS, TOO: Engage with your customers. You can t get a sense of their loyalty by sitting in your office. Make efforts to improve customer satisfaction as part of employee evaluations. Commend employees with awards or certificates for extraordinary customer service. Establish ways to identify and track customer attrition; contact wavering customers in a nonintrusive way - Donna Vieira, Chief Marketing Officer, Chase Consumer Banking

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