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In October of 2017 analysts at PwC’s Health Research Institute (HRI) conducted a study with 1,500 consumers to evaluate which healthcare experiences matter most to American patients. Study participants ranked the relative importance of 47 healthcare experience features. Of those, researchers identified 12 highly-valued features in five key categories that were common to all consumer segments:

  • Getting appointments sooner.
  • Convenient location and hours.
  • Getting test results without seeing a doctor.
  • Tests, prescriptions and procedures only when necessary.
  • Drugs with proof of good outcomes and few side effects.
  • State of the art facility with modern technology.
  • Lower cost care options.
  • Staff attentive to my needs and preferences.
  • Deciding treatment options with my doctor.
  • Communicating with patience.
  • Upfront explanation of out-of-pocket expenses.
  • Not having to repeat my information.

Findings published in the resulting report, “Customer Experience in the New Health Economy: The Data Cure,” point to the need for a more multi-faceted view of patient data to support the industry’s pursuit of a more personalized healthcare consumer experience. As researchers put it, “health companies should start connecting data about not just the patient encounter but also the preferences and social circumstances shaping everyday health and healthcare-related purchasing decisions.” Researchers point to the rise of patient choice and increased payment responsibility as key reasons healthcare organizations should make patient engagement and experience a top priority.

Healthcare executives appear equally aware of the pressing need to prioritize patient satisfaction. A separate interview conducted by HRI from 2017 to 2018 with executives from U.S. health insurer, pharmaceutical, health system, technology and academic institutions found that 81 percent of payer executives have invested in technology to improve the member experience. Seventy-three percent of those executives have specifically invested in data analytics capabilities to support those efforts. Nonetheless, 64 percent of health insurance executives and 88 percent of health system executives report that having insufficient information about customers is still a barrier to meeting consumer expectations.

To overcome these obstacles, HRI recommends that healthcare stakeholders partner for or acquire data assets that help paint a more robust patient picture that can, in turn, be used to tailor messaging and service offerings. Data segmentation variables can include, but are not limited to:

  • Patient demographics
  • Payer mix
  • Health conditions
  • Consumer motivators and preferences
  • Social determinants of health
  • Patient propensity to pay

The broader the patient data footprint, the better-equipped healthcare organizations are to deliver a tailored healthcare consumer experience, which supports improved patient activation, satisfaction and outcomes. Insurance executives surveyed by HRI understand that they need to work with providers to tailor care to consumers’ needs but 50 percent report difficulty with customer segmentation. The challenge is even greater among surveyed health system executives, with 85 percent reporting difficulty.

Researchers cite Press Ganey Associates’ estimate that U.S. hospitals have, on average, $850,000 at risk every year directly tied to their HCAHPS patient satisfaction survey results as a big motivator for health systems to up their patient engagement game. “For insurers, a five-star rating from the Centers for Medicare and Medicaid Services serves as a ringing endorsement in an increasingly competitive market,” researchers point out. “Under the Medicare Access and CHIP Reauthorization Act (MACRA), the law governing clinician payments for Medicare services, provider reimbursements will be based, in part, on patient engagement efforts such as promoting self-management and coaching between visits.”

To gain traction, HRI encourages healthcare stakeholders to arm staff with patient data insight and to support more and better engagement between staff and patients. Researchers recommend health management apps and care site alternatives such as retail clinics, home health visits and other direct-to-consumer offerings as opportunities to bring engagement beyond the traditional care setting.

With in-depth consumer data in hand, healthcare organizations can execute a data-driven clinical intervention strategy. Researchers contend that “by looking at consumer preferences by segment, companies can do a better job of figuring out which interventions are worth trying and which will result in higher returns on investment. The most sophisticated health companies will be able to segment their customer populations in ways that acknowledge demographic differences and critical clinical, behavioral and preference differences.”

BioIQ works with leading national health plans to orchestrate programs that offer members convenience, quality, support, personalization and communication. To date, BioIQ has facilitated personalized member outreach to millions of healthcare consumers to help plans close care gaps. To learn more, contact BioIQ at (888) 818-1594 or

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