The Healthcare Consumer S tate of Mind www.nationalresearch.com - - PDF document

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When Worlds Collide: Long-Term Care vs. Consumerism

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Presenters

Ryan Donohue Corporate Director of Program Development Rdonohue@nationalresearch.com Rich Kortum Director, Strategic Partnerships Rkortum@nationalresearch.com

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The Healthcare Consumer S tate of Mind

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The Healthcare Consumer S tate of Mind

• We are no longer on the tipping point of

consumer-driven healthcare

• We are now finally starting to grasp the

importance of building a 1:1 relationship

• We are dangerously unprepared to engage

healthcare’ s fastest growing payers over the long-term and in meaningful ways

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The Healthcare Consumer S tate of Mind

• S

ince 2012, National Research embarked on a “ blue sky exercise” to qualitatively research the consumer view of healthcare

• 176 consumers in 48 states participated in

focus groups

• 111,448 consumers polled

through national survey

• Results in NRC white paper

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The Healthcare Consumer S tate of Mind

Healthcare consumers want healthcare companies to stop acting like healthcare companies.

SOURCE: NRC’s Blue Sky Exercise, 2012-2013

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What’ s Wrong with Healthcare?

• Providers play a key role in what consumers describe as

“ the healthcare maze”

• Providers wrongly position as healers of the sick/ dying
• Consumers believe they can “ opt out” of the maze
• Consumers turn elsewhere for essential information
• Consumers seek a partner who will empower personal

health and providers seek to fulfill this promise – however the two parties could not be further apart

SOURCE: NRC’s Blue Sky Exercise, 2012-2013 www.nationalresearch.com SOURCE: NRC’s national consumer survey, April 2013, n size = 23,105, Top 2 Box responses only

13 24 26.4 26.9 29 36.2 48.6 67.1 67.7 73.4 Your Government (Fed & Local) Long Term Care/Nursing Homes Health Insurance Companies Fitness/Health Companies Home Health Services Your Employer Hospice/End of Life Services Pharmacies Hospitals Doctors/Nurses

How would you rate your overall trust and confidence in the following:

Who Do Consumers Trust the Most?

www.nationalresearch.com SOURCE: NRC’s national consumer survey, 2013, n size = 21,984

Consumer Perception Re: LTC use

41% 16% 26% 10% 7%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% (1) Not at all Likely (2) (3) (4) (5) Very Likely

Frequency % Response

In the future, how likely is it that you or a household member will need the services of a skilled nursing facility (including nursing homes) on either a temporary or long-term basis?

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www.nationalresearch.com SOURCE: NRC’s national consumer survey, 2013, n size = 21,984

Consumers on Future Long-Term Care Use

6% 10% 13% 20% 52%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Less than a year 0 to 3 years 2 to 5 years 4 to 10 years More than 10 years

Frequency % Response

When do you anticipate needing any such services?

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Where Perception Meets Reality

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VIRTUAL EXPERIENCE VIRTUAL EXPERIENCE TRUE TRANSPARENCY TRUE TRANSPARENCY PROVIDING HEALTHCARE PROVIDING HEALTHCARE

Where Perception Meets Reality

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• 87%
• f Americans use the internet regularly
• 39%

have visited WebMD.com

• 22%

have visited a local provider website

• 35%
• f consumers are likely or very likely to prefer

a healthcare provider following a website visit

SOURCES: National Research Corporation’s Market Insights survey, n size = 231,482, PEW Research Center, 2014, n size = 857

Virtual Experience: Web = Virtual Frontline

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What form of social media do you use as a source of health information?

SOURCE: National Research Corporation’s Market Insights survey, n size = 231,482

3% 4% 5% 13% 14% 16% 24% 41% 81%

FourSquare Vine Other Instagram LinkedIn Pinterest Twitter YouTube Facebook

Virtual Experience: A S

• cial & Mobile Play

55%

trust or highly trust information received from hospitals via social media sites

55%

trust or highly trust information received from hospitals via social media sites

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• 22%
• f consumers have used a mobile

device to seek health info/ resources

• 25%

anticipate using a mobile device to

seek health info/ resources next year

• 18%

prefer to interact with a provider

exclusively via mobile device

SOURCE: National Research Corporation’s Market Insights survey, n size = 231,482

Virtual Experience: A S

• cial & Mobile Play

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S

• cial & Mobile Create Relationships

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73 percent view online ratings/ reviews

before purchasing a product/ service – 83 percent of 18-34 years old – 82 percent of 35-44 years old – 69 percent of 45-64 years old – 52 percent of 65+ years old

SOURCE: National Research Corporation’s Digital Decision Maker study, 2015, n size = 3,002

Older Americans More Connected

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True Transparency: Consumers Want More

• Consumers seek transparency from the

ever-opaque healthcare industry

• Only 6 percent visited Nursing Home

Compare (13% visit Hospital Compare)

• Out of pocket costs doubled from 2003 to

2013 – and could double again for the average consumer

SOURCE: CNN Money, Kaiser Family Foundation, Credit Suisse, 2012-2013

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24 62.7 13.3 Don't Know No Yes

Do you believe healthcare providers are upfront and transparent about the prices of the healthcare services they provide to patients?

SOURCE: NRC’s Market Insights national survey, n size = 21,824

Healthcare Lacks Price Transparency

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• Consumers must be aware of out-of-pocket costs
• Providers should consider offering/ promoting

payment plans, credit options and loyalty programs

• Long-term care is an area of great opportunity for

price transparency and price differentiation

• Consumer-centric providers

will embrace price as an external benefit and an internal bellwether

True Transparency is an Opportunity

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• Transparency is more than a pricing paradigm
• Consumers seek to better understand entire

payment process – including their options

• Consumers want empowerment through information
• Consumers cannot

determine ‘ value’ without ‘ pricing’ AND ‘ quality’ information

True Transparency is More than Price

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Providing Healthcare: S tretching Ourselves

• The future long-term care provider will be

tasked with a dual purpose to the consumer:

care for the sick and the healthy

• Long-term care providers will be j udged

based on their ability to deliver health services as well as healthcare

• Even the word “ health” is seen far differently

from the word “ health care”

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Providing Healthcare = Opportunitie$

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Providing Healthcare: S tretching Ourselves

• No matter the setting there is a place for

healthcare in the midst of healthcare

• Resident quality of life is driven by more

than j ust clinical considerations

• S

taff stress plays heavily into the health equation for long-term care

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Consumers RE: Triple Aim

SOURCE: NRC’s national consumer survey, 2014, n size = 24,103 2.7 5.9 6 3.6 13.3 13.9 40.6 60.4 59.1 34.4 14.5 14.9 18.8 5.9 6.1 20 40 60 80 100

Cost Quality Access

When considering changes in healthcare, will the following increase, decrease, or stay the same in the coming year?

Increase greatly Increase somewhat Stay the same Decrease somewhat Decrease greatly

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Perception vs Reality

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What is Reality? ? ?

13 24 26.4 26.9 29 36.2 48.6 67.1 67.7 73.4 Your Government (Fed &… Long Term Care/Nursing… Health Insurance… Fitness/Health Companies Home Health Services Your Employer Hospice/End of Life… Pharmacies Hospitals Doctors/Nurses How would you rate your overall trust and confidence in the following:

SOURCE: NRC’s national consumer survey, April 2013, n size = 23,105, Top 2 l www.nationalresearch.com

Reality in LTC

86% 87% 87% 88% 88% 89% 89% Resident Family Short-Stay Discharge

88% 87% 89% 88% 88% 89% Customer Experience Skilled Nursing

Overall Satisfaction Willingness to Recommend

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Reality in LTC

89% 90% 90% 91% 91% 92% 92% AL Resident AL Family IL Resident

90% 90% 92% 90% 90% 91% Customer Experience Assisted / Independent Living

Overall Satisfaction Willingness to Recommend

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S killed Nursing Resident

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

S killed Nursing Resident

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

What Matters Most

Nation’s Skilled Nursing Residents Say:

• 1. Care (Concern) of S

taff

• 2. Competency of S

taff

• 3. Responsiveness of Management
• 4. Choices/ Preferences
• 5. RN/ L

VN/ LPN Care

SOURCE: NRC’s 2015 My InnerView national survey

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S killed Nursing Family

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

S killed Nursing Family

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

What Matters Most

SOURCE: NRC’s 2015 My InnerView national survey

Nation’s Skilled Nursing Families Say:

• 1. Care (Concern) of S

taff

• 2. Competency of S

taff

• 3. Choices/ Preferences
• 4. Responsiveness of Management
• 5. RN/ L

VN/ LPN Care

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S killed Nursing S hort-S tay Discharge

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

S killed Nursing S hort-S tay Discharge

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

What Matters Most

Nation’s Discharge Patients Say:

• 1. Care (Concern) of S

taff

• 2. Competency of S

taff

• 3. Choices/ Preferences
• 4. Responsiveness of Management
• 5. Quality of Medical Care

SOURCE: NRC’s 2015 My InnerView national survey

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Assisted Living Residents

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

Assisted Living Residents

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

What Matters Most

Nation’s Assisted Living Residents Say:

• 1. Responsiveness of Management
• 2. Choices/ Preferences
• 3. Comparison of Charges
• 4. Competency of S

taff

• 5. Care (Concern) of S

taff

SOURCE: NRC’s 2015 My InnerView national survey

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Assisted Living Family

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

Assisted Living Family

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

What Matters Most

Nation’s Assisted Living Families Say:

• 1. Responsiveness of Management
• 2. Choices/ Preferences
• 3. Comparison of Charges
• 4. Competency of S

taff

• 5. Care (Concern) of S

taff

SOURCE: NRC’s 2015 My InnerView national survey

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Independent Living Resident

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

Independent Living Resident

SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

What Matters Most

Nation’s Independent Living Residents Say:

SOURCE: NRC’s 2015 My InnerView national survey

• 1. Home-Like Atmosphere
• 2. Responsiveness of Management
• 3. Commitment to Independence
• 4. Care (concern) of S

taff

• 5. Responsiveness of S

taff

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Closing the “ Brand” Gap

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BRAND EXPERIENCE

Bridge #1: Understanding Brand Equity

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Presentation & appearance Way-finding Cleanliness Care environment Quality of Care Setting Online marketing Website Social media Mobile marketing DIGITAL CHANNELS FACILITY BUSINESS AND COMMUNICATION TOOLS Advertising Public Relations Collateral Direct mail Publications Forms Patient bills Staff attitude Staff knowledge Employee satisfaction Organizational culture Service response & follow-up EMPLOYEE AND RESIDENT INTERACTION

OVERALL BRAND EQUITY

The Components of Brand Equity

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• The gut feeling others have about us
• What keeps the customer coming back
• The reason our employees enj oy their j obs
• Our most important asset

What is a Brand?

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• S

logans, j ingles, logos, pretty pictures, etc.

• A waste of money during challenging times
• S
• mething only Marketing worries about
• A luxury for the most affluent hospitals

What is NOT a Brand?

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Brand Relationship S pectrum

Shadow Endorser Not Connected Token Endorser Strong Endorser Co- Drivers Master Driver Different Identity Same Identity

Branded House Sub- Brands Endorser Brands House of Brands

Brand Relationship Spectrum

SOURCE: HBR, 2004

Saturn (GM) Lexus (Toyota) Embassy Suites (Hilton) Courtyard by Marriott Sony Bravia HP Deskjet BMW Nissan Japan, Nissan USA

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Brand Relationship S pectrum

• Is there logic behind your brand architecture?
• Does your brand architecture fit who you are?

Are ALL services and resources identified? Are ALL services and resources clearly tied together? Are consumers able to follow your brand architecture?

• Is your brand ready for rapid consolidation?

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Bridge #2: Rethinking ‘ Experience’

• The physical plant is the least familiar component

to most consumers (and potential residents)

• Expand the value of the physical experience

through traditional and digital marketing

• The web is where the adult child is making

decisions on where to tour & consider

• Online experiences break the bonds of traditional

healthcare perceptions and expectations

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S treamlining via S ystem Approach

• Healthcare is inherently confusing
• Consumers seek a 1:1 relationship w/ providers
• Consumers value “ systemness” :
• 65 percent said they were more likely to

choose a provider that is part of a system

• 31 percent said it makes no difference
• 4 percent said they were less likely to

choose a provider that is part of a system

SOURCE: NRC’s national Market Insights survey, Dec 2012, n size = 21,379

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Creating Pre-Experience Value

• Consumers have warmed to scalable resources
• Consumers are increasingly trusting of technology

(including electronic health records)

• Ignoring the opportunity to build a “ virtual long

term care brand” comes at great peril in the age

• f the online customer
• Healthcare’ s sluggish tech adoption provides
• pportunities to providers willing to invest

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The Value of S implified Communications

• S

implifying communications means maximizing budget efficiency

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Bridge #3: Resourcing the Experience

• The experience is only as strong as those who

deliver it

• There is no admirable brand which does not have

engaged employees

• Employees play the most visible role in the

delivery of the experience – yet they are often excluded from the equation of value

• Employees are the cornerstone of the culture

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The Mission/ Vision/ Values Factor

MISSION VISION VALUES EXPERIENCE

Why do we exist? Where are we going? What behaviors will get us there? The benefactor of all of the above

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• Measurement allows understanding of the

perceptions, needs and motivations of customers

• Measurement mitigates ‘ vacuum thinking’
• Reveals insightful trends & predicts drivers of

future consumer and employee behavior

• Without measurement, assumptions grow,

decision-making suffers and inactivity thrives

Bridge #4: Measuring the Experience

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• Monitor the overall perception of your organization,

including those in the community

• Considering measuring the following:

– Consumer awareness of your brand – Consumer sentiment on your brand’ s image & quality – Consumer loyalty toward using and recommending your brand

• Measurement makes the intangible tangible
• If it cannot be measured it does not exist!

The Many Facets of Measurement

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What Influences the Customer Decision?

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Reason for Choosing

32% 28% 30% 35% 38% 42% 29% 22% 25% 27% 24% 22% 15% 22% 24% 4% 5% 2% 9% 13% 9% 12% 17% 18% 3% 3% 4% 1% 1% 0% 12% 12% 8% 20% 15% 16% 0% 20% 40% 60% 80% 100% 120% SNF Fam SNF Resident SNf Discharge AL Family AL Resident IL Resident Convenient location Good reputation Doctor or hospital Relative or friend Insurance requirement Other reason SOURCE: NRC’s 2015 My InnerView national survey www.nationalresearch.com

Reason for Choosing

32% 28% 30% 35% 38% 42% 29% 22% 25% 27% 24% 22% 15% 22% 24% 4% 5% 2% 9% 13% 9% 12% 17% 18% 3% 3% 4% 1% 1% 0% 12% 12% 8% 20% 15% 16% 0% 20% 40% 60% 80% 100% 120% SNF Fam SNF Resident SNf Discharge AL Family AL Resident IL Resident Convenient location Good reputation Doctor or hospital Relative or friend Insurance requirement Other reason SOURCE: NRC’s 2015 My InnerView national survey

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• Long-term care providers must be willing to adopt a

consumer point of view

• Becoming a provider of health & healthcare means

understanding the consumer & resident

• Consumers want more than simply healthcare and

they are searching for a 1:1 health relationship

• Consumers are sending providers across the

country a message: what’s important to me is changing –can you say the same?

Future S tate of Healthcare Consumerism

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Evidence Relevance Consequence

Action

Your performance is quantified by an

• utside party.

Your performance is matched to the performance of others. You process the potential negative effects of poor performance. You take action to avoid unwanted consequences.

The Feedback Loop

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Questions? ? ?