Jean-Pierre Stephan

It is no secret that the US healthcare system is notoriously complex. The
numerous product features and options offered by health plans are difficult to understand.
Pricing transparency is non-existent. That complexity, in turn, has a detrimental impact
on consumers’ access to care, quality of experience and health outcomes. Unfortunately,
the problem is getting worse. Consumers are frustrated when trying to determine whether
their providers are in the plan’s network, why they… Show more

It is no secret that the US healthcare system is notoriously complex. The
numerous product features and options offered by health plans are difficult to understand.
Pricing transparency is non-existent. That complexity, in turn, has a detrimental impact
on consumers’ access to care, quality of experience and health outcomes. Unfortunately,
the problem is getting worse. Consumers are frustrated when trying to determine whether
their providers are in the plan’s network, why they got an expensive bill for a routine service
they expected to be covered by insurance, or how to decipher unfamiliar language in their
insurance policies. Federal and state regulation has ramped up as health benefits offerings
have proliferated, further driving complexity, especially for providers and health plans. This
paper explores the findings and implications of recent Accenture research that gauged
consumers’ understanding of the healthcare system and their ability to navigate it to meet
their needs. It also proposes ways to address the complexity of the healthcare system to
ease the burden on consumers, payers and providers alike. Show less

The complexity of the US healthcare system is driving people to choose the ER for acute care needs instead of less expensive care settings. People with low healthcare system literacy use the ER much more than those with a better understanding of the healthcare system. Tackling this issue means introducing simplicity into the system with changes that make the right choice the easy choice for people.

Health systems that evolve to meet new consumer experience needs can expedite COVID-19 financial recovery and capture patients from competitors. 1 in 4 patients who believe their system is handling COVID-19 poorly plans to never receive the care or will wait at least a year. Two-thirds of patients are likely or highly likely to switch to a new health system if their expectations are not met. Organizations that improve the patient experience could potentially increase their revenues by 5% to… Show more

Health systems that evolve to meet new consumer experience needs can expedite COVID-19 financial recovery and capture patients from competitors. 1 in 4 patients who believe their system is handling COVID-19 poorly plans to never receive the care or will wait at least a year. Two-thirds of patients are likely or highly likely to switch to a new health system if their expectations are not met. Organizations that improve the patient experience could potentially increase their revenues by 5% to 10% pre-COVID levels within 12 months. Show less

In the digital economy—and in healthcare—trust fuels engagement and retention. In fact, Accenture research shows that people who trust their health payers are much more likely to stay with and recommend them to friends and family.

The fact that only one in 10 providers has strong trust in the health payers they work with points to a serious trust gap that can impact payers, providers and consumers too. This gap also makes it difficult for payers to exert the necessary influence on providers to drive critical strategic objectives forward. Mending one of the most important relationships in healthcare will take intelligent payers using human-centered design and artificial intelligence (AI) to transform payer-provider… Show more

The fact that only one in 10 providers has strong trust in the health payers they work with points to a serious trust gap that can impact payers, providers and consumers too. This gap also makes it difficult for payers to exert the necessary influence on providers to drive critical strategic objectives forward. Mending one of the most important relationships in healthcare will take intelligent payers using human-centered design and artificial intelligence (AI) to transform payer-provider interactions and the payer operations that underpin them. Show less

Rising healthcare costs sparked health plans and employers to use higher deductibles to transfer responsibility to individual consumers for making optimal shopping decisions about healthcare and coverage. The notion was that consumers would be more likely to seek out the right care at the right price if they were to bear the financial burden of paying more for services. However, consumers have become frustrated because they perceive that most health plans aren’t providing the necessary… Show more

Rising healthcare costs sparked health plans and employers to use higher deductibles to transfer responsibility to individual consumers for making optimal shopping decisions about healthcare and coverage. The notion was that consumers would be more likely to seek out the right care at the right price if they were to bear the financial burden of paying more for services. However, consumers have become frustrated because they perceive that most health plans aren’t providing the necessary information and support to make it easy to find the best care at the lowest price. Health plans are now paying a price: significantly lower consumer loyalty and satisfaction. Show less

Most people at one time or another have struggled to navigate the complexities of the U.S. health care system. Many have received unpleasant surprises, such as a medical bill they expected to be covered by their health insurance or an unexpectedly expensive bill for a simple service. This type of confusion results in a lot of administrative work, including avoidable calls to customer service centers or time spent helping people find lower-cost options for services. It is costing employers and… Show more

Most people at one time or another have struggled to navigate the complexities of the U.S. health care system. Many have received unpleasant surprises, such as a medical bill they expected to be covered by their health insurance or an unexpectedly expensive bill for a simple service. This type of confusion results in a lot of administrative work, including avoidable calls to customer service centers or time spent helping people find lower-cost options for services. It is costing employers and health plans billions of dollars each year. Show less

The US healthcare system is so complex that more than half of consumers do not understand how to navigate it appropriately, reveals Accenture research. This low healthcare system literacy is creating an estimated $4.8 billion annual administrative cost burden for payers.

Amid the wave of industry consolidation, health systems often overlook the importance of their brands. Yet it is a critical indicator of customer experience and loyalty that translates into both reputational and financial value. The better health systems become at harmonizing their organization brands with their physician brands to become “matched-strength brands,” the more value they can expect, reveals Accenture analysis.

Accenture research shows great customer service is a catalyst for meeting insurers’ promotion, retention and loyalty objectives and generating revenue.

Today’s consumer-driven marketplace is challenging the fundamentals of health insurance product design and marketing. Health and wellness products are a case in point.

Whether insurers today compete in a business-to-business or business-to-consumer market, they must continuously improve the customer experience to win and retain business. But how can they measure success of these efforts?

Tech-savvy, digitally enabled and discerning millennials have now surpassed baby boomers as the largest living generation in the United States, well on their way to comprising the biggest group in the healthcare market.

Millennials want to use digital channels for familiar experiences, such as scheduling a doctor’s appointment. But when they are confused and overwhelmed by complex decisions, such as choosing a health plan, they expect knowledgeable live assistance right away to have… Show more

Tech-savvy, digitally enabled and discerning millennials have now surpassed baby boomers as the largest living generation in the United States, well on their way to comprising the biggest group in the healthcare market.

Millennials want to use digital channels for familiar experiences, such as scheduling a doctor’s appointment. But when they are confused and overwhelmed by complex decisions, such as choosing a health plan, they expect knowledgeable live assistance right away to have their questions resolved on first contact. Insurers that deliver inconvenient experiences or poor customer service fall short on meeting millennial expectations. Show less

Healthcare consumers are becoming more digital, yet health insurers lag other industries in digital engagement. As consumers’ “digital intensity” grows, they are less likely to see differentiation among insurers—and more likely to shop around.

Despite an improvement in overall consumer trust of medical information
sources over the past two years, Accenture research shows that highly digital consumers—those with higher use of digital channels—are more concerned about medical information bias than their
less digital counterparts. That skepticism is eroding traditionally held consumer perceptions about the professional authority of payers and providers.

Consumer loyalty to healthcare providers is not what it used to be. The realities of the new healthcare market—consumers with high passion for healthcare providers, the rise of digital health disruptors and providers with lagging loyalty metrics—make providers vulnerable to patients switching to competitors. Something must change.

So how can healthcare providers reset the loyalty landscape? They can take a page from competitive consumer industries with experience having to earn their… Show more

Consumer loyalty to healthcare providers is not what it used to be. The realities of the new healthcare market—consumers with high passion for healthcare providers, the rise of digital health disruptors and providers with lagging loyalty metrics—make providers vulnerable to patients switching to competitors. Something must change.

So how can healthcare providers reset the loyalty landscape? They can take a page from competitive consumer industries with experience having to earn their customers’ loyalty. By adopting patient engagement practices from such consumer industries, healthcare providers can respond to this market disruption. What’s more, they can keep the patients they have—and earn new ones. Show less

Coordinated care networks are vital to healthcare improvement strategies. But the success of coordinated care networks is not guaranteed unless they can achieve sustainable membership growth. As these networks proliferate, both payers and providers need a more detailed understanding of what encourages people to join them—and what keeps them loyal. Patients, after all, are also consumers.

Accenture research shows that a majority of US consumers believe health plan transparency information is biased.

Consumers are unlikely to consult their health plan as a primary source of information for healthcare decision-making, according to the Accenture 2013 Healthcare Transparency Survey. They perceive medical information shared by health plans to be biased and hard to apply to their situation.

Lack of bias is very important to consumers. According to the survey, even… Show more

Accenture research shows that a majority of US consumers believe health plan transparency information is biased.

Consumers are unlikely to consult their health plan as a primary source of information for healthcare decision-making, according to the Accenture 2013 Healthcare Transparency Survey. They perceive medical information shared by health plans to be biased and hard to apply to their situation.

Lack of bias is very important to consumers. According to the survey, even consumers who trust their health plan for symptom information may not go there for help. In fact, consumers would consult Internet searches (e.g., Google) significantly more than health plans (87 percent versus 67 percent).

On a positive note, health plans are the go-to source for patient reviews, far surpassing other websites that feature doctor ratings. The survey also indicated that once the course of treatment is decided, consumers turn to their health plan to help them understand what will be required for their recovery (83 percent), how much time they will need to take off work (66 percent) and how the procedure will benefit them in the long term (40 percent). Show less

Provider-led health insurers outperform their traditional insurance peers in consumer satisfaction and brand loyalty, despite offering more limited networks.

Accenture’s research indicates that consumers trust information about their health up to 46 percent more often with provider-led insurers than traditional insurers.

Offering insurance is fertile ground for hospital systems that may want to build upon the relationship they have with patients, and offer an enhanced level of… Show more

Provider-led health insurers outperform their traditional insurance peers in consumer satisfaction and brand loyalty, despite offering more limited networks.

Accenture’s research indicates that consumers trust information about their health up to 46 percent more often with provider-led insurers than traditional insurers.

Offering insurance is fertile ground for hospital systems that may want to build upon the relationship they have with patients, and offer an enhanced level of care and convenience. This is why increasing numbers of hospital systems (e.g., providers) are becoming health insurers. These healthcare hybrids are emerging as strong contenders in the health insurance marketplace.

Provider-led insurers are such strong contenders because they are built on a foundation of trust. According to Accenture research, a consumer’s trust in his or her doctor is the leading indicator of trust for a health insurer. Show less

Are healthcare consumers willing to change to get what they want?

The Affordable Care Act (ACA) will introduce approximately 51 million people to the individual healthcare marketplace, 34 million who are currently uninsured and 17 million employees of small businesses. As the individual healthcare insurance market expands, so do the challenges these healthcare consumers present. What is getting in the way of effective consumer engagement in healthcare solutions? Accenture set out to… Show more

Are healthcare consumers willing to change to get what they want?

The Affordable Care Act (ACA) will introduce approximately 51 million people to the individual healthcare marketplace, 34 million who are currently uninsured and 17 million employees of small businesses. As the individual healthcare insurance market expands, so do the challenges these healthcare consumers present. What is getting in the way of effective consumer engagement in healthcare solutions? Accenture set out to answer this question by asking 1,900 US retail healthcare consumers about their healthcare needs and behaviors.

We found that health insurers have the opportunity to embrace the key elements of successful customer centricity transformations that have been tested and proven outside of healthcare for years. Show less