In recent years, transparency has been a clarion call for healthcare providers. With the launch of the insurance exchange marketplace — and subsequent drama over online glitches, identity security, and subsidy eligibility — it’s clear that providers are not the only ones struggling with transparency.
A first step toward a solution to this endemic problem in the American healthcare system would be to recognize that today’s healthcare consumers are vastly different from patients a decade or more ago.
They are beginning to shop for hospitals, physicians, and health insurance in much the same way they look for a new appliance. Website comparisons, consumer reviews and social sharing all influence consumers as they make their health care decisions. Hospitals and others in the industry need healthcare marketing plans that address consumer expectations in order to successfully manage a changing marketplace.
Healthcare.gov Problems Highlight Transparency Challenges
The numbers are in — eight million people opted for private insurance through state and federal exchanges, but signing up was not without challenges. The notoriously error-plagued sites created consumer frustrations that have not subsided with the closing of the enrollment period.
According to a recent article in the New York Times, discrepancies between personal data provided on the exchange and government records means that nearly two million consumers must provide additional information or take the risk of having to repay subsidies at tax time next April.
What caused the problem?
- Technical problems, such as difficulty in uploading requested documentation to Healthcare.gov made it difficult to resolve inconsistencies.
- Family size and the availability of employee-sponsored health insurance could not be verified on the exchanges.
- Manual entry slowed — and possibly resulted in data errors — because the planned system for converting documentation to electronic data was not in place.
And those problems have led to a bigger issue in terms of a positive future for government exchanges — consumer disillusionment. The Times article quotes National Health Law Program lawyer, Mara Youdelman, who said, “In some cases, consumers say they already sent the documents to the federal marketplace. They don’t understand why they are being asked to send them in again.”
The required documents range from birth certificates and Social Security cards to high school diplomas, state driver’s licenses, pay stubs or voter registration cards. While these consumers may just be frustrated now, if it turns out that subsidies must be paid back, the negative feedback will spiral.
It’s common knowledge that unhappy consumers are more likely to share their experiences, and a high percentage — up to 91 percent according to Lee Resources — will not do business with the offending organization again. To combat the potential loss of trust, marketplace providers may need a health care marketing plan that reassures nervous consumers.
Another consequence: Hospitals must prepare to weather a storm of billing headaches.
Unique Industry Standards Make Transparency More Difficult
Unlike other industries, where the consumer connects directly with the service or product provider, there is a third party separating the patient and the hospital.
Whether it is the Centers for Medicare and Medicaid (CMS) or a private insurance company, the process of negotiating fees and contracts leads to pricing disparity. Peter Fine, president and CEO of Banner Health in Phoenix, notes that “… it’s hard to be transparent when there are so many different reimbursement methodologies.”
Squeezed by low reimbursements, and competing against larger systems that leverage size to negotiate better rates, smaller hospital networks like Banner Health are using market research to reduce healthcare costs. Banner Health is succeeding in the pilot program for Medicare Accountable Care Organizations (ACOs) by focusing on the 5 percent of patients who consumed the most health care.
This success also suggests that a focused strategy and healthcare marketing plan could be an important tool for hospitals to attract targeted patients, reduce healthcare costs, and improve patient outcomes, while the industry goes through what promises to be an imperfect transition.
Using psychographic segmentation, hospitals and other health care providers can shift from generic marketing messages to customized approaches that adapt to the communication preferences and needs of individual consumers to motivate healthy behaviors. Moreover, communicating effectively in a style and method that resonate with target consumers facilitates transparency. The U.S. healthcare system is a vast, complicated machine, and transparency is just one of the cogs that must work in synch with others to truly win over consumers.