Fixing the patient satisfaction problem

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For a business that saves lives every day, health care gets low marks for customer satisfaction.

The latest net promoter scores give the healthcare industry a rating of 38 out of 100. That puts the business behind Apple, Chick-fil-a, Netflix, and Starbucks, but ahead of Exxon Mobil, Time Warner Cable, and Waste Management.

Why do customers give the same satisfaction grade to the medical industry as they give to the online flea market, eBay?

It’s not because Americans don’t appreciate the work of doctors and nurses. Those are among the most highly respected professions in the country.

The problem is the vast uncaring and inefficient bureaucracy that has been built up around the medical field. And I’m convinced there’s one main reason why being a customer of that medical bureaucracy is such a lousy experience – the economic incentives of our business are backwards.

Instead of rewarding health, we pay for sickness. Our fee-for-service healthcare system is set up to compensate businesses for churning out as many tests and procedures as quickly as possible.

Heads in beds – that, unfortunately, has become the fundamental economic model of so many modern hospitals and healthcare facilities. The business centers around illness, not wellness. Do the test, slap the Band-Aid on the problem, and move that patient out the door. Caught in a cycle where more time and effort is spent trying to recover faster payment to the provider than promoting a better life for the patient. Volume is king.

Right now, the system is set up to benefit medical businesses more than the medical customers. It’s complicated and confusing for the healthcare consumer. I’ve worked decades as an RN and CEO of healthcare companies, and even I have a hard time helping my own mom and dad decide between different Medicare supplemental insurance plans.

Confusion and complexity do not help the healthcare customer.

I believe the best way to fix these healthcare problems – by creating a system that benefits the customer – is to change the economic incentives for the companies in the system. For our senior population, the conversation should shift to how they want to live the years they have left and go from there, versus prescribing more medications and tests just because the economic incentive is to prescribe more medications and tests.

Fortunately, the economic pendulum is starting to swing the right direction. Instead of staying locked in the traditional fee-for-service system, the federal government through Medicare Advantage plans is promoting test programs that reward companies for keeping people healthy.

Medicare innovations such as Accountable Care Organizations, under the Shared Savings Program, ACO REACH, and Medicare Advantage put healthcare companies on the hook for health results. It’s a newer philosophy: Providers are rewarded for keeping patients well – which is what many physicians and providers want. Companies still treat a customer’s lung cancer, for example, but they also know it’s far healthier – and cheaper – to pay for a customer’s smoking cessation program in the long run. Prevention is better than cure.

When we think about customer satisfaction in the medical business, we must always remember one basic fact – you have to be human. And think like one. In healthcare, we can get so caught up in the innovations, regulations, interventions, and money that we forget to look at each patient as a person. We need to help them decide what’s right for them.

I can only say what my senior healthcare company has done to improve those satisfaction scores. We have partnered with two of the largest payors in Minnesota who are also investors, and we are going all in on global risk healthcare. This model, an especially innovative type of value-based care, takes full risk on improving a person’s health and lowering costs.

So far, the results have been dramatic: 28% reduction in inpatient admissions, 36% reduction in inpatient days, and 22% reduction in total spending.

Most gratifying to us, our customer satisfaction / net promoter score stands at 93. That’s nearly triple the healthcare industry standard – and higher than any top-rated company mentioned at the beginning of this column. Human-centered health care matters to people, providers, and payors. It can be applied to every setting – wherever a person lives. We just doubled-down on our global risk strategy going from 7,000 lives under our care to 35,000+ next year.

Customer satisfaction is up, and so are profits. Global risk and value-based care lead companies to rethink all the old assumptions about what customers want and what customers need.

Healthcare ultimately must be about customer care. Customers want to be treated as whole and living people, not fragmented billing opportunities of broken bones, clogged arteries, and impaired memory.

The sooner our healthcare system makes the shift to focus on customers, the better off we all will be. The metrics show it works – for patients and providers.

Joel Theisen, BSN, RN, is founder and chief executive of Lifespark, a Minnesota-based complete senior health company. Follow him on Twitter: @Lifespark_CEO.