Page 1 NRC Picker North Carolina Regional Networking Event Winston-Salem, NC| August 16, 2012 www.nationalresearch.com When Worlds Collide: Long-Term Care vs. Consumerism www.nationalresearch.com Presenters Ryan Donohue Corporate Director of Program Development [email protected]Rich Kortum Director, Strategic Partnerships [email protected]www.nationalresearch.com The Healthcare Consumer State of Mind
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Page 1NRC Picker North Carolina Regional Networking Event
Winston-Salem, NC| August 16, 2012
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When Worlds Collide: Long-Term Care vs. Consumerism
Page 2NRC Picker North Carolina Regional Networking Event
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The Healthcare Consumer State 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
www.nationalresearch.com
The Healthcare Consumer State of Mind
• Since 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 polledthrough national survey
• Results in NRC white paper
www.nationalresearch.com
The Healthcare Consumer State of Mind
Healthcare consumerswant 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?
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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 allLikely
(2) (3) (4) (5) Very Likely
Fre
qu
ency
%
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?
Page 4NRC Picker North Carolina Regional Networking Event
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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 ayear
0 to 3 years 2 to 5 years 4 to 10 years More than 10years
Fre
qu
ency
%
Response
When do you anticipate needing any such services?
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Where PerceptionMeets Reality
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VIRTUAL EXPERIENCEVIRTUAL EXPERIENCE
TRUE TRANSPARENCYTRUE TRANSPARENCY
PROVIDING HEALTHCAREPROVIDING HEALTHCARE
Where Perception Meets Reality
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• 87% of Americans use the internet regularly
• 39% have visited WebMD.com
• 22% have visited a local provider website
• 35% of 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
www.nationalresearch.com
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 Social & 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% of 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 Social & Mobile Play
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Social & 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
www.nationalresearch.com
• 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 providerswill embrace price as an external benefit and aninternal 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
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Providing Healthcare: Stretching 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 judged 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: Stretching 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 just clinical considerations
• Staff 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
0 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???
132426.426.929
36.248.6
67.167.7
73.4
Your Government (Fed &…Long Term Care/Nursing…
Health Insurance…Fitness/Health Companies
Home Health ServicesYour Employer
Hospice/End of Life…Pharmacies
HospitalsDoctors/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 ExperienceSkilled 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 ExperienceAssisted / Independent Living
Overall Satisfaction Willingness to Recommend
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Skilled Nursing Resident
SOURCE: NRC’s 2015 My InnerView national survey
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Skilled Nursing Resident
SOURCE: NRC’s 2015 My InnerView national survey
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What Matters Most
Nation’s Skilled Nursing Residents Say:
1. Care (Concern) of Staff
2. Competency of Staff
3. Responsiveness of Management
4. Choices/Preferences
5. RN/LVN/LPN Care
SOURCE: NRC’s 2015 My InnerView national survey
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Skilled Nursing Family
SOURCE: NRC’s 2015 My InnerView national survey
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Skilled Nursing Family
SOURCE: NRC’s 2015 My InnerView national survey
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What Matters Most
SOURCE: NRC’s 2015 My InnerView national survey
Nation’s Skilled Nursing Families Say:
1. Care (Concern) of Staff
2. Competency of Staff
3. Choices/Preferences
4. Responsiveness of Management
5. RN/LVN/LPN Care
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Skilled Nursing Short-Stay Discharge
SOURCE: NRC’s 2015 My InnerView national survey
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Skilled Nursing Short-Stay Discharge
SOURCE: NRC’s 2015 My InnerView national survey
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What Matters Most
Nation’s Discharge Patients Say:
1. Care (Concern) of Staff
2. Competency of Staff
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
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Assisted Living Residents
SOURCE: NRC’s 2015 My InnerView national survey
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What Matters Most
Nation’s Assisted Living Residents Say:
1. Responsiveness of Management
2. Choices/Preferences
3. Comparison of Charges
4. Competency of Staff
5. Care (Concern) of Staff
SOURCE: NRC’s 2015 My InnerView national survey
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Assisted Living Family
SOURCE: NRC’s 2015 My InnerView national survey
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Assisted Living Family
SOURCE: NRC’s 2015 My InnerView national survey
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What Matters Most
Nation’s Assisted Living Families Say:
1. Responsiveness of Management
2. Choices/Preferences
3. Comparison of Charges
4. Competency of Staff
5. Care (Concern) of Staff
SOURCE: NRC’s 2015 My InnerView national survey
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Independent Living Resident
SOURCE: NRC’s 2015 My InnerView national survey
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Independent Living Resident
SOURCE: NRC’s 2015 My InnerView national survey
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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 Staff
5. Responsiveness of Staff
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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
OVERALLBRANDEQUITY
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 enjoy their jobs
• Our most important asset
What is a Brand?
www.nationalresearch.com
• Slogans, jingles, logos, pretty pictures, etc.
• A waste of money during challenging times
• Something only Marketing worries about
• A luxury for the most affluent hospitals
What is NOT a Brand?
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Brand Relationship Spectrum
Shadow Endorser
Not Connected
TokenEndorser
StrongEndorser
Co-Drivers
MasterDriver
DifferentIdentity
SameIdentity
BrandedHouse
Sub-Brands
EndorserBrands
House ofBrands
BrandRelationship
Spectrum
SOURCE: HBR, 2004
Saturn(GM)
Lexus(Toyota)
EmbassySuites(Hilton)
Courtyardby Marriott
SonyBravia
HP Deskjet
BMWNissan Japan,Nissan USA
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Brand Relationship Spectrum
• 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?
www.nationalresearch.com
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
www.nationalresearch.com
Streamlining via System 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 of the online customer
• Healthcare’s sluggish tech adoption provides opportunities to providers willing to invest
www.nationalresearch.com
The Value of Simplified Communications
• Simplifying 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
Page 22NRC Picker North Carolina Regional Networking Event
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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
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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
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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 State of Healthcare Consumerism
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Evidence
Relevance
Consequence
Action
Your performance is quantified by an outside party.
Your performance is matched to the performance of others.
You process the potential negative effects of poor performance.