By Joy Stephenson-Laws, Managing Partner
One aspect of the traditional revenue model for most healthcare providers includes a strategy of maintaining patient loyalty while capturing new patients to replace the revenue lost through attrition. The goal is to provide financial growth that will keep pace or outpace the rate of operating cost increases. Many providers implement this strategy through a combination of marketing and operational activities that, with some tweaks here and there, have worked sufficiently well. And since it wasn't "broken," there was no compelling reason to "fix it."
But the days of "marketing as usual" are over, thanks to the generation known as "Millennials" taking the place of "Baby Boomers" as the largest population of people in the United States. According the U.S. Census Bureau, there are now over 83 million Millennials, (those born between 1981 and 1996), versus some 75 million Baby Boomers. Another way to put it, Millennials now represent a quarter of the U.S. population. And given that the older Millennials are now well into their 30s, this means that they are not only making healthcare decisions for themselves but most likely for their parents and grandparents as well.
So what does this mean for healthcare providers? It means that to ensure financial stability and viability over the next few decades, providers need to know how to attract Millennials to their facilities and how to keep them loyal. And, for many providers, this is far more easily said than done since Millennials are nothing like previous generations on how they view healthcare and how they consume it.
Perhaps one of the most visible changes, and one that has far-reaching implications for the industry, is that Millennials are abandoning Primary Care Physicians (PCPs) and opting instead for alternate sources of healthcare. Many of these options would not have even been contemplated as viable a decade ago. A recent study by the Kaiser Family Foundation revealed that almost 45 percent of Millennials do not have a PCP (compared to only 18 percent of their parents' generation). And, if you look at their grandparents, that number drops even lower, to around 12 percent. Another study done by the Employee Benefit Research Institute had similar results with 33 percent of Millennials not having a PCP, compared to 15 percent for those age 50 to 64.
While it may be tempting for hospitals to believe that by nature of their size, resources and services they are immune to this "Millennial Affect," they do so at their own financial risk. While Baby Boomers and previous generations accepted the status quo of the healthcare system, Millennials do not. In fact, many Millennials believe that healthcare in the United States today is inherently flawed. They tend to not fully trust the industry to do the right thing when it comes to their care, and they want to see changes that reflect their wants and needs. Millennials, who are familiar with instant gratification, also see healthcare as frustratingly inefficient and more like a stereotypical 20th Century-style assembly line.
And given their desire for institutions to work for the common good, they are also skeptical of healthcare providers' true motives. Many see providers as 'profit making machines.' Last, but certainly not least, Millennials depend (more than other generations) on a provider's reputation and online reviews, for example, Yelp!, in making a decision on which provider to use for their healthcare needs.
What Millennials Want from Healthcare Providers
Given that Millennials have never known a world without the Internet, on-demand digital content, social media and "Dr. Google," it's not surprising that their life experiences and technology have shaped their view of how they believe healthcare should work. Their model of healthcare offers:
Instant Access and Convenience
The idea of having to wait days, or even weeks, to see a doctor or other healthcare professionals is anathema to Millennials. They want wait times of less than 30 minutes and same-day appointments. And while some Millennials would previously just go to the ER - even with the additional wait and costs involved - they now head straight for their local retail clinic or urgent care center, many of which are conveniently located at their local CVS or Walmart. One Millennial even described heading to their local urgent care as being like "speed dating" but with a doctor instead of a potential mate. How popular have these clinics become? At last count, there are some 3,000 of them - and counting!
Transparency and Competitive Pricing
While Millennials are not alone in believing that healthcare is too expensive, they are, arguably, the only generation likely to ask their providers for discounts or a less expensive treatment option. They also like it when prices are posted (as many urgent care and retail clinics do) and where there are no hidden costs or final bill surprises. Comparison shopping among hospitals, doctors and other healthcare providers, (which would have been almost unheard of with previous generations), is commonplace with this generation. There is evidence that more than 40 percent of them ask for estimates before agreeing to any treatment plans. They can be so price-conscious that almost half have admitted to putting off healthcare because of the cost.
Millennials are connected 24/7 to their friends, their work and the world in general. So, it's no surprise they expect the same from their healthcare providers. Specifically, Millennials want to:
- Be able to use apps to book healthcare appointments rather than having to call
- Have online access to their and their families' health data
- Take advantage of preventative care services via their smart phones or other devices
- Have two-way, full electronic communication with their doctors and other providers
Results-based, Competitive Fees
Millennials do not blindly accept the pricing practices of the healthcare industry, and they know that healthcare costs increases have outpaced inflation for most, if not all, of their lives. As a result, they usually look for new ways to pay for healthcare to make sure they are getting the greatest proverbial bang for their healthcare buck. These include:
- Single, monthly, upfront payments with no copays or deductibles
- Upfront estimates rather than getting a bill after care is delivered
- Payment structures that reflect quality of care versus quantity of care
- Shared savings to encourage greater efficiency and cost effectiveness
- Incentives that reward healthiness and preventative care
Technologies such as telehealth to replace in-person visits that were inconceivable a few years back continue to gain acceptance and traction with Millennials. In fact, almost 75 percent of this generation have reported being interested in this service and more than half support its use. This is not surprising since Millennials are used to using video conferencing for personal phone calls and business meetings.
How Providers Can Keep Millennials' Business
The easiest way for providers to attract and keep Millennials as loyal patients and healthcare consumers is to listen to what they say they need and want rather than just conducting "business as usual." It also means borrowing processes and services from healthcare providers, retailers and professional services that have won the business and loyalty of Millennials. These include offering the following:
- Same-day appointments with reduced wait times
- Onsite, high-speed, free WiFi
- Wide variety of device chargers in waiting rooms, hospital rooms
- "Welcome" kiosks for check-in and follow-up appointments
- Courtesy tablets for accessing healthcare information while onsite
- Robust apps and portals for accessing health records and communications with physicians
- Telehealth via mobile devices
- Messaging and communications via message platforms, e.g., iMessage, WhatsApp
- Onsite urgent-care clinics similar to those offered by retailers
- Enhanced community wellness programs
While many of the above may seem somewhat out-of-place or alien to many hospitals, they are, to a great degree, very common outside of a healthcare setting. Given that companies such as Amazon and Google, which have defined the type of service Millennials want, are poised to become bigger players in healthcare, providers may need to become more like them and less like a traditional healthcare institution if they are to attract and retain the loyalty of almost a quarter of the U.S. population.
Joy Stephenson-Laws, JD, is the founder of Proactive Health Labs (www.phlabs.org), a national nonprofit health information company that provides education and tools needed to achieve optimal health. She also is founding and managing partner of Stephenson Acquisto & Colman (www.sacfirm.com), one of the nation´s leading health care law firms. She is also the author of "Minerals--The Forgotten Nutrient: Your Secret Weapon for Getting and Staying Healthy." She is based in California.