The Result of Healthcare Consumerism? Competition.

The concept of healthcare consumerism has been floating around the healthcare industry for decades. Recent federal regulations, including the 21st Century Cures Act and innovative price transparency rules, have propelled the industry towards newfound transparency, providing patients with the power to actively participate in their healthcare decisions.

In this dynamic environment, where healthcare is no longer confined to traditional boundaries, consumers have many choices. Most are driven by telehealth and disruptive retail health models. The fusion of consumerism and choice has intensified competition among healthcare stakeholders, where over 70% of patients turn to Google before scheduling appointments. This challenges organizations to elevate the consumer experience to secure unwavering loyalty.

What Drives Healthcare Consumers Away?

Before talking about winning more consumers over, let’s first examine three major drivers that send consumers scrambling away from a healthcare organization.

  • Money. A 2023 Gallup poll found 38% of Americans put off medical care due to cost in the last year. If consumers can’t easily find the price of an elective procedure or have received a surprise bill from a health system previously, they may be less likely to seek care from that organization again. 
  • Coverage confusion. If a consumer is unable to discern if a provider is in their network easily, they will be less likely to seek care from that clinician. Or, they may have been referred to an in-network physician, but prefer to see someone outside of the system. 
  • Data access and sharing capabilities. If it’s difficult to access a patient portal or they ask for their electronic health information and get the data printed, faxed, or on an outdated CD instead of digitally, they’re likely to walk away. Having to re-share their medical history at every appointment is also a deterrent. In fact, a 2022 study from CVS found that 85% of consumers want their records digitized, and access to that digital record is important when choosing a provider.

Gain a Competitive Edge Through Healthcare Consumerism

Compliance with government regulations, such as price transparency and interoperability rules, is a foundational step toward winning consumer loyalty. However, healthcare organizations must go beyond mere compliance to gain a competitive edge, attract new patients, and retain their loyalty.

  1. Interoperability as a Foundation: Treating interoperability as the starting point, healthcare organizations should dismantle information silos within and outside their structures, creating a collaborative environment with community organizations, providers, and payers. This approach enables consumers to gain comprehensive insights into their health. This includes the alignment of preferred providers with their health plan network and estimated costs.
  1. Digital Tools Revolutionizing Patient Engagement: The crux of healthcare consumerism lies in convenience, and digital tools are driving patient engagement to unprecedented levels. With 80% of consumers saying they’d use online appointment scheduling tools if available, digital scheduling has become a key factor.

Price transparency and interoperability rules were enacted so consumers would have more insight into out-of-pocket costs. They also allow consumers to access and share their medical records more easily. While mere compliance with regulations is a necessary baseline, it falls short of seizing a competitive advantage. To truly excel, healthcare organizations must transcend the confines of mere adherence to regulations. They must cultivate an environment where the consumer reigns supreme, crafting personalized experiences that resonate deeply. By prioritizing consumer-centric approaches and innovating beyond regulatory requirements, organizations can ascend to the forefront of this dynamic market. This will lead to attracting and retaining patients with unparalleled loyalty and satisfaction.

By embracing interoperability architecture, healthcare organizations can navigate the complex regulatory landscape more effectively, while also leveraging it as a strategic tool to gain a competitive edge in the market.

Meeting the Moment While It’s Here

Ultimately, healthcare organizations need to focus on creating a go-to health hub for consumers that encompasses their entire healthcare experience – think longitudinal care management (LCM). If they meet the moment, they will watch consumer volumes and loyalty grow.


Looking to dive deeper? We recently released the whitepaper: “From Compliance to Competitive Advantage: Regulatory Drivers Pushing Towards a Shoppable Healthcare Consumer.” Download it here. Don’t miss out on new content – subscribe here or follow us on social.

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