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January 5, 2018
September 23, 2022

One of the few advantages of an increasingly stingy health insurance system is the empowered consumer.  As premiums and deductibles continue to rise, more policyholders are making treatment decisions instead of deferring to their insurer. This new breed of health care shopper is also forcing changes in how patient care is promoted and delivered.

Online Ratings

The highest priority among consumers when choosing a treatment facility is patient ratings.  Many providers may dispute the validity of patient-based evaluations, as they may involve subjective influences that only tangentially relate to the quality of care, but consumers have come to rely on user ratings.  Besides, there is ample evidence that crowdsourced reviews often reflect actual performance metrics.  A study by Healthgrades found that hospitals with a five-star, top rating actually had a 71 percent lower patient fatality risk and 65 percent lower risk of complications.


However, at a more granular level, patient satisfaction is dependent upon their type of need.  If there is a need for urgent care, the highest priority, at 21 percent of respondents, is accessibility.  This is followed by care quality at 19 percent of responses. The patient satisfaction reviews are diminished in their importance.


On the other hand, if the issue is chronic or life-threatening, then reputational rating grows in importance. The study found that 47 percent of respondents would endure longer wait times for higher-rated physician when confronted with a long term health issue. This is especially true among people with higher incomes and those aged 65 or older.


Of course, cost is driving this consumer initiative so it also plays a significant role in provider choices. According to a 2016 Physicians Foundation report, there has been a decline in primary physician utilization due to rising deductibles.  When patients do seek out primary care, they often use pricing as a factor; one survey found that 75 percent of patients look for a lower pricing point.

This penchant for lower cost is fueling the greater utilization of retail health clinics that provide robust front-line care, often at a highly competitive price. It is also driving the push for greater price transparency.

Unfortunately, price transparency is not readily available in the health care community, despite an intensifying demand from consumers.  One notable example is the Healthcare Price Transparency Law that was supposed to go into effect in Ohio in January of 2017. However, enormous resistance from the Ohio Hospital Association has stalled its implementation. The OHA claims that it would put into place unnecessary administrative obstacles that would slow care delivery, but many analysts say the real issue is revealing insurer-negotiated prices for many services.

For many years, the health care community has been well insulated from consumer pressures common to other industries, but that is likely changing. As more online tools appear to analyze and evaluate providers, prospective patients will naturally use them to inform their decisions. In the coming years, more hospitals and physicians will need to modify their business operations to accommodate these consumer-driven desires. 


Article written by:

Dr. Rober Moghim, M.D. - CEO/Founder Health Carousel Locum Tenens