Distinguished partners of NRC Health,

COVID-19’s aftermath continues to influence consumers’ trust and engagement with healthcare. The future of healthcare, while uncertain, will focus heavily on personalizing consumers’ experiences—and those organizations that lead with empathy and Human Understanding to engage patients will be more than ready to meet any unforeseen challenges.

The NRC Health 2022 Healthcare Consumer Trends Report provides insight into how healthcare organizations can navigate the next year successfully. The report, compiled from millions of data points across more than 300,000 American households, captures an evolving snapshot of consumer sentiment.

Encouraging news awaits organizations that have embraced the fact that the only constant in life is change. With a change mindset, healthcare leaders can find creative solutions to engage more with consumers and patients and drive healthcare recall and brand awareness. To that end, this report will outline how consumer sentiment continues to evolve along several important trendlines:

Part 1: Care deferment

Part 2: Wellness and mental-health engagement

Part 3: Telemedicine opportunities

Part 4: Healthcare recall

Part 5: Human Understanding

These insights, grounded in the single most extensive database of American healthcare consumers, should help industry leaders lay the foundation to futureproof their organizations in the aftermath of COVID-19 and beyond.

We hope you find it informative and worthwhile.

Sincerely,

Helen Hrdy,
Chief Growth Officer, NRC Health

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One of the most significant disruptions in healthcare delivery in modern history has been caused by consumers deferring care during the pandemic. The excellent news is, NRC Health data shows that healthcare deferment is now decreasing, and consumers are starting to resume services. However, healthcare systems should be mindful that some of the consumers who return could be sicker and costlier in 2022 than they would have been before.

As of Q4 2021, 27.1% of consumer respondents state that they have delayed care, compared to the peak of 33% in Q4 2020. The rate at which consumers are resuming services has risen by 149% from 2020 to 2021 across all major service lines. The most considerable increase in volume is evidenced in the inpatient care setting (175%), followed by outpatient services (165%) and retail clinics (167%). There have also been significant increases in volume in the medical practice (147%) and emergency department (148%) areas.

While the COVID-19 pandemic caused many consumers to delay several types of care, preventative care was particularly affected, especially in conditions where the COVID-19 virus can be most acute.

• Blood pressure tests declined 5.5%, from 54.2% in Q1 2020 to 48.7% in Q4 2021
• Routine physical exams declined 4.7%, from 42.6% in Q1 2020 to 37.9% in Q4 2021
• BMI (Body Mass Index) screenings declined 2.8%, from 14.0% in Q1 2020 to 11.2% in Q4 2021

And the percentage of consumers having no preventative service or test increased 1.8%, from 18.2% in Q1 2020 to 20% in Q4 2021.

Healthcare systems should also consider that 13% of respondents say they’re unsure when to resume healthcare activities, and 4.6% say they won’t return to healthcare. Left untreated, many patients’ conditions are likely to deteriorate, leading to serious adverse outcomes that health systems may not be able to treat.

Findings like these—and others that show that patients delaying myocardial infarction or appendicitis care prioritized avoidance of COVID-19 exposure over seeking appropriate care—suggest that healthcare systems and public-health organizations should develop effective communications for patients and the community at large to reassure them and encourage timely healthcare for critical needs during the ongoing COVID-19 pandemic and other similar scenarios.¹

Recognizing this, some healthcare systems have reached out directly to chronically ill patients and those at risk for chronic disease, with campaigns to get them to return to care. Other efforts have included hosting virtual town halls, advertising on social media, holding Facebook Live events, and reaching out to business leaders.² But whatever the method used, it’s time to close the gap on educating the public around the importance of timely healthcare.

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Although telehealth usage has increased in counseling (206%), it is devastating to acknowledge that nearly one third (30%) of consumers report that their mental health has worsened due to the COVID-19 pandemic. Additionally, mental-health hospitalizations have increased by 190% from 2020 to 2021.

Depression remained common during the pandemic and worsened for some people. A broader national study from the Centers for Disease Control and Prevention showed that the percentage of adults with recent symptoms of a depressive disorder had increased, from 24.5% in August 2020 to 30.2% in December.

Healthcare systems should note that it’s crucial to identify people with depression, because it’s a decisive risk factor for cardiovascular disease. And if people are becoming more depressed because of the pandemic, healthcare systems could see a higher incidence of cardiovascular disease in a few years. Women, particularly those of childbearing and child-rearing age, may have experienced a specific burden during the pandemic, given that they often had to take on increased caregiving duties.³

Before 2020, mental disorders were the leading cause of the global health-related burden, with depressive and anxiety disorders contributing to this burden. The emergence of the COVID-19 pandemic has created an environment where many determinants of poor mental health are exacerbated. There is an imperative need for up-to-date information on the mental-health impacts of COVID-19 that can inform health-system responses.⁴

The increased frequency of symptoms of anxiety and depression in an ongoing CDC study indicates that mental-health services and resources, including telehealth behavioral services, are critical, particularly among populations disproportionately affected by COVID-19. National COVID-19 trends demonstrate that specific populations have been disproportionately affected by high COVID-19 incidence, which suggests that these populations might also be more vulnerable to the psychological consequences of COVID-19.⁵

The pandemic has created an increased urgency to strengthen mental-health systems in most countries. Mitigation strategies could incorporate ways to promote mental well-being and target the determinants of poor mental health, along with interventions to treat those with mental disorders. Taking no action to address the burden of major depressive and anxiety disorders should not be an option.⁶

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While telemedicine struggled with how reimbursement and logistics would work in years past, the widespread adoption of this technology has grabbed and is now holding consumer interest. Consumers’ excitement for telehealth has hovered around 55% throughout the pandemic, compared to the pre-pandemic average of 49.3% in Q1 2020. Consumers 35 to 44 years old are the most excited about telehealth (68.1%), whereas people 65 and older are the least excited (45.2%).

Consumers have determined that telehealth’s inherent ease of use, amount of time spent with providers, courtesy, respect received, and attentiveness has made the technology a winner, and not just with family practice, internal medicine, and nurse practitioners.

And while telehealth makes sense for many areas, it’s not a slam dunk for every healthcare specialty. NRC Health data shows that telehealth usage has decreased in several areas, including:

Physicians and healthcare organizations are innovating in other areas of digital health, thinking beyond videoconferencing to sensors, augmented intelligence, wearables, and more to reduce costs and improve health outcomes, care experience, and work-life balance.⁷

Given that telehealth usage has more than doubled since 2020, healthcare systems should cultivate an effective and meaningful telehealth practice and consider digital health innovations. Healthcare systems should also prioritize provider time and attentiveness, as well as financial transparency, in their telehealth offerings.

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A healthcare system’s obsession with brand loyalty is easy to understand. In driving down costs and capturing recurring revenues, consumer loyalty is a significant driver of health-system profitability. Frequent patient visits drive up the quality of care by improving care continuity and reducing the potential backlash associated with not keeping routine healthcare a priority.

The good news for healthcare systems is, consumer healthcare recall is starting to climb, and healthcare systems can capitalize on this growing trend. NRC Health data from Market Insights recalling key performance indicators year-over-year find that marketing recall has increased by 5.1%, from the lowest point of 59.4% in 2020 to 64.5% in 2021.

Additionally, consumers report an increase in helpful health information from hospital websites (+5.8%) from 2020 to 2021. Consumers who have visited a hospital website are also up 4.6% since November 2020, with an all-time high of 31% visiting a hospital website as of November 2021.

This trend fuels digital healthcare efforts, offering healthcare systems an abundance of data that can be used to personalize communications and deliver connected tools and data for consumers to give them the information they want, when they want it. Digital healthcare can also automate everything from data entry to medicine distribution and research analysis, providing staff with resources and time to give the best-personalized care possible to each consumer. Ultimately, the ability to be proactive in communications allows for better disease prevention, circumventing the need to treat many conditions.⁸

Consumer behavior communication tells us that more than half (51.2%) of consumers say they will use a handheld mobile device to access information in the next year. Social media is one of the most significant drivers of handheld mobile information, and its use is up (10.8%) from 7.4% in 2020 and is now the third most recalled ad platform behind television (38.7%) and billboards (11.8%).

Healthcare organizations should build their brands using personalization techniques and an omnichannel approach to target and engage active patients.

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Personalized experiences are slowly becoming the norm as consumers engage and share information with hospitals and practitioners, who then use this information to personalize experiences further. With personalization at the center of emerging healthcare, consumers will seek new levels of health and wellness—but only if healthcare organizations get it right.

Consumers’ likelihood to recommend hospitals and health systems has increased by 3.9 points from 20.2 in 2020 to 23.3 as of November 2021; while patient experience peaked during the onset of the pandemic—with Net Promoter Scores at 56 in April 2020 for hospital inpatients and emergency departments—but have been declining since, resulting in an NPS of 44 in December 2021. While consumers’ likelihood of recommending hospitals and health systems increases, patients’ likelihood of recommending hospitals decreases, indicating that the patient experience is not meeting expectations. The bottom line? Hospitals and health systems must meet people where they are.

The key to enhancing a patient’s care journey is understanding preferences in advance, which can be achieved with communication assessments. Healthcare systems should deliver a person-centered, equity-focused experience as a standard measure across care settings, and treat each patient as a unique individual while personalizing their experience.

During the past 15 years covering the existence of the CAHPS program, NRC Health has seen the overall percentage of patients recommending an organization barely increasing—yet the industry is spending billions of dollars a year to drive improvement against such measures.

What needs to shift is an understanding that 99% of a patient’s life happens beyond the hospital care setting. When healthcare organizations begin to understand each person’s expectations in advance of their interaction or episode of care, they can personalize those interactions at the right moments and exceed those expectations.

In light of the 2021 Consumer Trends Report, NRC Health reported that an increasing number of consumers had indicated no particular preference for a healthcare brand. In 2021, the percentage of consumers indicating “no preference” was 34.5%, indicating a plateau in “no preference.” But while the number of consumers with no preference has plateaued, hospitals and health systems have a vested interest in ensuring that their brand is preferred.

Consequently, healthcare organizations must strive for seamless connectivity between service recovery and missed patient expectations, driving caregiver recognition and positive comments on social media to enhance reputation. Now is the time for healthcare organizations to use meaningful advertising and aim their messaging at patients in a personalized way that adds value to their life.

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The global pandemic surrounding COVID-19 and its variants has caused healthcare organizations to quickly learn that transformational change is necessary to meet demand and move the industry forward. And while many hospitals and health systems have shown they can be flexible despite catastrophic loss, the pandemic has shone a light on how necessary consumer-driven improvements and a better patient experience are to continued survival and growth.

The healthcare industry can draw on NRC Health’s six Human Understanding imperatives to strengthen their commitment to consumers:

When organizations lead with empathy and Human Understanding and can engage patients to co-design the care experience, they will be more than ready to meet any future challenges.

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