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The healthcare consumer confidence crisis: Q&A with Brian Wynne, VP and general manager at NRC Health

The following article also appears on the Becker’s Hospital Review website and can be found here.


Startling news for health system leaders: consumer trust in the healthcare industry is at an all-time low. Persisting frustrations and mounting costs have left consumers feeling alienated and cynical.

But responsive organizations can still win back the trust of their customers. Brian Wynne, vice president and general manager with NRC Health, weighs in on how.

Question: What do healthcare leaders miss about patient perception?

Brian Wynne: The lay consumer doesn’t necessarily share our perception of how healthcare options are discovered, purchased, and received. Insiders tend to believe that huge health campuses, slick new websites, and expanding physician networks represent unprecedented access for consumers. But for customers, a hospital campus is a maze, digital “front doors” for most health systems leave much to be desired, and inconsistencies in service lead to a lot of frustration.

One perception that consumers and healthcare professionals do share is that the system is remarkably complex. However, it’s the responsibility of health system leaders to simplify it for patients.

Q: How would you advise leaders to close these gaps?

BW: They should take a more holistic perspective. Most healthcare brands take an overly narrow approach to patient feedback. HCAHPS simply doesn’t capture everything a health brand needs to know.

Yes, surveys will tell you how patients feel about episodes of care. But what about before and after the stay? Interactions with family and friends, online research, getting an appointment, and the discharge and billing processes all add up to a comprehensive brand experience. Organizations can’t neglect any part of it.

Q: Just how severe is this crisis?

BW: It’s well past time to take the issue seriously. According to our research, consumers rate their confidence in the healthcare industry at just 67.7 out of 100 — the lowest score we’ve ever recorded. Confidence scores are especially low among 18 to 34-year-olds (64.5), people earning under $25,000 per year (62.2), and minority groups like Native Americans (61.3) and Pacific Islander Americans (53.4).

Those scores reflect a broad reckoning of the entire industry. When we look at how much patients trust physicians in particular, the picture looks even grimmer: consumers give them a confidence score of just 54.9 out of 100.

We have to acknowledge that, in some ways, the healthcare industry has failed to earn patients’ trust. That may be why many of them are turning to non-traditional providers, and why tech giants are eager to disrupt the space.

Q: Are patients reacting to a decline in quality of care?

BW: Not according to our data.

Patients actually rate their care experiences rather well, scoring them at 72.2 out of 100. This beats out how they rank other industries like hospitality and ride-sharing, and ties with the score they give brick-and-mortar retail shops. Only online retail ranks better.

It’s a puzzling contradiction. Patients like how their providers treat them in isolated encounters, but don’t necessarily believe that providers have their best interests at heart.

Q: Where does this mistrust come from?

BW: Our data suggests that pricing may be the culprit. I doubt many healthcare leaders would be surprised to learn that American consumers score healthcare’s affordability at just 24.7 out of 100.

A shocking 9.5 percent of consumers were uninsured in 2017, with the number expected to climb this year. Furthermore, a rise in high-deductible health plans has left Americans shouldering a larger portion of their healthcare costs than ever before.

Many Americans can’t afford it. Nearly 23 percent of consumers reported that, in the last six months, sticker shock from healthcare prices persuaded them to defer care.

More than any other statistic, that one troubles me. It means patients are feeling priced out of care. No wonder they’re also feeling cynical regarding traditional care and seeking alternatives.

Q: What can healthcare leaders do to recover trust from patients?

BW: For most healthcare organizations, competing on price is a non-starter. Instead, I’d recommend health systems focus on increasing the value they offer. Which means health systems will need to define what “value” means to their customers along each step of their care journey.

Real-time feedback, for example, should become a staple for organizations trying to learn what their patients really want inside a care setting. So should in-depth market research, managed digital communities and targeted focus groups.

The goal is to elevate the state of service to what consumers expect. With time and persistent effort, that will win back their confidence.

Q: Are you optimistic about organizations’ abilities to resolve the confidence crisis?

BW: Certainly. This problem has a solution. I believe leaders in healthcare have a genuine and innate desire to create experiences that inspire loyalty to their organizations. Right now, it falls to health systems — and their technology partners — to deliver on the promises made to their customers to restore the confidence that we see lacking today.