Is “satisfaction” enough? That's the intriguing question raised by a new study that suggests even though many patients give relatively high satisfaction ratings on the care they receive, they still have issues with many elements of their health care experience.

The “2019 Healthcare Consumer Trends Report,” published by NRC Health, compiled more than a million responses from hundreds of thousands of households, and also included insights of health care leaders from around the country.

The conclusion of the report is that consumers expect more than merely being satisfied with their health care relationships. “The health care consumer has evolved, and they expect health systems to evolve along with them,” the report said. “Patients nowadays don't just want excellent care. They want care that conforms to their elevated expectations—care delivered with more ease, convenience, and choice.”

Providers popular, institutions less so

As many surveys show, consumers feel connected to their providers. The report found that among patients, positive comments about providers outnumber negative ones by more than two to one. NRC Health's data showed that 87 percent of patient comments praised clinicians' courtesy and respect, and 53 percent of comments reflect positive clinical-staff communications.

One area where providers did not score well was in the area of case histories: the report found that one in five (26 percent) of patients reported that doctors didn't show enough knowledge of their prior health episodes. Only slightly more, 28 percent, reported that doctors were adequately informed.

Not surprisingly, wait times draw complaints; 77 percent of comments about wait times were negative. Patients also were more negative about non-clinical staff: 67 percent of comments said administrative and support staff do not treat patients with respect. Billing and insurance functions also got poor ratings: thirty-four percent of comments complained about the billing and insurance process; just 26 percent of comments expressed satisfaction with it. (The remainder of comments were neutral.)

The report concluded that patients have mixed feelings about their clinical experience. “On the one hand, they can't say enough good things about their providers, and feel well-treated by the clinicians who care for them,” the report said. “On the other hand, their encounters with ancillary parts of the care experience—support staff, waiting rooms, billing, etc.—leave much to be desired.”

Convenience is king

The report also examined the ongoing evolution of how care is delivered. Retail clinics and telehealth, it said, are seeing strong growth as consumers continue to highly value convenience.

“Over the last 14 years, the ranks of retail providers have swelled by 500 percent,” the report noted, “putting a retail clinic within a ten-minute drive of more than 30 percent of U.S. households. With such convenience available to them, it's no wonder that the number of primary-care office visits declined by 18 percent from 2012 to 2016.”

And the report called the growth of telehealth services “stunning”—noting that nearly 60 percent of employers now offer some type of digital health care appointments to employees. It also noted that the CEO of Kaiser Permanente said more than 50 percent of the health system's patient visits were conducted through a telehealth platform in 2016. “There's no reason to believe that these trends will slow down, as consumers continue to expect ever-more convenient access to care,” the report said.

A more troubling finding was that some patients continue to defer care—usually because they are unable to pay for services. The report's data showed that in the last two years, nearly 23 percent of patients have delayed getting necessary medical treatment—the highest percentage since 2010.

“Every health leader should be concerned about that figure,” the report said. “Without diagnosis or treatment, many of these conditions are likely to get worse over time, which ultimately increases the costs of intervention and leads to worse outcomes.”

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Quality care isn't enough to meet the expectations of today's health care consumers

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