A consumer-obsessed strategy is key to rebuilding primary care

While healthcare consumerism has reshaped the way patients engage and feel empowered in their care, for many health systems, it’s had the opposite effect, fragmenting patient care access and threatening the continuity of primary care into high-acuity settings—not to mention organizational bottom lines.

Consumerism in healthcare has heralded a new era in which patients are the arbiters of their own health and well-being journeys. With patients responsible for more of their healthcare, their decisions are guided not just by their clinical needs but also by their personal preferences.

“We've long seen this demand for easier access to care, faster access to care, more affordability,” Arielle Trzcinski, a principal analyst at Forrester, said in an interview. “Ease of access led to the rise of retailers and digital health and folks being able to offer these different experiences for patients.”

Indeed, retail health utilization skyrocketed between 2021 and 2022 by 202 percent, according to FAIR Health data. That increased access is due in large part to the convenience of retail health clinics and what’s often a lower price tag.

But while it’s notable that retail health clinics and other care modalities, like telehealth and urgent care centers, are filling the gap in consumer healthcare needs, there are some unintended consequences that legacy health systems face.

“It's led to a greater fragmentation of the patient journey within healthcare,” Trzcinski explained.

With the rise of retail health clinics has come a bigger population of patients without a primary care provider. That’s because many patients get their primary care needs met in the retail setting.

Data from the Primary Care Collaborative (PCC) and AAFP Graham Center showed that the number of Americans with a usual source of care has dropped 10 percent in the last 18 years, with only about three-quarters of people saying they have a regular primary care provider or at least a facility where they know they can access care.

Some health systems are seeing nearly half their populations without a primary care provider, Trzcinski added, while there are some projections that say retailers will own up to 30 percent of primary care by 2025.

“While primary care is not necessarily the money maker for health systems, it's a really important feeder and lifeline both for the patient and for the health system to ensure that folks are getting the care and the support that they need,” she said. “So, if we break that, we suddenly have severed that lifeline.”

Health systems are starting to respond to this problem by augmenting their existing systems to make care access more convenient, potentially eliminating the need for retail health and urgent care centers.

For other health systems, it’s more of an “if you can’t beat ‘em, join ‘em” situation. Partnerships between larger health systems and area retail health clinics aim to drive care coordination and help retail health patients receiving a serious diagnosis get in for higher acuity care.

“Another trend that's emerging is this focus on customer experience platforms for healthcare,” Trzcinski stated. “So how do we start to change the relationship of a patient with their health system?”

Health systems taking this track are looking at how they can create value for patients and build their brand outside of a clinical encounter and beyond the friction points they already handle.

Indeed, many health systems have already invested in point solutions for some of their patients’ biggest problems. Digital bill pay and simplified scheduling options come to mind. But those aren’t the high-emotion touch points that most health systems want, Trzcinski explained, because they are mostly associated with the most negative parts of the patient experience.

“We have to figure out how we find these other opportunities to engage with consumers in between those episodes of care so that they think of us differently,” she said of health systems. “Our brand is top of mind, we can differentiate ourselves so that they do know that we're there to support them in their overall wellness journey.”

Trzcinski and her colleagues at Forrester have one strategy in mind: adopt a customer-obsessed mindset.

“A customer-obsessed approach to technology enables an organization to quickly reconfigure business structures and capabilities to meet future customer and employee needs with adaptivity, creativity, and resilience,” Trzcinksi and her colleagues wrote in a February 2024 Forrest report, which was emailed to PatientEngagementHIT. “Traditional HCOs prioritize delivering technology based on efficiency. Leading HCOs that are customer obsessed and score high on future fit deliver technology that creates business and customer value.”

Of course, being customer-obsessed has a good business proposition, Trzcinski suggested, and that’s important for health systems that are nearly always operating on fairly thin margins. But it’s also good for patient loyalty and retention over time because a consumer obsession bases purchasing and strategy decisions upon what the patient needs and wants.

“It has to be pervasive across the decisions that you make, the strategy that you implement, the way that you operate, the technology that you're building,” Trzcinski advised. “It should be done based on what is the need of the customer? What are the jobs to be done for that customer? Where do they want us in their life?”

Of course, there can be no consumer-obsessed mindset without consumer-centered data. Health systems need information to help form their understanding of the patient/consumer, and that information can come from numerous different patient interactions, patient experience surveys, and other data sources, including the health system call center.

There’s also some serious potential in the health data that patients themselves control, if only patients had the education and data literacy necessary to feel comfortable sharing it.

“When I think about just consumer control of their data, it's in part because it will help you create that more robust understanding of your consumer,” Trzcinski said.

“We have so much data within healthcare, but we struggle so much to be able to analyze it and turn it into something that is usable and that we can turn into insight or turn into a training data set. We have to solve that problem to really think about how do we truly create valuable trustworthy experiences in the future and be able to tap into some of these technologies in a more scalable way.”

To get there, industry stakeholders are going to have to turn to patients themselves, who are the owners and arbiters of their health data. But healthcare has a trust problem when it comes to data sharing and privacy.

While patients are open to the idea of contributing their data to health-forward initiatives, healthcare still needs to reconsider its approach to consumer education. In the second part of this two-part interview series, we explore the strategies necessary to improve patient health data literacy and fortify patient data ownership.