Cost, Location Top Factors Influencing Patient Care Access Decisions

Cost might be the most important issue when making patient care access decisions, but factors like convenience and location aren’t far behind, according to the Healthcare Patient Consumer Survey from JLL, a company focused on real estate.

The survey of around 4,000 US healthcare consumers indicates that organizations have more to consider than just their payer partnerships—although those are important. Making sure that clinics are centrally located will also help increase an organization’s market share, the researchers indicated.

These findings come as healthcare organizations rebound financially following the COVID-19 pandemic. The public health crisis sparked a crisis in healthcare finances, but as the nation embraces a new normal and adjusts to a post-PHE world, provider groups are finding themselves on the rebound.

Part of that includes increasing market share and revenue by understanding what makes a patient choose a certain provider.

Overwhelmingly, cost led the way in access decisions, the survey showed.

Patients are particularly swayed by the potential out-of-pocket costs they could incur when visiting a healthcare provider, with 80 percent of survey respondents indicating that they foremost prioritize visiting providers that accept their insurance. This preference was particularly salient for folks with both private and public insurance but less so for individuals without any insurance coverage at all.

But convenience, particularly in terms of office location, wasn’t far behind.

Ranked as the second-most influential factor in choosing a healthcare provider, patients noted that travel times were paramount. In fact, convenient location proved beneficial when looking at patient satisfaction scores.

A majority (86 percent) of those giving good satisfaction scores (defined as a Net Promoter Score of 9 or 10) said their office had a convenient location, while 85 percent said parking was easy and 91 percent said it was easy to get where they needed to go.

Conversely, only around two-thirds of people giving lower satisfaction scores (NPS of 6 or lower) said their office was convenient, had convenient parking, or was easy to get to.

The link between high satisfaction scores and reported convenience may influence organizational strategy as some providers consider new or different locations.

“A strong location strategy can improve reach for health systems and physician practices and potentially improve care outcomes,” the researchers wrote. “But there is a balance between convenience and cost—health systems need to balance the benefits of being close to their target population with the cost of a new facility or doctors’ time in transit from a local clinic to the hospital.”

This means organizations need to be judicious in deciding which types of offices they need to invest in. Convenient location might be more important in the primary care or urgent care space because patients access this type of care at a far higher frequency than more specialized care, like outpatient surgical centers.

Healthcare organizations may consider locating offices close to other service sectors, like a pharmacy or a grocery store. Just over half (58 percent) of patient respondents said they pair a doctor’s visit with an errand. Patients were most likely to visit the pharmacy and the grocery store, although some also paired the office visit with a meal at a restaurant, the data showed.

Those findings about co-location of clinic offices and other places to run errands give credence to the argument for investing in retail health clinics. Patient respondents were eager to access healthcare at a retail clinic; although 63 percent said they had not done this before, 72 percent said they would consider doing so. Only 29 percent said they would not consider visiting a retail clinic, and even fewer had visited one but would not do so again.

Retail clinics particularly proved popular among Millennial and Gen Z patients, and among patients who prioritized getting an appointment more quickly than they would have in a more traditional healthcare setting.

Of course, it’s not just the low-cost and convenient office that’s going to win out in terms of care access; healthcare organizations need good patient experience scores and clinical outcomes to back those features.

Four in 10 respondents said that reputation of quality care was within the top five most important characteristics when judging potential providers. This was true for all types of care but was especially important for inpatient care or surgery and outpatient behavioral health.

And while much is being made of online provider review websites, the survey showed that patients still primarily value the views and experiences of their existing providers and family and friends.

Getting a referral for a specialist was important for 46 percent of respondents, while 53 percent valued referrals for outpatient surgery and 51 percent for inpatient care. Meanwhile, a third of respondents said recommendations from family and friends were key for outpatient behavioral health, likely due to the personal nature of this type of care.

“Having a good program in place to collect patient and employee feedback can make sure providers are in touch with their reputation in the marketplace,” the researchers advised.

Ensuring a good reputation starts with a good patient experience. While positive clinical outcomes are paramount, the survey indicated that features like facility cleanliness, a comfortable waiting room, and a comfortable exam room are all tied to better NPS. Emergency departments have room for improvement in overall care experience, the survey respondents indicated, while primary care and outpatient surgical centers excel in patient experience.

But more than anything, it’s the service and attentiveness of staff that improve NPS, the survey showed. Attentiveness was highest in primary care offices, the researchers concluded.