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Top 3 factors driving patient loyalty across generations
Faced with competing priorities across generations, health systems should home in on reliability, competence and respect to drive loyalty and market share.
Confronting key shifts in patient demographics, uncertainty tied to healthcare consumerism and a looming patient loyalty problem, NRC Health says healthcare organizations need to prioritize three things to maintain market share: reliability, competence and respect.
That's the thesis of the patient experience surveying and consulting company's latest report, the "2025 Experience Perspective," which offers a roadmap for hospitals and healthcare systems working to build patient loyalty by way of building patient trust.
"Trust in healthcare is evolving -- driven principally and importantly by demographic shifts and changing expectations among consumers, patients, and employees," NRC Health said in the report, received via email. "Social, cultural, and demographic factors have always shaped things like expectations, brand perception, and trust."
For this report specifically, NRC Health focused on the way age impacts patient perceptions and trust in the healthcare system. Indeed, healthcare is on the precipice of monumental shifts in patient generations, the organization contended.
For around a decade, medicine has adjusted to an influx of Baby Boomers into the Medicare age demographic.
But now, Gen X, too, is nearing retirement age. As populations age, their chronic disease burden increases, meaning demand from this demographic will likely increase, too. How must organizations shift to accommodate a generation that will need more medical care than ever before?
At the same time, Millennials are starting to represent the biggest share of healthcare consumers. This demographic is reaching parenting age and is likely to start taking care of their aging parents. It stands to reason that Millennials will be a key patient demographic as they assume responsibility for managing the care of multiple generations at once.
"So the question for health leaders is this: How can trust be leveraged to build and sustain loyalty among current healthcare users and employees, while also addressing demographic shifts and the changes in expectations that younger generations will bring with them as they age into more frequent utilization of services?" the NRC Health report authors queried.
The solution lies beyond assessing current patient perceptions of healthcare organizations. Healthcare organizations need to do those things, the report authors said, but they also need to understand how those perceptions fluctuate across age demographics.
Using insights about Gen Z, Millennial, Gen X, Baby Boomer and Silent Generation patients, NRC Health proposed an agile approach to patient loyalty that hinges on reliability, competence and respect.
Patient trust is imperative
Indeed, that question of trust is an important one. Healthcare organizations are operating on razor-thin margins and managing pressure from new market entrants with the technology and agility to meet prevailing consumer needs. Hospitals and health systems need to build trust to drive patient loyalty and maintain their market share.
NRC Health remarked on some of its previous data indicating that patients are 300% more likely to recommend a hospital when they trust that hospital. The link between trust and the likelihood to recommend remains even when controlling for age and other demographic factors. Moreover, patients are also more likely to give a higher Net Promoter Score when they also say they always trust the care team.
This link is even more pronounced when looking at younger age cohorts. Healthcare organizations working to build loyalty among younger patients -- meaning those who have a lifetime of healthcare needs ahead of them -- will need to focus on trust.
What drives consumer trust?
Consumer trust is extremely complex because different demographics want different things from their healthcare providers, NRC Health argued. Although numerous demographic factors can impact patient preferences, this report focuses on age and reveals key commonalities across generations.
Across all age cohorts, reliability, competence and respect emerged as the most important factors in establishing patient trust.
However, some factors are more important to some ages than others. For example, reliability is more important to Baby Boomers and the Silent Generation, while Gen X prioritizes competence. Meanwhile, Millennials and Gen Z are more likely to value respect.
Moreover, different generations say different behaviors constitute each of these values. For example, competence and respect look different for younger patients compared to their older counterparts.
Gen Z, Millennials and Gen X say competence means using effective safety protocols during treatment. For Boomers, competence means using effective and proven treatments, and for the Silent Generation, it means using the most up-to-date treatments and technologies.
In terms of respect, generational expectations differ even more. Nearly every generation wants their provider to see them as a human and not just a set of symptoms, but they diverge in other areas.
For example, Gen Z seeks providers who are accommodating of all people, such as those with disabilities or members of the LGBTQ+ community. For Millennials, respect means an emphasis on patient activation and shared decision-making. Gen X wants staff to be sensitive to all forms of diversity, while Boomers and the Silent Generation want providers who listen to all of their questions and concerns.
Still, every age cohort puts a pretty big premium on reliability, competence and respect, and these factors are all interconnected. It would therefore be an efficient strategy for healthcare organizations to predicate their patient trust strategies on reliability, competence and respect, NRC Health advised.
Other drivers of patient trust include the following:
- Respecting a patient's opinion.
- Spending enough time with the patient.
- Answering questions in a way that makes sense.
- Listening to the patient's perspective.
- Pain management.
- Compassion.
- Courtesy and respect.
- Thorough explanations.
- Consistent information access and inclusion in care decisions.
Healthcare systems work against an image problem
Building that trust, and therefore loyalty, could be an uphill battle for healthcare organizations, NRC Health said, especially being that most health systems have an image and reputation problem.
Notably, patients across all age cohorts have a less-than-optimal perception of hospital brands. This is true even of the Silent Generation, which by far views hospitals the most favorably of any patient generation.
Part of the issue is that patients don't draw much of distinction between different hospital brands, NRC Health said. Only about a quarter of consumers said they view their "top of mind" hospitals as unique, meaning they see even the top hospitals in their area as the same as all of the others.
This opens up a key marketing opportunity, the report authors suggested.
Healthcare organizations should identify some of the best work happening inside their facilities and use that work to build a brand of trust. Outlining that the hospital is easy to access, employs caring clinicians and participates in a certain health plan will be key to drawing in more patients.
Expanding access as a market differentiator
The NRC Health researchers flagged access, an element of reliability, as a particular differentiator. Although access is improving, only about a third of Millennials, Gen X and Boomers said access to their "top-of-mind" hospital was optimal. For Gen Z, that number was one in four.
Hospitals need to revamp their access efforts and market them, the report authors suggested. Poor accessibility opens the door to new market entrants such as retail health clinics. Indeed, 43% of Gen Z and 38% of Millennials said they're excited to try using a retail health clinic in the future.
Similarly, patient trust in non-traditional healthcare players, like Amazon, is growing. Right now, about half of consumers think Amazon's One Medical healthcare offering can provide better care than traditional providers.
Healthcare organizations looking to maintain and grow market share should reconsider their patient access strategies and market them.
Healthcare organizations also need to examine what makes them stand out. Currently, a third of patients have no hospital preference, which NRC Health pointed out is a lot of healthcare dollars left on the table. By examining how organizations can stand out in a crowded field, they might recoup some of those dollars.
Hospitals and health systems need to target better collaboration with their marketing teams. Particularly, they should consider their marketing team as a messenger of what the hospital is already doing well, the report authors recommended.
Organizations might also consider creating more entry points for patients, like increasing telehealth options, opening urgent care and walk-in clinics or forging partnerships with existing urgent cares.
"Embedding trust into strategy drives innovation by unveiling opportunities to redesign care to improve consumer, patient, employee and clinician experiences," the report authors concluded. "These focus areas for trust improvements spur organizational innovation, growth and market share; create value; reduce costs and increase efficiencies that benefit both health systems and the people they care for."
Sara Heath has reported news related to patient engagement and health equity since 2015.
