The COVID-19 pandemic has reshaped the way that people are seeking healthcare, from virtual care adoption to increasingly consumerist attitudes about medical services. The pandemic created an environment where patients are rethinking their ideal experience and their expectations for follow-up. Many patients are embracing the idea of healthcare as a consumer good, weighing their options and considering factors like online reviews and pricing.

The consumerist approach to healthcare extends to emergency services, according to three experts from innovative care delivery groups focused on physician staffing within emergency and urgent care settings. Dr. Yogin Patel, ApolloMD president, Dr. Amer Aldeen, US Acute Care Solutions (USACS) chief medical officer, and Billy Strunk, executive vice president of revenue strategy and operations at US Acute Care Solutions, shared insights on what consumerism means for emergency medicine during a recent Emergency Department Practice Management Association webinar sponsored by athenahealth. 

Redefining value in healthcare

Patients are increasingly savvy about how they make healthcare decisions — they no longer just go to their local hospital because that’s where they’ve always gone. All three panelists used “patients” and “consumers” interchangeably, in a sign of how entrenched they see consumerism in healthcare. Consumers view healthcare just like any other consumer good, which means that they prioritize convenience, transparent pricing, and a prompt and flawless experience.

All that boils down to a consumer quest for value — or as Aldeen puts it, “a quest for quality over cost.” That begs the question: How are consumers defining quality today? “When I started in emergency medicine about 13 years ago, ‘good, fast, nice’ was what made a good emergency physician,” said Patel. 

Aldeen agrees that the “good, fast, nice” paradigm is still a great measure of quality. “Experience would be the ‘nice’ part of it,” Aldeen explained. “‘Good’ would be the high-quality elements of the actual care that’s provided. And ‘fast,’ of course, we all know — time to discharge, time to be seen.” He also adds that transparency — especially relative to the competition, now that patients are comparing options based on quality and experience — helps provide consumers with the value proposition they’re seeking.

Improving the patient experience, from bedside to bill pay

The patient experience doesn’t end at discharge, however. “People are now making decisions based off of everything from wait times, to availability of telemedicine, to reviews that are left online, to their overall previous bill pay experience,” said Strunk. Increased digital adoption and changes in consumer purchasing behavior have required emergency medicine to adapt, particularly on the revenue cycle management side.

“Patients, now more than ever, will be comparing their overall bill pay experience, their patient engagement experience, with other services they use today,” Strunk explained. “They will expect a very similar ease-of-use…and they expect very customized ways to interact with customer service.”

Influenced by their experience with other consumer services like Netflix or Uber, Strunk says, patients are looking for increased price transparency, a streamlined payment experience, and the ability to ask questions and get help with their healthcare bills. All of those factors feed back into online reviews and impact future decisions about where and how patients want to receive care.

Uncovering areas for promise — and caution — beyond the pandemic

The way patients want to access care was, of course, also significantly impacted by COVID-19. Patel says telehealth is a great example of how the pandemic helped consumers overcome the inertia of the traditional doctor-patient relationship. Hospitals are now including virtual care as an essential part of their forward-looking strategy. “We are at an incredible time of change,” noted Patel. “All of us should look at that as a tremendous opportunity.”

But the pandemic has also exposed areas for concern. “Perhaps most frustratingly and worryingly for us as physicians, high-acuity cases that had initial subtle presentations were being missed” because they weren’t coming into the emergency department, said Aldeen. “People were having their strokes and [heart attacks] at home.”

Aldeen says that even though emergency department visits at USACS hospitals are trending upward again, volumes haven’t yet reached pre-pandemic levels. That’s partly because some visits are appropriately taking place via telehealth, but Aldeen worries that some patients still aren’t seeking the proper care, at the proper time and place. “The question is whether the consumerism that now is derived from the post-pandemic era actually drives people to seek appropriate care in our EDs, in our urgent cares, in our free-standing EDs.”

Meeting patients where they are

As consumerism drives some care out of the hospital setting, healthcare organizations are rethinking and expanding the services they offer. “Telehealth really is the key differentiator here,” said Aldeen. From virtual tele-ICU to observation and follow-up, virtual care provides the convenience and flexibility that consumers are looking for, and the pandemic gave consumers the push they needed to get comfortable with virtual care.

According to Aldeen, emergency departments can benefit from telehealth by “offering a service to help patients decide whether they should in fact come into the emergency department. And hey, maybe we can save them several thousand dollars and save the entire system money and provide high-quality care, just by talking to someone for a little bit of time.”

On the revenue cycle management side, Strunk highlights the need to meet patients where they are with a customized, personalized bill pay experience. Patients want to pay their bills, Strunk says, but they need a user-friendly experience to succeed. For some patients, that may mean offering unique payment plans based on their financial means. Others may want an easy way to ask questions about their charges through text or chat functions — not everyone wants to wait on hold for 20 minutes to get an answer. To keep consumers happy, organizations need to “make it as frictionless as possible for them to pay their bill, understand their bill, and feel good about the overall bill-pay experience,” said Strunk.

Training for the new patient-provider relationship 

Changing consumer attitudes towards healthcare also have a tangible impact on the relationship between physician and patient. Picture a patient who’s on their smartphone looking up diagnoses, even while their physician is talking to them. This paradigm can be frustrating for providers in the moment, but Patel advises that providers convert this into an opportunity for education. “I’d much rather have an informed patient in front of me than have someone who’s completely disengaged or disassociated with their care,” he explained.

Aldeen emphasizes that physicians need to train for these types of interactions, as he expects they will become increasingly common. Providers may need to learn new skills, like how to explain to nervous patients that chest pain in an 18-year-old is not the same as chest pain in a 75-year-old, for example. “This is the principle of lifelong learning,” said Aldeen. “We all took an oath to take the best care of patients possible, and this is part of that.”