SC Consumer Perceptions of Hospitals
July 2014
Assumption: a hostile environment
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chargemaster
medical errors
The Bitter Pill
transparency
profits
executive salaries
Medicaid expansion
CON
ObamaCare
Value of market research
“Some use research as a
drunkard uses a lamp
post . . . for support,
rather than for
illumination.”
David Ogilvy
Our research was illuminating
Utah’s campaign
The Utah Hospital Association developed a campaign to
increase trust and confidence in hospitals. That
campaign included paid advertising.
Its theme was Utah Hospital Association: The trusted
voice of health care
We were considering modeling a SC campaign based on
Utah’s.
Excellent messaging, but not the right one for SC
hospitals because . . . .
South Carolinians trust their hospitals
 Hospitals are highly regarded compared to
other institutions, ranking in top 4 among
firefighters, military and doctors.
 South Carolinians gave lowest rankings to
health insurers, state government, and
federal government.
 68% of respondents believe hospitals are a
credible source of health care information.
Our investment in quality is paying dividends
Nearly 80% of respondents believe the quality of hospital
care in SC is excellent/good.
About half say quality has improved over the last 4 years.
80% consider quality “extremely important” in choosing a
hospital.
Just 1 in 5 say they are “extremely concerned” about a
serious medical mistake while being treated in a SC
hospital.
Most consumers perceive quality in SC hospitals as similar
to quality in other states.
Responses do not differ by political affiliation.
But we do have areas of weakness
 Hospital costs are too high. (61%)
 Cost is a national problem.
 40% are “extremely concerned” about paying hospital bills
and 32% have the same level of concern over dealing with
the billing office after a hospital visit.
 Public doesn’t blame hospitals, yet.
 Consumers need more information to make decisions.
 Nearly 70% would make health decisions differently
if they knew the true costs of treatment.
 Only 23% are very or extremely aware of range of services
at local hospital
 Hospitals are not perceived as efficient.
 38% believe hospitals are efficient.
 34% believe hospitals are working hard to control costs.
Where do consumers go for info?
 By far, most rely on personal experience,
personal physician, and word of mouth
(friends, family and colleagues) for healthrelated information.
 A second tier of sources includes hospitals,
media stories, websites, and insurers.
 Advertisements (9%) and social media
(10%) are lowest ranked sources.
 However, persons under 35 tend to use
websites and social media much more than
older persons.
What info are they looking for?
QUALITY
Hospital ratings/
reviews (79%)
Physicians on medical
staff (72%)
Special services
provided (71%)
PRICE
Average charges for
procedures (65%)
Out of pocket estimates
(64%)
Insurers with which
hospital contracts (63%)
Itemized list of all fees
(63%)
=
VALUE
What else would they like to know?
 Health coverage options (60%)
 How many times procedure has been performed (55%)
 Average payment (50%)
 How to choose a doctor (37%)
 How to choose a hospital (35%)
 Hospital policy on financial assistance (35%)
 Charity care provided (29%)
 Hospital profit/loss
(21%)
Public expectations of hospitals emphasize
quality of care
 Care for the sick
 Bring good physicians into the community
 Provide emergency care
 Focus on prevention as much as treatment (90%)
Public policy views
More than half of respondents agree
it is just as important for government
to fund hospitals as it is to fund other
public institutions.
Public funding of hospitals is money
well spent.
The majority (75%) believe Medicaid
funding should either increase or stay
the same.
The majority believe the ACA will lead
to higher costs and lower quality of
care.
Less than half know that SC is not
participating in Medicaid expansion.
Public policy views
Less than a third know that the
federal government is paying most of
the expansion costs.
60% of respondents overestimate the
number of South Carolinians on
Medicaid. 24% said they didn’t know.
Only 6% have communicated with an
elected official regarding a health
care issue.
Only 20% believe that the public, the
media and/or elected officials have
negative attitudes regarding
hospitals.
Regardless of credibility, politicians and media
discuss your business for you with your stakeholders.
www.schealthdata.org
A problem or an opportunity?
Dear Hospital Communicator:
If someone goes on the SC Health Data page posted by S.C.
Department of Health and Human Services and checks out the
numbers for your hospital, they might wonder about the future of the
hospital.
I know numbers don't always tell the full story. Do you think it might
be good for somebody from the hospital to sit down and talk with me
about the financial health and future of the hospital? So many small
hospitals in the state are struggling, and I've written about several
others. But I haven't done much on your hospital.
Thanks,
Joey Holleman
Staff Writer, The State
What are our options?
 Do nothing and keep quiet.
 Do nothing, whine and criticize without an
alternative to displace the contrary view.
 Create a relevant, accurate, meaningful
alternative and actively communicate it to
stakeholders.
Conversations are taking place beyond SC,
and hospitals are taking action.
“…been 'studied' for 6 years in a row by the
AG's office and availability of pricing is a topic
discussed each time. Our hospitals have
voluntarily placed common charges on their
web pages, and made their charity policies
and documents available.”
Bob Olsen, Montana Hospital Association
CHA adopts “modern pricing” effort
“CHA has been working over the last two years on a solution to the current
hospital pricing/charging system . . . CHA undertook this work in an effort to
proactively mitigate efforts by others to mandate unreasonable and
unsustainable pricing policies on hospitals and to improve the public’s
perception about hospital bills and pricing.
. . . CHA Board adopted “Modern Pricing”, a voluntary effort by hospitals to
adjust their prices (i.e. charges) to a level that is explainable, understandable
and reflects the unique cost structure of the hospital’s mission and patient
population.
Hospitals across the state are taking steps to adopt modern pricing . . .
Throughout the development, staff worked closely with top officials at the
Centers for Medicare & Medicaid Services, the Office of the Inspector General,
expert legal counsel and others.
. . . modern pricing is one of the steps hospitals can take to make information
more meaningful and user friendly to patients and purchasers.. every
stakeholder – providers, health plans, employers and purchasers – has a role
in making meaningful price information available to patients.”
Duane Dauner, CEO, California Hospital Association
Summary
1. South Carolinians trust their hospitals.
2. Quality is king.
3. Public and stakeholder concerns over
price and efficiency are increasing.
Lack of information is as damaging
as bad information.
Others are discussing hospitals
with key audiences.
4. All patient interactions affect a hospital’s
image and financial health.
5. The public (voters) has little voice
regarding “hospital business” and policy.
Going forward
1. Proactively get involved in the discussion on cost.
2. Promote hospital efforts to improve population
health.
3. Continue to focus on quality. It’s working!
4. Use internal assets (SCHA training programs and
digital media) to help address customer
service/culture change in hospitals.
5. Consider activating a highly supportive public to
address key policy issues after ground is gained
on cost/efficiency perception.