Tips for preparing your practice to survive the millennial patient

Editor’s Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Carol Gibbons, RN, BSN, NHA, who is CEO of CJ Consulting, which specializes in healthcare revenue cycle management. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.

Millennials have surpassed generation Xers in the workforce, according to a Pew Research Center (PWC) analysis of U.S. Census Bureau data. 

Now, you ask, “Why is this important to my medical practice?” But, have you considered the impact of this group on your operation and in the way you recruit new patients to your business?

Read last week's blog: Who is ruining the healthcare system?

 This generation has grown up with the Internet, smart phones, and almost instant access to healthcare information.  They approach healthcare much differently than Baby Boomers and they expect more personal interaction with their healthcare providers. Some studies are calling this group Generation C because they are so connected.

Many millennials do not schedule routine preventive visits with their providers.  According to ZocDoc, this number may be as high at 93% not scheduling preventive care.  When they are sick, they go to the Internet to evaluate physicians and find a location convenient to them.

 As this group becomes the biggest labor force group, physician practices will be forced to focus on their website and invest in a company that can do search engine optimization (SEO) to enhance their reputation online.

Examining the resurgence of primary care

Millennials as a consumer group are more likely to question the cost of care and want to understand their “out of pocket” up front.  According to the PWC research, they want physicians, pharmacists, and other providers to sit down with them and discuss costs. They are more likely to survey other healthcare businesses to find the lowest cost service, especially with medications. While Baby Boomers want to compare insurance option through printed material, millennials and generation Xers want to compare on line.

Next: How to modify your practice for millennials

One of the downsides to having information be available on the Internet is that patients attempt to diagnose their problems or change the plan of care based on support sites or other information sites not managed by legitimate organization. I personally experienced this with my cousin, as she was deciding on a plan for treatment of her breast cancer.  She had excellent physicians and her tumor called for a specific treatment plan of drugs and then radiation therapy.  She found a support site that advocated a different less aggressive plan and started questioning what the appropriate plan should be, spending more time on the Internet.

MOC, recertifications are ‘cancers’ doctors should rally against

I finally asked her to show me the statistics and research associated with the support site that showed the 5-year survival rate of her specific cancer type.  We finally agreed that she should not spend so much time on the internet and allow her healthcare team direct her care based on the best research available.

Physicians must develop an approach for the practice that encourages millennials to choose their practice over other community options.  They want more coaching and counseling about their health and they want more convenient appointments.  They do not want to be in a waiting room for 2 hours before they get to see the physician and will pay more for that convenience.  They will also choose retail clinics for some healthcare issues because of convenience and the speed with which they are seen.

 Many of these patients would embrace eVisits via their computer, and a few practices with patient portals are experimenting with this option.  This is a cash pay visit since most insurance do not pay for a visit outside of the practice location.

Why are we wasting money on healthcare with poor outcomes?

As the reimbursement model changes over the next three year to a merit-based incentive payment, you should be surveying your patients to identify ways to meet their needs.  You must give them an incentive to do their yearly preventive care to help you meet your quality targets.  If you listen to your patients and work with your staff, you should be able to develop a program that provides flexibility and motivation to your patients to help you meet your quality measure goals. 

Ways to modify your practice:

·       Website

Make sure patients can find your website –SEO is crucial and requires a professional.

-Make sure your website is linked to page one on search engines when someone searches for your practice or your specialty.
-Online appointments should be available.
-Appointment App-: Some of the patient portals are offering an app for your patients to download from their phone.
-Forms need to be available on the website-preferably in a format they can fill out online versus printing them.

Next: Importance of social media, your online reputation and eVisits

·       Social media

-Embrace Facebook and other social media resources.
-Give your patients unique healthcare information on your Facebook.

-Put pictures of staff activities and patient’s talking positively about your practice.
 -Encourage happy patients to rate your practice on sites like Yelp or ZocDoc.

In case you missed it: Young doctors are jumping ship to non-clinical roles
 

·       Online reputation

-At least once a month someone should go to all sites and see who has left ratings about the practice.  Some of the good ones you can link to your website, but you will need a professional to help you.
 

·       eVisits

-Sign up for a secure email and carve out time to do eVisits if you have enough providers to cover this function.  This will be a cash pay visit, so you need to be able to collect the payment before talking to the patient.
 

·       Insurance payments for eVisits

-Some carriers have purchased companies that have the provider network to do electronic visits for their customers.  If an insurance company is offering this to your patients and you are on call anyway in the evenings and weekends, then you have a platform to negotiate payments to you versus the other company when you take care of your patients.
 

·       Urgent care

-Find an urgent care company convenient to your practice with an EMR that can communicate with your EMR through secure Messaging .

-Set up a referral process where you will recommend your patients visit the urgent care after hours and not use the ER when possible.  In exchange, they will send the notes through a secure portal so you know the patient has been seen and you can upload the note.  This allows your staff to do a follow up phone call and schedule the patient for continued care in your office if needed.

-Follow-up calls are essential marketing to your patient that you are managing their care.

Next: Making your practice more competitive

·       Availability

-You are always going to compete with the retail clinics because of their convenience and convenience will always trump care.

·       -Evaluate your practice; is there a way to notify patients when there is a delay, or when they are next in line to be seen?  Some practices in commercial areas are using the same technology that restaurants use to allow patients to go shop or get a cup of coffee while they wait.

·       -You can also send them a text when they should return when they are the next person in line to be seen.

·       -If patients are taking time off from work, set up a way to text them 30 minutes prior to their place in line.
 

·       Wireless

-Consider setting up a separate wireless point to allow patients to use their phone or tablet while in the waiting room.
 

·       Reward wellness

-Consider rewards when a patient completes their wellness visit.  Millennials are notorious for not scheduling these visits.  With the merit-based incentive payment model coming down the road, these visits will improve your quality score.  Many of the commercial carriers are going to adopt a similar model to decrease their expenses.

-Remember the bottom line for the carrier is cost not quality.
 

·       Counseling and coaching

-Provide some of the “I want” services that patients will pay for like weight loss coaching, smoking cessation programs, skin care and rejuvenation, personal exercise coaching, and etc.

-These items keep your patients in contact with your practice and they are more likely to come to the practice for all their care needs.

-Out-service your competition to prevent patients looking for another practice.

Next: Millennials will affect your practice whether you like it or not

·       Payment options and clear statements

-Provide online payment options and allow them to get their statement online.  This will improve your bottom line as well as make your patients happy.
 

·       Patient appreciation

-Once or twice a year, have a patient appreciation day when you have fun activities for patients to come and share with your staff.

-You might have samples of skincare products, sunscreen, or other items. 

-Involve your drug reps and other vendors that will assist in covering the cost for these appreciation days.

Millennials will continue to impact the operation of physician practices as they age with different expectations than the baby boomer group.  The survival of your practice is predicated on whether you can adapt to this new patient group with new expectations derived from the digital age we are experiencing.