The 75-million strong Millennial generation – people between the ages of 18 and 34 – will soon outnumber boomers and is already transforming how healthcare providers deliver care. Although Millennials are the most diverse group of people in American history, and must be recognized as having different backgrounds and opinions, they are united in their expectations from traditional healthcare institutions: make things more convenient, relevant, simpler, and less expensive than the convoluted, fragmented, bureaucratic and costly experience that exists today.
Millennials have transitioned into adulthood during a time of economic hardship and significant reforms to the healthcare system. These two conditions, among other cultural shifts, have created no small amount of distrust and lack of confidence in traditional institutions. Few human-facing institutions are as resistant to change as healthcare is, but the industry incumbents will have to adapt – or watch from the sidelines as the new world leaves them behind.
Numerous surveys illustrate the extent of the change that is about to hit healthcare. Millennials prefer retail and urgent care clinics over traditional doctors’ offices and hospitals, meaning that provider organizations will either have to confront or collaborate with non-traditional players to meet the need for lower-cost, convenient care. Millennials also tend to consult online reviews to determine which provider to visit and which health plan to purchase. This means that provider and physician reputation, long determined by educational credentials and U.S. News and World Report surveys, is subject to HealthGrades or Yelp reviews that can be written and published from an iPhone – all with little to no context and accountability.
The new generation of healthcare consumers is also more likely to ask for up-front pricing from providers and bargain for lower prices when the bill arrives. With provider margins squeezed by lower reimbursement and an increase in out-of-pocket spending driven by high-deductible health plans, providers might have no choice but to improve their mechanical bill collections processes. We should expect to see more patient-friendly practices such as discounts for faster payment or generous pay-over-time financing programs.
Millennials are also inclined to self-diagnose their minor conditions instead of visiting a doctor first; part of this shift reflects a need for greater control, but it is control enabled by new streams of information available online. When these young patients do visit a provider, they select among a choice of hospitals based on reputation or prior experiences instead of location or technology. The bottom line is that the traditional determinants of success for providers – proximity and the acquisition of advanced technology – might not endure for long into the future.
Millennials are different from previous generations in their expectations for providers, as well. Most want to have access to their personal health records and results through a patient portal, reachable on demand from their smartphones. Most want to have access to their providers in non-office settings, such as through video conference or email exchanges. These expectations will challenge and change the way providers and patients interact, a topic that will be explored in further depth on this blog in the future.
Millennials place more importance on practices outside of the doctor’s office – exercise, diet and holistic wellness – than on what the medical establishment provides: visits, tests, treatment and medications. This change in priorities means that providers can no longer expect patients to place their primary trust in the authority of traditional institutions. For that matter, the traditional roles of influence enjoyed by physicians is starting to give way to nurse practitioners and allied health professionals, and there is evidence that millennials do not care as much as older generations do about the differences between a physician and a nurse practitioner. That professional role shift is accompanied with changes in how healthcare professionals are paid, from individual provider reimbursements to team-based bundled payments.
Provider organizations have an imperative to respond to the real and transformative expectations of this emerging generation. Not only are Millennials consumers of healthcare, but they are also becoming providers of care and some are decision-makers for their parents’ healthcare. Because elderly patients account for the majority of healthcare utilization, Millennials have decision and purchasing power well beyond the domain of their own, somewhat less-involved healthcare needs. This reality is emerging at a time when the Centers for Medicare and Medicaid Services (CMS) is stepping up its efforts to provide more transparency around cost and quality of acute, hospital-based services and nursing and home care services.
What do these changes mean for traditional healthcare providers? It means investing in greater patient-facing information services, designing facilities to be low-overhead and patient-friendly, reinventing the care navigation and billing process to make sense for humans, helping caregivers get paid for interactions with patients outside the office that keep patients healthy, and valuing the role of holistic treatment and personal health that is valued by this next generation.
Said Corey Schwartz, managing director of Communispace Health: “It is critical to work with, not against, [Millennials’] unique set of healthcare values by embracing institutional aversion and self-reliance, providing tools for empowerment and connection, and expanding your own notions of health and wellness.”
Millennials are growing up fast, and making more critical decisions about healthcare for themselves, their patients and for their older family members. While these changes will be disruptive and result in dramatic market shifts, the traditional organizations that adapt will survive to see the reward of their efforts before long.
NOTE: The views expressed here are those of the authors and do not necessarily represent or reflect the views of Healthcare, Inc. and HealthCare.com