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Generational trends in ASC care

As more people turn to ASCs and outpatient facilities for orthopedic, ocular, GI, women’s health, or other procedures, ASC patient populations could become more varied.

Given that many of these patients will be directly responsible for a substantial portion of the costs of their care, they may be more inclined to approach decisions about that care from a consumer mindset, playing a more informed and proactive role in navigating their healthcare experiences.

For these reasons, it is important for providers to understand their patients’ generational mix and consider how generational differences may affect consumers’ expectations, needs and preferences related to healthcare. ASC leaders who do so may be able to gain a competitive advantage, positioning themselves for sustained growth and helping more patients get the care they need without delay.

Breaking down the generational mix
Different demographers may define the generations in distinct ways, but for the purposes of recent CareCredit research studies, the following groupings were applied: Baby Boomers, born from 1946 to 1964; Generation X, born between 1965 and 1982; Millennials, born from 1983 to 1994; and Generation Z, the youngest generation, born from 1995 on.

Based on their current age, members of different generations have varied life experiences, having witnessed unique world events, historic milestones and technological advances. To take just one example, major technology advances like the advent of personal computers (Boomers), the Internet (Gen X), smartphones (Millennials), and mobile apps and social media (Gen Z) likely made a strong impression on individuals experiencing them for the first time (or seeing them become widespread).

Impact on healthcare decisions and purchases
Not surprisingly, CareCredit research confirmed that technology can be a major point of difference among the generations. While many Baby Boomers are extremely tech-savvy, and though not every Gen Z individual is constantly connected, the younger generations tend to be more comfortable with technology, allowing it to play a more integral role in many aspects of their everyday lives. Healthcare providers should consider these preferences when building out patient experiences, especially those involving online channels, which can be strongly appealing to some patients but may leave others eager for alternatives.

For example, Millennials are very inclined to go online for healthcare information, using Google searches and sites like WebMD and Wikipedia at significantly higher rates than older consumers.1 Millennials are also more likely to use online payment portals than non-Millennials (61 percent vs. 39 percent), and they are more open to using telehealth services. If your patient mix includes a high concentration of Millennials, you may want to look to these types of channels to engage with your patients.

Generational differences go beyond technology as well.

  • Boomers are more likely than other generations to consider personal health important. This holds true for all aspects of health, including physical, mental, emotional, spiritual, and financial.1
  • Generation X patients tend to value input from family and friends more than other generations when deciding whether or not to make a doctor appointment, though they also place great importance on recommendations from doctors.1
  • Millennials are more likely to pay with a debit card or cash, while older generations pay more often with credit cards. Millennials are also more likely to have additional spending or savings accounts for healthcare purchases, such as an HSA, FSA, HRA, or HIA.1
  • Gen Z (the youngest and one of the largest cohorts of consumers) are shifting away from traditional payment methods. In one study, fewer than half of Gen Z respondents reported having a credit card (43 percent), checking account (42 percent), or savings account (39 percent), but 61 percent said they use PayPal, and 21 percent used peer-to-peer payment apps like Venmo and Cash App.2

Confusion and costs in common
One area where there seems to be agreement across the generations is struggling with the complexity of the healthcare system. According to our research, the top four sources of confusion are the same for all four groups: coverage, insurance plan options, cost, and billing. Among those topics, we do see some variation by generation, however. For instance, while insurance coverage is the biggest question mark for everyone, it’s especially concerning for Gen X — 35 percent of our survey participants cited it as their biggest source of confusion or difficulty. More than a quarter of Baby Boomers chose insurance plan options as the most confusing aspect of healthcare, but just 10 percent named cost as their top challenge, likely reflecting the experience of transitioning to Medicare. For Millennials, cost is a bigger concern, presumably due to significant out-of-pocket expenses, an earlier career phase, and life events like marriage and children.

In terms of healthcare spending, rising costs are affecting members of all generations. Both premiums and deductibles have risen significantly in recent years3, and one analysis released in mid-2018 projected that consumer out-of-pocket healthcare spending would reach $608 billion in 2019, an increase of more than 46 percent since 20144. In light of this, it’s no surprise that we’re seeing such a shift toward healthcare consumerism, with patients wanting more clarity and control related to their healthcare investments. They may expect things like transparent pricing, clear financial policies, on-demand access to account details, more information available via more channels, and options for how and when to make payments. This last point may be especially important for patients for whom large medical bills would represent a significant hardship, such as the 40 percent of Americans who report being unable to cover an unexpected expense of $400, or needing to borrow money or sell possessions to do so.5

Caring for patients of multiple generations
It can be very helpful for providers in an ASC environment to have an awareness of generational differences, but it’s important not to overemphasize them. No matter what a patient’s background, the key is earning his or her trust, especially in the context of surgery, which may be a new, intimidating and disruptive experience for many patients, even in an outpatient scenario.

While acknowledging personal preferences and tailoring one’s approach can help establish rapport, communicating clearly and honestly matters even more. Offering solutions like new payment options, or a range of ways to exchange information (such as text, email, and online chat in addition to phone calls) can help attract and keep younger generations (and potentially older ones as well). But innovation alone isn’t enough. Regardless of the communication channel — and traditional channels like phone, mail, and print materials are likely always to play a role — it’s important to be transparent, empathetic, committed, and responsive. Patients of all generations have a fundamental need to be heard and understood — and to know that providers are able and willing to help them.

1CareCredit Generational Health Research Study, Q3 2018.
2CareCredit: Understanding Generation Z, Q1 2018.

For more than 30 years, CareCredit has provided a valuable financing option for treatments and procedures insurance typically doesn't cover, either in part or in full. Cardholders can also use the CareCredit health, wellness, and personal care credit card to pay for deductibles, co-payments, and other out-of-pocket costs. Providers who accept CareCredit receive payment in two business days.

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