Entries in Surveys & Reports (158)


Healthcare Consumers on Technology and Decision Making: A Dozen Things To Know from a UnitedHealthcare Survey

by Clive Riddle, September 27, 2019

As healthcare consumers are about to embark into a decade, a new survey tells us they are turning even more to technology for health information, decision-making and purchasing. UnitedHealthcare has released results from their fourth-annual Consumer Sentiment Survey, which “examines Americans’ attitudes and opinions about multiple areas of health care, including open enrollment preparedness, technology and transparency trends and health literacy.” United tells us the study focuses on three areas: 1) Open Enrollment Preparedness; 2) Technology & Transparency Trends; and 3) Health Literacy & Consumer Preferences.


Here’s a dozen takeaways from the survey:

  1. A new-high 37% have used the internet or mobile apps to comparison shop for care (14% in 2012), including 50% of Millennials
  2. 46% cited a health care professional, such as a doctor or nurse, as the first source of information about specific health symptoms or ailments, and 20% first use the internet or a mobile app
  3. 39% who shopped online changed the facility or care provider (or both) as a result
  4. 64% “never” know the Rx costs before leaving the doctor’s office; 21%  “sometimes” know and 11% always know the price.
  5. 45% said they would be interested in their physician using AI in care decisions (including 55% of Millennials); and 28% were uninterested
  6. For those interested in AI support for physicians, 46% were motivated by the potential for a more accurate diagnosis; 31% cited the potential to reduce human error; and 15% hoped for faster treatment decisions
  7. 39% would likely use telemedicine in the future to access care (up 2 from 2016)
  8. 75% of those with benefits say they are prepared for the fall’s open enrollment season (down 2 points from last year) including 84% of Gen-Xers and 78% of Baby Boomers, but just 69% of Millennials and 44% of Gen-Z.
  9. 36% devote less than one hour to open enrollment; 27% spent between one and three hours; and 23% said more than three hours.
  10. 55% check if their doctors are in-network for the health plan they intend to select
  11. 59% successfully defined plan premium, 53% defined the meaning of deductible, while 335 could define out-of-pocket maximum and 21% define co-insurance
  12. 66% preferred speaking directly with a customer service representative to resolve health plan issues; and 10% preferred a self-service option through an app or online.

New Changes in Health Care Executive Pay

The Spring 2019 issue of Warren Salary Surveys is published and there are some interesting findings highlighted here.


Warren is the oldest and largest survey of its kind reporting 600 positions in the health care industry. Large and small health plans, health systems and ACOs are reporting their data every 6 months and the data includes salary, bonus by region and by size and type of plan.


This week saw a report of a large health system in the southwest began to move bonus payments in line with patient engagement. By using HCAPS score improvement as well as patient complaint resolution and satisfaction scoring to create a base formula for bonus pay, the health system is moving towards a more patient centric incentive system.


Signaling further changes in the health care compensation programs offered by Accountable Care Organizations and Health Maintenance Organizations, Warren is observing an increase in compensation for positions such as financial analysts representing a 3.32% increase over 2018 to $68,859 and Underwriters moving to $66,749 as an average reported nationally by over 160 plans over the past year (Collected in spring 2019).


VP of Planning and Development saw a large jump of 5% to $243,181.00 over last year, perhaps revealing more focus on new markets and new products. In the medical management departments, there was an increase in pharmacy service coordinator to $52,457, underscoring for many health plans the need to better manage pharmacy costs especially for Medicare Advantage patients.


The biggest gain was in the position of Clinical Informaticist: a 13% gain to a salary averaging $105,778. These people are very hard to find and several organizations have started to create an internal training program to move some of their health information specialists into affiliated support roles to learn the clinical informatics discipline and support the lead informatics person.


Finally, the newer lead executive positions in Accountable Care Organizations CEO show an average salary of $269,575 with a range of $211,911 in the mountain states to $356,888 in the northeast. The majority of the ACOs reporting were not-for-profit with an average of $280,953 salary. At this point few bonuses have been calculated for the ACO chief executive, but Warren sees the above formula of measuring patient engagement improvements to be a very new but a meaningful way for ACO Boards of Directors and managers to consider these types of incentives to attract and retain talented ACO executives who continue to be elusive in the marketplace.


Further information can be obtained at:


The Latest on Physician Burnout

By Clive Riddle, August 9, 2019

InCrowd has just released their 16-page 2019 Physician Burnout Survey report - a follow-up to their 2016 burnout research, asking their participating physicians how they’re coping with job-related stress. They found “sixty-eight percent of US-based physicians surveyed reported experiencing burnout at some level,” and that “primary care physicians (PCPs) report higher burnout rates than specialists, with 79% of PCPs personally experiencing burnout compared with 57% of specialists. And, more than a third of InCrowd physicians surveyed said they would not recommend their profession to a young family member.”

The report also shares findings that: 

  • Burnout is highest among younger physicians, with those in their 30s and 40s reporting highest rates of burnout (74%), and burnout rates dropping thereafter.
  • Hospital employees report slightly worse metrics for addressing burnout (20% effective) compared to those who work across private practices (27% effective).
  • Those who report that their facilities effectively address burnout credit workplace initiatives that improve workflow (46%), provide schedule flexibility (45%), and support wellness (41%).
  • When asked what actions their facilities could take to alleviate the issue of physician burnout, over half of respondents report that increased support staffing (66%), mandatory vacation time or half-days (57%), and reduced patient volume (56%) are likely to help. 

InCrowd notes their findings are “higher than the 43-54% range found in MedScape’s 2019 national report yet lower than the 80% of The Physicians Foundation/Merritt Hawkins biennial survey of September 2018. With PCPs, however, InCrowd found nearly 80% burnout levels—dramatically higher than the 43.9% cited in an American Academy of Family Physicians (AAFP) study of March 2019, which itself reflected a decline from 54.4% in 2014.”

Last month, Spok, Inc. released a paper: "Clinician Burnout in Healthcare: A Report for Healthcare Leaders" providing survey results from over 470 clinical staff at U.S. hospitals and health systems. in which clinician perception of burnout was measured. 92% of clinicians said burnout is “a public health crisis that demands urgent action.” 

When asked "what prevents clinicians from seeking help for potential symptoms of burnout, the No. 1 obstacle cited by respondents (65%) was that their organization lacks institutional attention and resources. When asked how often their organization leaders discuss burnout, 47% said rarely or never."  When asked "whether increased or ineffective technology contributes to the risk of clinician burnout, the vast majority (90% of all respondents) strongly or moderately agreed. And 89% of respondents said burdensome or increased workload (not related to direct patient care) is the biggest factor that contributes to this risk."

The Spok survey also found:

  • 70% experience symptoms of burnout "considerably” or “a great deal.
  • 95% believe improving EHR usability will be at least somewhat helpful
  • 30% of respondents said their organizations are improving EHR usability
  • Nurses use an average of 4.1 technology systems daily 
  • Physicians use an average of 3.9 systems daily and clinical leaders 3.5
  • 20% reported mental health treatment or support is available
  • 13% have a chief wellness officer or equivalent
  • 11% reported not experiencing risk factors including work-related stress, lost satisfaction, or a loss of efficacy in their own work

The Spok survey certainly lays much of the problem at the lap of HER. The InCrowd survey asked for suggestions on how to reduce burnout and “more than half (51%) of those providing additional recommendations suggest improving processes related to administrative burden: 23% suggest employing scribes, 23% advocate for reduced documentation, and 5% propose scheduling more time for charting.” 


Two Papers on the Health Plan Medicare Opportunity

By Clive Riddle, August 2, 2019 

Oracle has released an Executive Insight paper on the Opportunity Ahead for Agile and Efficient Medicare Advantage Plans,  cautioning that “While the opportunity is great, MA plans are not automatically a wise or profitable business decision for all health insurers. There is growing competition as new players enter the market, and cost and margin pressures continue unabated. To make the most of this opportunity, MA plans must look to accelerate innovation while optimizing costs across their enterprises— from marketing and enrollment to plan configuration, claims processing, compliance, and renewal.”

They report on three development plans should consider now:

  1. It is “Time to flex strength with expanded flex benefits. In 2019, MA plans were cleared to offer new flex benefits, designed to move plans toward expanded population health capabilities.”
  2. “MA plans look to differentiate on other fronts and deliver high levels of service—without placing profitability and stability in peril.”
  3. Payers are eager to bring new urgency and focus to improving claims accuracy and delivering innovative provider payment models.

HealthEdge has just released results of its Voice of the Market Survey, a study of 201 health insurance executives directly involved in Medicare lines of business. 92% responded that they are trying to grow their Medicare Advantage book of business faster than their traditional Medicare Supplement business.


Here’s some key findings from their survey:

  • 53.2% said the value-based model of Medicare Advantage significantly factors into a desire to grow the business, while 42.8% said it moderately factor in.
  • Expanding to new service areas ranked first in level of importance as the steps being taken to attract new Medicare and Medicare Advantage members, followed by (2) Appealing to tech-savvy digital consumers; (3) Providing incentives for healthy behaviors; (4) Addressing social determinants of health; and (5) Marketing/advertising to prospective members
  • Applicable steps above get re-ordered somewhat when ranking importance to retain current Medicare and Medicare Advantage members: (1) Appealing to tech-savvy digital consumers; (2) Addressing social determinants of health; (3) Providing cost transparency; (and 4) Providing incentives for healthy behaviors; (5) Providing education services to members about their benefits
  • There is not consensus on what is the biggest challenge to acquiring new members in the Medicare or Medicare Advantage (MA) line of business.  29.4% said it was funding/executing marketing outreach to  attract new members; 23.8% said competitors who  dominate the market; 22.4% said offering the variety of  plans necessary to satisfy members; and  19.9% answered differentiating  between MA and  traditional Medicare.
  • When asked “what is the biggest external challenge your organization faces in the Medicare and Medicare Advantage line of business.” Competitors seem top of mind, with 34.3% responding “competition”; and another 29.9% stating “members unwilling to switch plans from a competitor. Other responses were 19.9% replying “regulations” and 15.9% saying “member demands.”



Overconfident Healthcare Organizations? Could Be According to Healthcare Cybersecurity Survey 

By Clive Riddle, July 19, 2019

LexisNexis Risk Solutions in collaboration with Information Security Media Group has released results from their recent survey of hospitals, medical groups and payers, in their new 18-page report The State of Patient Identity Management, which found 50% are confident they have the necessary controls in place to prevent unauthorized access to patient information, 58% believe their portal cybersecurity is above average (and only 6% feel they are below average), yet 35% don’t deploy multifactor authentication.

To digress, some insight into those results can be gained from reading last week’s mcolblog post by Kim Bellard on Our Dinning-Kruger Healthcare System, which discusses the Dunning Kruger effect involving “the cognitive bias that leads people to overestimate their knowledge or expertise,” illustrated in the world of NPR’s Lake Wobegon – where “all the children are above average.” 

88% of the organizations surveyed had patient/member portals, and 93% use username and password as the patient portal authentication method. 65% deploy multifactor authentication, with 39% using a knowledge-based Q&A for verification, 38% using email verification, and 13% deploy device identification. 65% report that their individual state budgets for patient identity management will not increase in 2019.

Here’s the top three cybersecurity takeaways of the report according to LexisNexis:

  1. Traditional authentication methods are insufficient: As a result of many healthcare data breaches, hackers have access to legitimate credentials; users are also easily phished. Therefore, traditional username and password verification are considered an entry point, not a barrier, and alone cannot be relied upon to provide a confident level of security.
  2. Multifactor authentication should be considered a baseline best practice: HCOs should rely on a variety of controls, ranging from knowledge-based questions and verified one-time passwords to device analytics and biometrics to authenticate users based on the riskiness of the transaction. The more risky the access request is, the more stringent the authentication technique should be.
  3. The balance between optimizing the user experience and protecting the data must be achieved in an effective cybersecurity strategy: HCOs need to make it easy for patients and partners to access records while ensuring adequate data protection. To do this, an HCO's cybersecurity strategy should layer low to no-friction identity checks up front, making it easier for the right users to get through and layer more friction-producing identity checks on the back end that only users noted as suspicious would complete.