Trust

The 11th Annual ReviveHealth Trust Index™ reveals
the first 360-degree view of trust in healthcare.

Harsh realities revealed about the state of trust among consumers and healthcare’s major players

For 10 years, we have produced the only research focused on the B2B aspects of trust in healthcare — year after year revealing a dismal state of trust among its core parties — hospitals, physicians, and health plans.

Now, in our 11th year conducting the Trust Index™ survey, we’ve introduced a consumer perspective for the first time confirming that lack of trust is as widespread as we thought: Hospitals don’t trust health plans. Health plans don’t trust hospitals. Amidst all this distrust,the consumer loses. Our results show that the industry has a long way to go.

How do we track trust?

In our survey, we asked organizations (and, this year, consumers) to indicate their trust in other institutions based on the three following factors:

Honesty

“this organization is accurate and honest in representing itself and its intentions”

Reliability

“this organization makes every effort to honor its commitments”

Fairness

“this organization balances its interests with mine and doesn’t routinely take advantage of me”

The (dire) current state

Providers don’t trust health plans.
Health plans don’t trust providers.
The consumer gets caught in the line of fire,
and the industry suffers.

Health Systems

Level of Trust in Health Plans

52.0

Physicians

Level of Trust in Health Plans

55.0

Health Plans

Level of Trust in Health Systems

68.4

Caught in the line of fire

And — amidst all this distrust — the consumer loses.

See for yourself. How do you think consumers
graded each of the parties below?

Health Systems

Your grade:
Consumers say: C (72.4)

Physicians

Your grade:
Consumers say: C+ (79.3)

Health Plans

Your grade:
Consumers say: D+ (69.0)

Perhaps the most revealing sign of the times:

Consumer trust in healthcare is so low, they’d like the government to run it — 63% of respondents said that if they were a U.S. Senator, they would vote “yes” on “Medicare For All.”

The ‘consumer-driven’ transition is happening so slowly

Despite industry chatter about consumer-driven healthcare, the results of our 11th Trust Index™ show that consumer desire is not a driver in the transition to value. When asked to rank important factors promoting the transition to value, both health system and health plan executives ranked public sentiment about healthcare costs and coverage dead last. See below for the top five driving (and restraining) forces.

Issues identified as “very important” factors driving/restraining the transition to more of a value-based payment structure:

Driving Forces
Support from physician community/leadership
68%
Gain reputational or competitive advantage
62%
Government initiatives
57%
Private payor/health insurance initatives
55%
Increased trust
53%
Restraining Forces
Caution by leadership to take risk or move quickly
62%
Lack of technologies & processes
61%
Decreased trust
51%
Doubts about the efficacy of Federal programs
50%
Risk of losing reputational or competitive advantage
39%

Issues identified as “very important” factors driving/restraining the transition to more of a value-based payment structure:

Driving Forces
Gain reputational or competitive edge
73%
Increased trust
68%
Government initiatives
67%
Support from physician community/leadership
66%
Provider organizations actively seeking plan involvement
62%
Restraining Forces
Lack of data
62%
Lack of technologies
59%
Lack of processes
53%
Doubts about the efficacy of Federal programs
50%
Decreased trust
48%

The disconnect is real

It’s clear that health plans and providers have very different definitions of value-based claims and revenue.

Health System Executives

12% value · 88% volume

During the course of calendar year 2017, what percentage of your total commercial revenues will be based on volume versus value?

Health Plan Executives

46% value · 54% volume

During the course of calendar year 2017, what percentage of your the total claims you pay for commercially insured patients will be based on volume versus value?

Closing the trust gap

  • Know where you stand

    Do the research to understand where your organization stands on key issues and the size and nature of your Trust Gap with your key stakeholders.

  • Think differently about your payor/provider relationship

    Be willing to form new and different kinds of relationships. Aversion to taking on risk tops the list of factors stalling the transition to value-based care. At least 95 percent of health system executives say caution by leadership to take on additional risk is hindering the transition while 100 percent of health plan executives point to this provider resistance.

  • Start small, then build and scale up

    To the degree there has been any progress on the trust issue, it appears to be based on the various parties working together to implement pay-for-quality initiatives. Seventy-six percent of health systems executives and 64 percent of health plan executives cited pay-for-quality programs as the most popular strategy for making the shift from volume to value.

  • Secure partners to deliver relevant, trustworthy data

    Another key factor providers say holds them back from a more rapid transition to value-based payment arrangements is the lack of technologies and processes to support this transition, including access to timely, reliable, and actionable data.

  • Owning the moments that matter

    Communication, education, and physician and employee engagement play a huge role in driving trust among key stakeholders and trust in your brand. With better communication between and among health systems, health plans, and front-line physicians, trust will improve — which in turn will help improve the patient experience and (hopefully) consumer trust in the healthcare system.

View the Webinar Reveal

On October 26, we partnered with Dan Prince of SMG Catalyst Healthcare Research to publicly reveal the results of the 2017 survey for the first time. Below, you can watch the recording and download the slides to share with your team or colleagues.

The ReviveHealth National Trust Index Survey™ is a study of the attitudes and opinions of practicing physicians, executives from the nation’s largest health insurance companies, hospital and health system leaders who negotiate and/or approve managed care contracts with national health insurance companies, and the study of consumers’ opinions and attitudes regarding insurers, doctors, and hospitals. The study was conducted via web survey directed to each of the audiences of interest between the dates of June 14 and August 11, 2017.

Composite score values are calculated as an equally-weighted mean of all three individual Trust measures (Honesty, Reliability, Fairness). Academic literature on the topic of trust informed the section of the trust, honesty, and fairness attributes.

Currently in its eleventh year, the study is a collaborative project between ReviveHealth and SMG Catalyst Healthcare Research with the goal of providing a national perspective of opinions on trust in the B2B and B2C healthcare space.

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