Consumerism Has Introduced Itself to U.S. Healthcare

The old model has run out of road

The financial picture is familiar to anyone who has sat in a budget review this year. Average EBITDA remains depressed and many systems are operating at a loss. Labor and supply costs have not come down. Market volatility has not gone away.

At the same time, the competitive ground is shifting under the hospital. New entrants innovate faster and cheaper. New service models are capturing business that used to walk through the front door, and care itself is moving out of the building to surgical centers, imaging, and virtual visits.

The third pressure is the one that changes the math. Patient responsibility keeps rising as premiums, deductibles, and out of pocket maximums climb. The number of uninsured and underinsured patients is growing. OBBBA is reshaping hospital revenue, unfavorable state legislation keeps expanding, and attorneys general are actively litigating hospitals. The patient has become the payer, and payers have choices.

Two leaders I respect put it plainly. Jennifer Bollinger, SVP and Chief Consumer Officer at Sutter Health: people are consumers always and patients sometimes. Michael Mercurio, former VP of Revenue Cycle at Mass General Brigham: it used to be that customers needed us, now we need them.

Doing the same thing and expecting different results is not a strategy. Health systems that engage consumers on the consumer’s terms will stay relevant. The rest will be left behind, and it will happen faster than the last decade suggests.

The bar was set outside healthcare

Nobody just goes to the doctor anymore. People want a seamless experience that fits the rest of their digital life, and they learned what that looks like from their bank, their airline, and their grocery app. Self scheduling, virtual check in, click to chat, a symptom checker, a text that says the room is ready, a map that finds the parking spot, a photo of the insurance card instead of a clipboard. None of this is exotic. It is simply expected.

So ask the questions a direct to consumer brand would ask. How do we acquire customers more thoughtfully? How do we earn loyalty? What is the real cost to serve a patient, and what is the lifetime value of keeping one? How do we make it more likely that a bill gets paid? Most health systems cannot answer these with a number. That gap is the opportunity.

Trust is the real work

Trust is not built in a single moment. It is earned or lost in every interaction, and those interactions sort into three tiers.

1. It just has to work. Check a balance, get the phone answered, pay a bill. Mostly digital and self service. Get it right and trust holds. Get it wrong and trust erodes quietly.
2. Solve my problem. A billing error, a scheduling mess. Digital plus a human who can actually fix it. This is where you surprise someone or lose them.
3. Advocate for me. Financial assistance, the greeting at registration, the moment of real need. Primarily human. This is where lifetime value is created.

The organizations pulling ahead invest in a specific stack of capabilities, and the stack is what turns consumerism from a slogan into growth. At the base sits operational and technical excellence: operational rigor, modern technology and analytics, continuous improvement. On top of that, seamless engagement: omnichannel interactions without friction, transparent communication, employees empowered to act. At the top, customer centered design: deep customer understanding, personalization at scale, and a brand promise people can repeat. Capabilities build trust. Trust produces growth. Culture holds it together.

What it produces when operators run it

At Providence, this approach returned 13x on the investment. The numbers tell the story better than the strategy does.

Outcome	Result
Patient collections	Up 15% in two years
Digital payments	Up 46% in the first 30 days
Pre service collections	Up 25%
Payment plan inventory	2.5x
Operating costs	Down 9%
Inbound phone volume	Down 50% as digital took the load
Staff turnover	Down 33%, vacancy rate from 9% to 5%
Patient satisfaction	Up 10 points
First contact resolution	From 65% to 91%
Financial assistance	Usage up 30%, completion rate up 25%
Medicaid enrollments	Up to 35,000, roughly $20M in revenue impact

Notice what is on that list. Revenue, cost, employee retention, and patient satisfaction moved together, because they were never separate problems. Real time data made it possible to catch a failing experience and redesign the process while it still mattered. ROI and empathy turned out to be the same project.

Providence is not alone. Large systems investing in consumerism are seeing results. Baylor Scott and White expanded MyBSWHealth into omnichannel access and delivery and put community advocates in the field. NewYork-Presbyterian built NYP Connect, virtual urgent care, and patient navigators. Others have paired AI chat and automation with a Lyft partnership and same day care, or built always on access with eConsults and integrated digital self service. The common thread is not the technology. It is a decision to treat access, ease, and follow through as operating disciplines.

Where to start

The opportunity is the same in every market I have worked in: build experiences that people choose on purpose, and make the return measurable. In practice that means five things, and they reinforce each other.

• Increase acquisition and retention
• Build relationships that last a lifetime, not an episode
• Improve patient related revenue
• Reduce the cost to serve
• Create market leading patient satisfaction

None of these require a transformation office or a multi year roadmap to begin. They require picking the interaction that is quietly eroding trust today, instrumenting it, and fixing it with the people who run it. Then the next one.

If you are working through the same questions, I would welcome the chance to compare notes. Reach me at jeff@pelorushx.com.

Built by operators. Driven by results.