Americans’
trust
in
the
overall
healthcare
system
is
dwindling
—
but
experts
believe
it
can
be
rebuilt.
Public
trust
in
the
U.S.
healthcare
system
fell
from
71.5%
in
2020
to
40.1%
in
2024,
according
to
recent
research
from
Johns
Hopkins
University.
There
are
also
various
studies
showing
that
feelings
of
distrust
are
rising
particularly
quickly
in
marginalized
communities
due
to
longstanding
disparities
in
access
and
treatment
outcomes,
compounded
by
experiences
of
discrimination
and
historical
injustices
like
medical
experimentation.
As
trust
in
the
healthcare
system
erodes,
experts
say
that
rebuilding
it
will
require
both
payers
and
providers
to
prioritize
empathy,
transparency
and
personalized
communication.
What
factors
influence
patient
trust?
The
public’s
trust
in
the
overall
U.S.
healthcare
system
is
declining
—
but
most
of
the
reasons
people
cite
for
distrust
don’t
have
to
do
with
providers,
according
to
research
released
last
week
by
AMF
Media
Group
and
the
Medical
Group
Management
Association
(MGMA).
The
report
is
based
on
survey
responses
from
2,400
U.S.
adults
across
a
wide
variety
of
socioeconomic
backgrounds.
When
asked
what
has
weakened
their
trust
in
the
healthcare
system
in
the
past
five
years,
respondents
identified
the
influence
of
insurers,
pharmaceutical
companies
and
the
government
as
the
major
contributors
to
declining
trust.
Notably,
the
Covid-19
pandemic
and
vaccine
efficacy
were
not
commonly
cited
as
factors
in
the
waning
of
trust,
despite
the
widespread
attention
these
issues
received
in
the
last
few
years.
When
asked
what
can
improve
trust,
respondents
cited
cultural
relatability
as
an
important
factor,
with
this
being
especially
true
for
Black
and
Hispanic
patients.
When
it
comes
to
patient
trust,
providers
are
caught
in
the
crosshairs,
said
Andrew
Swanson,
chief
revenue
officer
at
MGMA.
They
sit
at
the
intersection
of
patients,
insurers
and
pharmaceutical
companies
—
and
often
absorb
patients’
frustration
over
costs
and
lack
of
coverage
transparency,
even
though
they
don’t
control
those
systems,
Swanson
explained.
He
noted
that
MGMA
recently
held
a
meeting
with
about
50
provider
executives
about
how
to
tackle
this
problem.
Some
of
the
executives
suggested
that
hospitals
and
medical
offices
start
having
more
open
and
honest
dialogues
with
patients
about
how
uncertain
and
difficult
it
can
be
for
them
to
navigate
their
care
journeys,
he
said.
“We
have
to
give
them
advice
and
counsel,
but
we
can’t
tell
them
what
to
do.
We
need
patience.
I
think
what
healthcare
organizations
really
have
to
own
is
that
they
are
going
to
have
these
conversations,
whether
they
want
to
have
them
or
not.
They’re
not
running
the
insurance
company,
so
it’s
not
their
business
to
tell
insurers
what
to
do
or
to
tell
patients
what
to
do
about
their
interactions
with
insurance,
but
they
have
to
be
a
sounding
board
for
patients
as
they
come
in,”
Swanson
declared.
Overall,
the
survey
data
showed
that
patients
want
care
providers
who
are
empathetic
and
take
the
time
to
treat
them
like
an
individual,
he
added.
With
providers’
days
being
so
busy,
they
can
sometimes
unintentionally
come
off
as
cold
or
unfeeling.
For
example,
patient
portals
now
give
people
instant
access
to
their
lab
or
imaging
results,
Swanson
pointed
out.
In
some
cases,
the
patient
might
access
these
records
before
getting
a
chance
to
talk
them
over
with
their
doctor,
which
could
cause
unnecessary
distress
and
break
down
trust.
“We
don’t
want
to
not
be
transparent.
We
want
to
give
people
their
information,
but
they
need
to
be
given
it
with
care,
empathy
and
a
knowledgeable
voiceover
so
they
understand
the
results
that
they’re
getting,”
Swanson
stated.
Support
for
cultural
and
linguistic
diversity
is
also
crucial,
he
said.
Cultural
awareness
training
alone
isn’t
enough,
Swanson
warned.
Providers
need
practical
resources
—
such
as
bedside
translation
services
and
visual
reminders
posted
in
rooms
—
to
help
them
communicate
sensitively
with
diverse
patient
populations,
especially
during
busy
clinical
days,
he
explained.
How
healthcare
leaders
can
better
understand
the
erosion
of
trust
It’s
difficult
to
improve
patient
trust
without
reliable
ways
to
measure
it,
said
Mark
Lomax,
CEO
of
healthcare
software
startup
PEP
Health.
Measurement
enables
providers
to
pinpoint
when
and
where
trust
erodes
so
that
they
can
then
take
immediate
steps
to
rebuild
it,
he
remarked.
Last
week,
PEP
launched
its
“trust
score”
—
a
real-time
metric
that
quantifies
trust
by
using
AI
to
analyze
patient
feedback
all
across
the
internet.
The
tool
analyzes
40
million
unsolicited
patient
comments
from
sources
like
social
media,
online
reviews
and
patient
forums
—
representing
about
1
in
9
Americans,
Lomax
stated.
Unlike
traditional
surveys,
which
can
be
slow
and
usually
have
low
response
rates,
the
trust
score
taps
into
real,
unfiltered
patient
feedback,
he
noted.
The
startup
based
the
score
on
academic
research,
especially
the
“RISE”
model
of
trust,
which
includes
logic,
authenticity
and
emotional
connection
as
its
core
pillars.
Lomax
said
trust
disappears
if
any
one
of
these
elements
breaks
down.
PEP’s
goal
was
to
codify
trust
using
these
concepts
with
natural
language
processing
AI.
The
company’s
AI
analyzes
trust
drivers
and
indicators,
Lomax
noted.
Drivers
are
specific
qualities
that
patients
mention
about
their
providers
in
their
feedback,
such
as
kindness
or
active
listening.
Indicators
are
observable
patient
behaviors
that
happen
as
a
result
of
trust,
such
as
patient
retention
or
gratitude.
Patients
can
reveal
these
kinds
of
behaviors
by
writing
these
like
“I’ve
been
seeing
Dr.
X
for
five
years”
or
“I’m
so
glad
Dr.
X
took
time
to
answer
all
my
questions,”
Lomax
explained.
All
of
these
factors
are
mapped
out
on
a
dashboard,
forming
a
“real-time,
3D
picture
of
trust,”
he
stated.
PEP’s
trust
score
dashboard
—
which
can
be
used
by
both
providers
and
payers
—
analyzes
trust
across
health
systems,
service
lines,
geographic
regions
and
time.
Scores
are
on
a
1–5
scale,
with
3
as
a
neutral
point.
A
score
below
3
means
more
negative
than
positive
sentiment.
PEP’s
internal
analysis
determined
that
a
one-point
decline
in
trust
can
result
in
more
than
$12
million
in
annual
lost
revenue
for
a
large
health
system.
A
study
by
Deloitte
also
found
that
providers
with
higher
patient-reported
experience
scores
performed
better
financially
than
those
with
lower
scores.
Specifically,
hospitals
that
patients
rated
as
“excellent”
had
an
average
net
margin
of
4.7%,
compared
to
1.8%
for
hospitals
with
low
ratings.
Lomax
pointed
out
that
PEP’s
tool
is
customizable.
Users
can
tailor
their
dashboards
to
view
data
by
geography,
benchmark
against
their
peers
or
analyze
trust
in
specific
clinical
areas.
For
example,
ECU
Health
in
North
Carolina
worked
with
PEP
to
develop
a
trust
dashboard
by
market
area,
driven
by
interest
from
Julie
Kennedy
Oehlert,
the
health
system’s
chief
experience
officer.
ECU
is
one
of
a
few
U.S.
health
systems
that
are
piloting
the
trust
score,
Lomax
said.
“Trust
is
the
foundation
of
the
relationship
between
healthcare
and
those
they
serve.
When
trust
is
present
in
the
relationship,
patients
adhere
to
treatment
plans,
seek
medical
care
when
needed,
and
have
frank
conversations
with
their
care
team
which
is
vital
to
their
health
planning,”
Oehlert
said
in
a
statement.
“This
trust
also
fuels
the
passion
and
purpose
of
those
that
provide
care,
insulating
against
burnout.”
She
also
noted
that
the
trust
score
is
less
about
adding
another
metric
for
providers
to
manage
and
more
about
achieving
a
deeper
understanding
of
patient
relationships,
which
play
an
important
role
in
overall
health
outcomes.
How
more
effective
communication
can
help
boost
trust
Effective
communication
is
a
key
piece
of
the
puzzle
for
providers
and
payers
looking
to
improve
patient
and
member
trust
levels,
noted
Bob
Farrell,
CEO
of
healthcare
engagement
platform
mPulse.
“We’re
seeing
progressive
organizations
do
a
better
job
at
either
repairing
trust
or
building
new
trust
by
using
digital
engagement
techniques
to
provide
literacy,
tailored
touch
points
and
specifics
along
a
patient’s
healthcare
journey
to
help
them
feel
like
the
plan
or
the
provider
understands
what
they’re
going
through,”
he
declared.
Americans
increasingly
want
to
be
active
participants
in
their
healthcare,
Farrell
pointed
out.
They
have
more
tools
and
information
at
their
disposal
than
ever
before
—
but
it
usually
comes
from
sources
like
social
media
and
ChatGPT,
not
their
health
plan
or
provider.
Farrell
noted
that
healthcare
organizations
have
the
opportunity
to
use
data
analytics
and
AI
to
determine
how
best
to
engage
with
specific
patients
or
members
based
on
their
health
and
demographic
profiles.
“If
you’re
a
72
year-old
male
who
has
diabetes
and
has
had
two
falls
in
the
last
24
months,
you’re
going
to
have
a
much
different
profile
than
a
32
year-old
woman
who
is
dealing
with
prenatal
and
early
childhood
issues.
You
got
to
engage
with
those
people
correctly,”
he
remarked.
Personalization
helps
build
trust
because
it
helps
people
feel
more
understood,
Farrell
said.
When
payers
or
providers
apply
the
same
approach
to
very
different
populations,
it
can
feel
abrasive
and
impersonal,
he
explained.
When
outreach
is
personalized,
engagement
rates
significantly
improve,
sometimes
jumping
from
the
low
single
digits
to
the
20–30%
range,
Farrell
stated.
He
also
highlighted
the
importance
of
delivering
content
that
mirrors
the
user’s
everyday
digital
experiences,
such
as
Instagram-style
video
delivery,
saying
that
this
can
improve
receptiveness.
To
rebuild
trust,
healthcare
leaders
need
to
recognize
that
patients
don’t
just
want
lab
results
and
factual
answers
—
they
want
to
feel
seen,
heard
and
supported
during
some
of
life’s
most
difficult
moments.
Experts
agree
that
in
order
to
make
patients
feel
this
way,
providers
and
payers
need
to
employ
a
human
approach
centered
on
empathy
and
tailored
communication.
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