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July 19, 2016

Why Advocate Health Care focuses more on measuring patient loyalty than satisfaction

Daily Briefing

Rather than focusing on traditional patient satisfaction metrics, Advocate Health Care is taking a hard look at patient loyalty in an effort to drive long-term growth, three system administrators—Rishi Sikka, Tina Esposito, and Jim Skogsbergh—write in Hospitals & Health Networks.

Advocate administrators noticed that, due to greater cost-sharing requirements, patients were growing increasingly cost-sensitive—and the change was affecting where they sought care.

To better understand what drives some patients to keep coming back to Advocate physicians and specialists, the Chicago-based system began to track patient loyalty—a shift from their focus on traditional patient satisfaction metrics.

The shift "makes a lot of sense for us," Sikka, Esposito, and Skogsbergh write, as health care is becoming a more retail- and value-oriented industry. "Measuring and improving patient loyalty is rapidly becoming a critical competency for health care systems."

Patient loyalty score

To measure patient loyalty, they created a Patient Loyalty Score from CAHPS survey questions, such as "Would you recommend this hospital to your family and friends?"

Based on how their responses, patients are classified as either promoters or detractors. To aggregate the score, Advocate subtracts the percentage of detractors from the percentage of promoters.

By this scoring, the overall Advocate system has a loyalty score of 79 out of 100. But the scores fluctuate between the system's dozen hospitals, ranging from 58 to 81.

Advocate uses the score as a baseline to establish targets to improve patient loyalty. Now, Advocate aims to be in the 75th percentile of its local care market in the next two years.


Advocate is investing heavily in the effort. To better serve price-sensitive patients, for instance, Advocate created a call center to respond to inquiries about prices and estimated out-of-pocket costs. Setting it up wasn't easy, Sikka, Esposito, and Skogsbergh write: Hospitals across the system had to standardize costs for procedures to ensure that patients received accurate assessments.

Three myths about patient loyalty—busted

Advocate is also investing in providing more same-day appointments, as well as extended appointment hours. It also has opened clinics in Walgreens stores and is piloting a virtual visits program.

And the system is striving to better coordinate care for at-risk patients. Oncology patients, for instance, are assigned a medical navigator who helps them stay on top of their appointments, specialists, and therapies. Similarly, outpatient care managers help patients who are at high risk of needing unnecessary care, while a transition coaching service helps patients leaving the hospital who don't have home health care.

"We believe these services help provide a high-touch experience across the continuum of care and engender patient loyalty," Sikka, Esposito, and Skogsbergh conclude (Minemyer, FierceHealthcare, 7/14; Sikka et al., Hospitals & Health Networks, 7/14).

Build patient and consumer loyalty

The word "consumer" hasn't been in the health care lexicon for long. Yet it's undeniable that today's patients have more places than ever to shop around for health care. Getting patients in the door—and keeping them coming back—means providing both a 21st century consumer experience and a top-notch patient experience.

To build loyalty, you must understand a person's need as a patient and as a consumer. Our infographic outlines three key values to win them over.


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  1. Current Article Why Advocate Health Care focuses more on measuring patient loyalty than satisfaction

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