Customer satisfaction with hospitals grows as health care sector shifts

One word defines health care right now: consolidation.

Pharmacy benefits managers (PBMs) are merging with insurers. United Health Group led the charge a few years ago, buying Catamaran. Now CVS is buying Aetna and Cigna is buying Express Scripts. Walmart is in talks to buy Humana. Some see this as motivated by the potential for Amazon to leap into the health care space; the major players are joining forces to ensure they’ll be able to compete.

But the joining of PBMs with insurers could have an effect on hospitals as well.

UnitedHealth bought Surgical Care Affiliates to expand into primary and urgent care in ambulances, and picked up a physician group, moving closer to direct delivery of medical care. CVS and Aetna plan to add community medical clinics to their repertoire. Walmart already operates retail health clinics and has said it would begin offering lab-testing services in some stores.

The $18 billion urgent care center space is expected to grow nearly 6 percent in 2018, building on the more than 7,600 urgent care centers in the U.S. as of June 2017. The number of centers in 2017 was up nearly 10 percent over 2015.

The surge in clinics could be the reason that customer satisfaction with emergency room services jumped 6 percent since last year, to an ACSI score of 73.

That was the most dramatic change in the health care and social assistance sector, and drove the 1.3 percent increase in customer satisfaction with hospitals.

Inpatient hospital care saw a 1 percent rise to an ACSI score of 77. The gains in ER and inpatient care helped offset a decline for outpatient care, which ebbed 3 percent to 78.

Patient satisfaction with ambulatory care (office visits to doctors, dentists, optometrists, and mental health professionals) held steady at 77 for the third year in a row.

Among patients 51 years and up, satisfaction with hospitals was much higher, at a score of 80, than among those 18-50 years old, where it stood at just 72. The difference in satisfaction between the two age groups was most pronounced in outpatient care and emergency room services, where ACSI scores among those 51 and up were 10 points higher than scores for those 18-50.

It will be interesting to see the effect that continued growth of urgent care clinics will have on ER perception moving forward. And when Amazon, along with its collaborators JPMorgan Chase and Berkshire Hathaway, does make moves in health care, it will be anyone’s guess how the health care and social assistance sector, and patients’ satisfaction with its services, will respond.

UPS tops FedEx in customer satisfaction, as Amazon appears on the horizon

Amazon overshadows many industries, as we saw last month in the retail sector. Now, consumer shipping, long the beneficiary of all those Amazon orders, is bracing for a future in which Amazon makes its own deliveries.

The Wall Street Journal last month reported that Amazon is planning to launch “Shipping with Amazon,” a delivery service for businesses shipping to consumers. Of course it would take years for Amazon to build a parcel delivery network at the scale of United Parcel Service (UPS) and FedEx, but even the specter of Amazon should be enough for the established players in the shipping industry to redouble their efforts in serving customers.

Where do they stand right now?

Customer satisfaction with consumer shipping was stable at an ACSI score of 81 (out of 100), but UPS jumped into the lead at 82, growing 1 percent over 2017. FedEx fell 1 percent to 81. The U.S. Postal Service’s Express and Priority Mail business climbed 1 percent, but remains a distant third place at 76.

Customers gave top marks to shippers for delivering packages in good condition (88) and making it easy to track shipments (86). Customers who visited a post office or a UPS or FedEx store feel that service staff members were slightly less courteous and helpful this year (85), but all other customer experience benchmarks remained the same.

It might seem easy to write off the U.S. Postal Service’s Express and Priority Mail business, which remains well behind the category’s leaders in terms of overall customer satisfaction. But it’s actually tied with FedEx in customer loyalty and has a lower percentage of customer complaints. UPS had the best scores in the industry for each of those measures.

With Amazon dipping its toes in the shipping space and, according to the Wall Street Journal, threatening to undercut UPS and FedEx pricing, the shipping giants can only rely on their established infrastructure so long. Investing in customer service could continue to set these companies apart.

ACSI Launches Voter Satisfaction Survey

ACSI Presidential Election Survey: A Measure of Voter Satisfaction With the Major Party Candidates and Their Campaigns

Week of September 5 to September 9, 2016

The American Customer Satisfaction Index (ACSI) launches a new study tracking “voter satisfaction” with the race for U.S. president, to be updated each week with new data until November 7, 2016 (the day before the election).

Customer satisfaction is a proven predictor of purchases of goods and services; therefore, it should have predictive power for presidential elections as well. Like consumers, voters may pick candidates based on the “expected satisfaction” that a candidate will deliver. Expected satisfaction, in turn, is predicted by current satisfaction. Accordingly, the ACSI will track expected and current satisfaction with the two major party candidates, Hillary Clinton and Donald Trump.

In markets for goods and services, current satisfaction is determined by a customer’s “consumption experience.” In the absence of any such actual experience prior to the inauguration of a new president and a period of actual governing, the ACSI uses a proxy that measures satisfaction with each candidate’s campaign. From these two measures—expectations and satisfaction with the candidates and their campaigns—both the breadth (“market share” or voter share) and depth (satisfaction) of support are derived for each candidate. An algorithm for estimating voter share and satisfaction is used to group registered voters into “strong” and “weak” supporters of each candidate and to identify both the size and satisfaction levels of those groups.

Beginning with data from the week of August 1 to 5 for the first wave and ending with the week of September 5 to 9, a total of 5,311 interviews were conducted thus far. During the first week of August, voter satisfaction was 74 for Clinton and 72 for Trump. These results do not represent percentages but rather ACSI scores on a scale from 0 to 100. The corresponding estimated voter share (or market share) in week one for Clinton was 49% versus 39% for Trump. Thus, not only was Clinton’s satisfaction score higher than Trump’s, her share of the vote also was substantially higher.

Following the first week of August, voter satisfaction for Trump slipped, rebounded, and peaked, and then declined for two consecutive weeks. During the same period, Clinton’s voter satisfaction was mostly flat, but then also declined for two weeks. According to the most recent data, Clinton’s satisfaction score has dropped to 73 (-1), while her voter share has receded 2%. Meanwhile, Trump’s satisfaction is unchanged since the first week of August, although he has gained in voter share (+3% to 42%). Nevertheless, Clinton continues to lead in both voter satisfaction (73 vs. 72) and voter share (47% vs. 42%).

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Unlike traditional trial heat polls, measuring current and expected satisfaction with the major party candidates allows researchers to group voters into “strong” and “weak” support groups. In the diagram, “strong” supporters are those defined as being much more satisfied with one candidate and much less so with the other. “Weak” supporters are defined as those only somewhat more satisfied with one candidate over the other. “Undecideds” express equal satisfaction/dissatisfaction with the two candidates.

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For Clinton, 35% are strong supporters. For Trump, 30% are strong supporters. When combining strong and weak supporters, Clinton currently has a voter share of 47% and Trump has 42%. 11% are equally satisfied or dissatisfied with the candidates.

The following table shows how support for each candidate has fluctuated over the past six weeks. For Trump, the share of strong supporters has risen from 27% to 30%, while Clinton’s has actually declined (to 35% in week six from 38% in week one). Undecideds have shrunk from 13% of the total to 11%, although the number of undecideds is actually higher now than in the prior week.

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The following tables depict voter share for each candidate for the week of September 5 to September 9 among various demographic groups. Clinton holds a strong lead over Trump among respondents 18 to 34 and a slight lead among voters 35 to 54. The two candidates are nearly even among voters 55 and above. Similarly, Clinton holds a big lead among women, while enjoying a smaller lead among men.

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Clinton holds a massive lead over Trump among African Americans and a strong lead among Hispanics, but among white voters the two are tied. Finally, respondents with less than a college degree break decisively for Trump, while those with a college degree or more favor Clinton by almost 20 percentage points.

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Download Free PDF of This Survey »

Press Release: Clinton Leads Trump in Voter Satisfaction, According to ACSI »

ACSI 2015: The Year in Review

The year 2015 marked customer satisfaction downturns across nearly every economic sector—from the post-holiday 2014 retail segment to U.S. federal government services. At the national level, overall U.S. customer satisfaction retreated across four quarters, adding to a string of consecutive declines that began in 2014.

According to ACSI results released from February to December 2015, 70% of 43 measured industries showed year-over-year satisfaction declines, with products or services from 59% of measured companies deemed less satisfying according to their own customers.

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In the public sector, citizens were less satisfied with services of the federal government during the year 2015, although the pace of decline slowed considerably compared with the two prior years.

Despite this pervasive weakening of consumer opinions of goods and services over the past year, the most recent satisfaction levels tracked by the ACSI are not dramatically different from pre-Great Recession data. It is possible that the years immediately following the recession represent a honeymoon period when companies went to greater lengths to attract and keep their customers—and when those customers may have been more willing to adjust their expectations.

Coming soon at www.theacsi.org: customer satisfaction results for the fourth quarter of 2015, including ACSI scores for more than 60 online and traditional retailers, based on data collected during the holiday shopping season.

ACSI Federal Government Report 2015 »

ACSI 2015 Year in Review: 
Slumping Customer Satisfaction Across Much of the U.S. Economy »

Investor’s Business Daily: Facebook Made Way More Users Happy in 2015: ASCI »

Money: These Companies Were the Biggest Customer Satisfaction Losers for 2015 »

Driver Satisfaction Shake-Up for Luxury Cars

Drivers who opt for luxury are typically among the most satisfied, according to two decades of ACSI research on customer satisfaction with automobiles and light vehicles. When it comes to premium-priced vehicles, manufacturers strive to pair top-notch service with features aimed at comfort and luxury—all of which helps boost satisfaction.

ACSI findings for 2014, however, reveal widespread deterioration in driver satisfaction. Among 21 measured car brands, 80% show some decline in ACSI compared with the prior year. The two that take the hardest hit are both luxury makes: Acura and Cadillac. By contrast, Germany’s Mercedes-Benz still leads the field as it did in 2013, albeit at the lower ACSI score of 86, while GM’s Buick is one of only two nameplates to post a gain (+1% to 83).

With a sharp drop of 7%, Honda’s Acura tumbles down to last place for 2014. In its second year of measurement, Acura scores 77, down from 83 a year ago. Another luxury newcomer to ACSI, Audi, inhabits the low end with a debut score of 79.

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Cadillac, GM’s flagship luxury make, plunges 6% to 80, failing to score above average for the first time in ACSI history. The drop in customer satisfaction for Cadillac coincides with news that the brand’s August year-on-year sales in the U.S. are down 18%, in sharp contrast to the industry’s overall gain of 5.5%.

View more automobile scores »

AutoGuide: Mercedes, Subaru Top Customer Satisfaction Survey »

Bloomberg: GM’s Chevrolet, Buick Achieve Sole Gains in Auto Survey »

MarketWatch: The most hated car company in America is »

The Wall Street Journal: Automotive Customer Satisfaction Dips for Second Straight Year »

Fast Food Patrons Find Less to Love at McDonald’s

When it comes to dining out, choosing a big-name venue may result in big disappointment. McDonald’s is a prime example that number one in sales does not always add up to number one in customer satisfaction. In fact, fast food Goliath Mickey D’s has been serving up less satisfaction to its patrons than any other competing chain for 20 years. Consistency may be good in some cases, but not when it involves being an industry customer satisfaction laggard.

Since the ACSI’s inception in 1994, McDonald’s has earned the lowest ACSI score among a dozen major fast food chains such as Pizza Hut, Wendy’s, Subway, and more. The ACSI also measures smaller chains and independent restaurants in aggregate (shown in the chart as “all others”). In stark contrast to McDonald’s, these smaller chains—including the rapidly growing fast casual brands Panera and Chipotle—have always been just above or much higher than the industry average for customer satisfaction. This year, small chains are on top with an industry-leading ACSI score of 84 (scale of 0 to 100). This is a whopping 13 points ahead of last-place McDonald’s at 71.

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A possible silver lining for McDonald’s is that it no longer scores in the 60s, as it did for many years. With a large and diverse customer base, maintaining a higher level of satisfaction may always be challenging for the company. In 2014, McDonald’s declines 3%, down from a peak score of 73 in 2013. Smaller chains, in contrast, improve 2% and set a new record high for the industry at large.

View more fast food ACSI scores »

United Press International: Americans Are Not ‘Lovin’ McDonald’s That Much Anymore »

Business Insider: America’s Favorite Fast Food Chains »

USA TODAY: Not-So-Happy Meal: McDonald’s Satisfaction Lags »

Chicago Tribune: McDonald’s Ranks Last in Customer Satisfaction »

24/7 Wall St: Poor Wages Given as Reason for Poor McDonald’s Service Rating »

What Will It Take to Keep Policyholder Satisfaction on Track?

As 2013 drew to a close, the ACSI issued its annual report on the Finance and Insurance sector, which showed across-the-board gains for three categories of insurance. Top improvement went to property and casualty insurance, up 3.8% to an ACSI benchmark of 81. This dovetails with the P/C insurance industry reporting its “best year since the financial crisis;” nevertheless, industry experts anticipate “more headwinds” going into 2014.

Health insurers face even greater challenges ahead, as the marketplace undergoes an expansion of historic proportions with the advent of the Affordable Care Act. Like P/C insurers, health insurers did a better job of satisfying customers, but with a modest gain of 1.4% to a much lower ACSI score of 73. Policyholder satisfaction for life insurers hit the high mark of 83, but the industry’s 2.5% gain came mainly from an upswing with smaller companies, who continue to outperform the larger carriers.

Looking at what each group does best, P/C policyholders respond positively to their local agents—giving them strong ratings of 87 for courtesy and helpfulness with policy purchases and 85 for claims handling. On the other hand, discounts and rewards are somewhat lacking (77), as customers seek better value from industry pricing. Life insurers are efficient when it comes to policy approval (87), but fall even further behind on discounting or bundling policies (74). For health insurance, policyholders are happy with their access to primary care doctors (82), but crave more plan choice (71)—a factor that may be as much about the limits of employer plans as it is about the providers themselves.

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Billing, timeliness, and website quality are key elements that impact the policyholder experience for all insurance types. According to customers, P/C insurers excel when it comes to understandable billing statements (85) whereas health insurers do not (75). Given the complexity of billing medical procedures and calculating deductibles and copays, this is hardly surprising. Nevertheless, this clearly is an area where companies could gain an advantage by developing more user-friendly processes.

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P/C insurers also are adept at offering high quality, multichannel solutions for communicating about policies and claims. The industry’s website satisfaction (83) and call center satisfaction (81) are much higher than the national ACSI averages of 78 and 74, respectively. For life insurers, website satisfaction also is above average (81). Across multiple channels, health insurers lag behind, just as they do for billing statement clarity, with website satisfaction at 73 and call center satisfaction at 72.

ACSI Finance and Insurance Report 2013 »

Are Luxury Hotels Always Better?

For the hotel industry, the ACSI measures 10 customer experience elements—from ease of making a reservation and check-in to food services, in-room entertainment and staff courtesy. Across five lodging types (economy, midscale, upscale, upper upscale, and luxury), reservation and check-in processes function well, with scores ranging from 84 for economy to 90 for luxury properties.

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Ratings for loyalty programs, Internet service, and staff courtesy show little variation for midscale through luxury. In fact, staff courtesy for luxury brands ties that of midscale chains at 86. Guest satisfaction among hotel types varies the most when it comes to room cleanliness and comfort, food services, and hotel amenities.

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As expected, luxury hotels come out on top and economy properties at the bottom across nearly all aspects of the customer experience, according to their respective guests. There is opportunity, however, for midscale and upscale properties to create services that offer guests an experience that compares well with upper-upscale and luxury hotels by focusing on the most salient aspects: room quality, food quality and on-site amenities such as pools, fitness rooms and business centers.

Read more about the hotel industry in the ACSI October 2013 e-newsletter article, Marriott Hospitality Shines in New Hotel Brand Study.

Follow this link to fill out a short form to subscribe to ACSI e-newsletter  »

 

Can Hotels Make Guests Happy Across Diverse Brand Portfolios?

For several years, the hotel industry has been a fairly steady performer when it comes to customer satisfaction, according to ACSI research. From 2008 to 2010, guest satisfaction with hotels was stable at 75 (on a 0 to 100 scale). Next came three straight years at 77—a record high for the industry, but middling compared with the national ACSI average of 76.5.

The hotel industry’s flat trend, however, masks differences in the customer experience offered by some of the biggest names by market share in lodging. More upscale hoteliers tend to dominate the category, with Marriott in the top spot this year at 82, followed closely by Hilton 80. Budget-conscious chains such as Choice Hotels (75) and Wyndham Worldwide (72) comprise the lower end of the industry.

But many of these corporations are home to diverse lodging brands—from upscale resorts to midrange business-oriented properties to family-friendly budget brands. For instance, Marriott owns JW Marriott, a luxury hotel chain, alongside Fairfield Inn & Suites by Marriott, a midscale brand. Hilton, also know for its resorts, offers Hilton Garden Inn, an upscale property with appeal to both business and leisure travelers.

Next month, the ACSI will uncover the customer satisfaction differences—or lack thereof—among two dozen of the most popular hotel brands that come under the aegis of Choice Hotels, Hilton Worldwide, Marriott International, and more. The new study has the potential to reveal strengths and weaknesses within the brand portfolios of major hotel chains, as well as facilitate comparisons between competitors at the brand level.

 Read About ACSI Hotel Brand Study  »

ACSI Attends EMACS 2012

In October, ACSI staff will travel to San Diego, California, to join 350+ energy utility professionals at the 15th annual  EMACS – The Customer Experience Conference, organized by Chartwell. The 2012 conference, set for October 9 to 12, will feature over 30 presentations on topics that shape the overall experience of residential energy utility customers.

The conference represents the flagship customer experience event for the energy utility industry. EMACS attendees are invited to stop by Booth 805 in the Exhibit Hall of the Manchester Grand Hyatt to meet with ACSI staff and learn about our services for energy utility clients.

For nearly two decades, the ACSI has benchmarked residential customer satisfaction for the largest investor-owned utilities in the United States. In 2013, the ACSI will complete its third year of measuring satisfaction with municipal and cooperative utilities.

In April of each year, the ACSI publicly releases first quarter scores for approximately 30 utilities, identified by independent ACSI researchers based on size of residential business. The first quarter scores, however, tell only a small fraction of the customer experience story. By engaging ACSI services, energy utility clients access confidential data four times each year, covering not only customer satisfaction itself, but also customers’ perceptions of power reliability and the ability to restore power after an outage.