Loyalty to Loyalty Metrics: Evaluating the Use of “Likelihood to Recommend” in Health Care Experience

Abstract

Summary Loyalty in a customer relationship may be simply defined as a positive feeling about a brand that drives behavior to repurchase services or products and creates a preference for that brand in the future. The original articulation of the Net Promoter Score (NPS) was anchored in repurchasing behaviors in multiple industries, which notably did not include health care. As health care becomes increasingly consumer driven and fragmented by new and nontraditional models of care, efforts to measure patient and/or employee loyalty — often characterized as a likelihood to recommend or NPS, is growing. However, the value framework in health care is ultimately about better health, higher quality/safety, and exceptional experience at lower cost — not loyalty programs. In fact, most organizations do not track retention of patients longitudinally nor the growth associated with word of mouth. When strategically deployed, survey questions that ask about likelihood to recommend can help organizations establish trending data that can be a valuable indicator for health care organizations looking to drive improvement and to understand what is working and what is not. However, such data must be supplemented with robust analytics to assess operational and financial impact and methods of uncovering the drivers behind the likelihood-to-recommend scores. The authors offer a perspective of what they know to date and considerations for a meaningful approach.