Before the mid-1980s, there were few options when it came to getting quick medical care on an outpatient basis. From unbearably long emergency room wait times (and the associated large bills) to the growing difficulty of actually finding or booking an appointment, there was a mounting frustration in the healthcare space. Ultimately, this gap led to a rise in what we now call “urgent cares”, and an emphasis on providing a better patient experience.
Legacy ER & Urgent Care has expanded this model further, offering dual emergency room and urgent care locations to meet the needs of patients in the United States. Today, they are the largest dual provider of both emergency and urgent care services in the country, and a leader in delivering superior patient experience.
News of their success and innovative business model has garnered a high volume of interest from major healthcare providers and hospital investors looking to provide similar access to communities across the country. To ensure a high standard of patient satisfaction and retention through their continued expansion, Legacy ER & Urgent Care implemented CustomerGauge—a Net Promoter System® that helps them track and improve patient experience- across their locations.
Getting Started with a Net Promoter System
Before partnering with CustomerGauge, Legacy ER & Urgent Care found that one of the biggest hurdles when it came to focusing on their patient experience was that the healthcare industry simply wasn’t built for it. Prior to CustomerGauge, Legacy ER & Urgent Care always paid close attention to patient feedback, but did not have the detailed processes for improvement and tracking they do today.
That all changed in 2016, when Legacy ER & Urgent Care implemented CustomerGauge, which enabled them to track and respond to patients in real-time and analyze satisfaction. Chief Marketing Officer, David Apple, attributes the success of the implementation to first and foremost, employee buy-in of the system and its value,
“We streamlined the process by empowering our leaders, on both the care and administrative side, to lead the NPS program and really hone in on not just the bad experiences (we have a workflow process for that), but also to celebrate the wins. It was spreading the word about our promoters that got everybody excited.”
By establishing buy-in with their employees, Legacy ER & Urgent Care built out their Net Promoter System across their locations, which enabled them to track patient satisfaction.
Closing the Loop to Improve Patient Satisfaction and Retention
As part of their CustomerGauge workflow process, Legacy ER & Urgent Care uses consistent survey best practices. Patients are sent surveys about their experience within 24 hours of their visit via email. If they do not receive a response within 36 hours, they send out a secondary email reminder, which has led to improved response rates and higher retention within their patient base.
“We’ve taken everything that healthcare typically does [when it comes to patient satisfaction and patient experience] and thrown it out the window. " - David Apple, Chief Marketing Officer
Once a patient has submitted a survey, as part of their follow-up workflow, leaders at each location are notified of detractors or passives in real-time via email using CustomerGauge’s issue escalation. At this point, the clock is ticking. To ensure dissatisfied patients are contacted ASAP, every facility has designated ‘first-responders’, such as a nurse or physician leader, to reach out for solutions. Legacy ER & Urgent Care will not consider a case closed until the issue is resolved.
In addition to care-based first responders, billing and insurance-related issues also include separate first-responders—meaning issues are always designated to the right person in the company. Issues are processed and closed in no more than 36-48 hours of notification. When asked if this process has noticeably improved their patient experience, CMO David Apple stated:
“100%. Knowing how important promoters are to our business, we implemented improvements as issues arise. For example, if we see any consistent issues in billing, co-pay, or other procedures, we make changes in our operational process to improve based on that patient feedback.” - David Apple, Chief Marketing Officer of Legacy ER & Urgent Care.
Best Practices for Winning Patient Experience and NPS
Proper employee training, good survey procedures, and streamlined follow-up are just a few of the best practices that Legacy ER & Urgent Care have employed over the last few years. Since investing in patient experience and retention, Legacy ER & Urgent Care has experienced a 15-point increase in their NPS score overall. But how did they get there?
For Legacy ER & Urgent Care, following the status quo didn’t cut it:
“We’ve taken everything that healthcare typically does [when it comes to patient satisfaction and patient experience] and thrown it out the window. It’s a complete transition away from a typical healthcare experience. Our NPS score and patient experience comes from the whole package. Before patients are even done checking in, somebody is greeting them in the room and bringing them in. We’re aware that a majority of the people we see are probably having a bad day, so it’s important to set that initial tone very high, even when people first walk in.”
Legacy ER & Urgent Care employ numerous best practices to ensure success within their NPS program to increase satisfaction and grow their business:
• Employee buy-in, encouragement and thorough training of the tools and procedures
• Fast and proven survey process and follow-up
• Consistent patient/customer experience procedures across multiple locations
• Tying revenue to a patient/customer experience program to justify investments
"Knowing how important promoters are to our business, we implemented improvements as issues arise."
With CustomerGauge, Legacy ER & Urgent Care hopes to continue delivering consistent, outstanding patient experience, and tie their efforts to revenue and growth as they continue to expand.
According to NPSBenchmarks.com, the average Net Promoter Score for the health care industry—from primary care to physical therapist—is 75. However, according to a third-party survey of N. Texas Free-Freestanding ERs and Hospital
EDs, the industry benchmark is even lower. Healthcare has been slow to adapt NPS or any customer feedback tools. Legacy ER & Urgent Care’s NPS score of 81 is a significant achievement considering it is on par with top retailers and customer service-oriented brands.
By the end of the year, Legacy ER & Urgent Care expects revenue from existing patients to grow by 200%. Given both their ability to justify their patient experience program via revenue and the value in their business’ dual model, Legacy ER & Urgent Care is looking forward to an exciting year of expansion and growth:
“There’s going to be a seismic shift in healthcare across the country. People are looking for better access and experience. As such, we are looking to expand. We have a lot of major hospitals and healthcare systems around the country that are interested in partnering with us to deliver our model to states that don’t have any community access care that. We’re in a good position to grow rapidly, and we have the people and the system [CustomerGauge] in place now to help us with this expansion. It’s going to be an exciting year.”
CustomerGauge is a software-as-a-service platform that improves customer experience using the industry-standard Net Promoter System. The system helps companies automatically measure and analyze feedback in real-time, act to reduce churn through close-loop tools and grow their bottom line.
EU: +31 208 20 21 60
About Legacy ER & Urgent Care
Legacy ER & Urgent Care is the largest dual provider of both emergency and urgent care in the country, and runs on one simple premise: there has got to be a better way to deliver emergency services while providing extraordinary customer experience and only billing for the care you need.
The landscape of healthcare is changing. Better access, better service, and honest billing have become patient directives because it makes sense - it's intuitive. The team who developed the hybrid retail care model and built the chain of successful, North Texas-based, Legacy ER & Urgent Care facilities, is now launching Intuitive Health. Intuitive Health will serve as an expansion brand to partner with health systems around the country.
Joint venture partnerships have been in the works since the second quarter of 2016, but efforts have recently been accelerated due to consumer request and a heightened interest from health systems. “North Texas has provided an exceptional proving ground,” said Thom Herrmann CEO of Intuitive Health. “The ability to meet our patients' needs, while maintaining a high level of customer service and providing honest billing, has been the winning combination for us.” The state of Texas is a semi-regulated state, which allows ownership of freestanding emergency departments independent of hospital systems. “The perception that free-standing emergency rooms and urgent care facilities are on every corner is not exactly untrue. However, this incredible rise has also seen a continued sell-off, as consumers continue to understand the costs associated with an emergency department and owners understand the expense of operations,” Herrmann continued. “In comparison, our facilities have seen a consistent level of growth since 2008, regardless of the 500 percent increase in competition. This is a direct result of our hybrid retail care model and relentless pursuit of customer service.”
As expansion continues, Intuitive Health will remain dedicated to the support and operations of their Legacy ER & Urgent Care locations. The executive team will remain in place, with the addition of healthcare leadership veterans to the board of directors and the business development team. “We have an accomplished team of healthcare specialists, advisors and capital partners in place,” Herrmann stated. “We are excited to bring our hybrid retail care and customer service model to quality health systems around the country.”
About Intuitive Health
Intuitive Health partners with health systems nationwide to build, operate and launch hybrid retail healthcare facilities that provide urgent care and emergency services under one roof. Intuitive’s convenient care facilities drive patient acquisition, increase visibility and deliver the high-level customer service patients demand.
About Legacy ER & Urgent Care
Founded in 2008, Legacy ER & Urgent Care is one of the nation’s first healthcare models to offer both urgent care and emergency room treatment options under one roof. By providing transparent billing, a welcoming clinical environment, and one-on-one service with board-certified, emergency-trained physicians, Legacy has built an exceptional customer service program, with industry-leading ratings. The hybrid retail care model gives patients access to immediate care at a full-service, on-site emergency room 24/7 and urgent care center level services from 7A-9P daily, allowing patients to only pay for the level of service needed.
Intuitive Health is one of the most progressive retail healthcare companies in the US.