Turning patient uncertainty into loyalty

In brief

• Only 65% of patients will definitely stay with their provider. The rest sit in an uncertain middle: not dissatisfied, not committed.
  
  
• When engagement slips from "very" to "somewhat," likelihood to stay drops 53 percentage points. The decline is not gradual. It's a cliff.
  
  
• Top-quartile health systems hold loyalty scores of 70% to 80%, earned through disciplined execution across the journey, not standout moments.
  

The patients you're losing aren't complaining. They're drifting.

Across six core relationship metrics, less than 60% of patients are strongly engaged and loyal. But this is not a story of widespread dissatisfaction. It is a story of silent vulnerability. A large segment of patients sits just below the loyalty threshold, tolerating the experience without truly committing. They rarely raise concerns, yet they are more likely to switch than to stay. With switching now easier than ever and acquisition costs continuing to rise, these patients represent the biggest retention risk most health providers are not managing.

The uncertain middle represents the largest opportunity for health providers to strengthen patient loyalty and retention.

Consistency separates top performers from the rest

The difference between top and bottom-quartile health providers is not one standout strength. It is disciplined execution across the entire patient relationship. Top-quartile organizations hold loyalty scores of 70% to 80% and maintain a roughly 10-point advantage across nearly every engagement driver. They earn that advantage by removing access barriers, making routine interactions easier to complete, closing digital quality gaps and treating trust as a measurable outcome. The results are better patient relationships, stronger retention and more sustainable growth.

The uncertain middle is the loyalty opportunity

The patients sitting in the middle are not waiting for a reason to leave. They are waiting for a reason to stay. Most will never flag their dissatisfaction. They will simply choose another provider the next time it is convenient. Patient loyalty is not simply an experience metric. It is a growth metric that influences retention, digital adoption and long-term patient value. Health providers that treat experience as a connected growth strategy, not a set of isolated fixes, will be the ones that convert passive patients into committed ones and build the trust needed to bring them along into digital, virtual and AI-enabled care.

Are patient behaviors changing?

As a follow up to our 2021 study, “The difference between loyalty and leaving,” we wanted to assess how health insurers perform across 9 key touchpoints that drive satisfaction, loyalty, value and ease of use to understand people’s selection and switching behaviors. Likewise, we asked people who had sought or received care in the last 12 months to evaluate their healthcare providers performance across 10 key touchpoints and how that affects their selection and loyalty.

Primary drivers of trust

From provider-patient relationships to payer interactions, trust has a cascading effect on people and the operational excellence achieved by the health organizations that excel in building trust. In today’s transactional mindset, we can lose sight of the primary drivers of trust, providing (or enabling) access to expectations of care, facilitating understanding of coverage, and delivering diagnoses/treatment-through experiences that humanize healthcare. Trust significantly influences people’s behavior in terms of patient engagement, loyalty and digital technology adoption. As leaders address workforce challenges, and invest in new technologies, including telehealth and generative AI, it would be wise to place trust as the cornerstone of investment and outreach efforts.

Key facts about consumer loyalty to their payer and provider