MHA 506 Week 1 Health Care Consumer Behavior Example

How a Retired Teacher Chooses Where to Have Her Knee Replaced: Consumer Behavior, Price Shopping and Online Reviews for a Joint Replacement Service Line

[Student Name]

University of Phoenix

MHA/506: Ethical Marketing: The New Health Care Economics

Week 1 Assignment

[Instructor Name]

[Date]

The health system, its service line, patients and survey are composites written for a model paper; national data and research come from the sources listed.

A composite three-hospital nonprofit system in a metropolitan area of 1.2 million people plans to open an outpatient joint replacement program at its surgery center. Before designing any marketing, the system's director of strategy and marketing, a student in the Master of Health Administration, set out to understand how patients actually choose where to have a knee or hip replaced. This paper examines that behavior through one composite patient, national evidence and the system's own survey.

One Patient's Decision

A 67-year-old retired teacher had walked two miles every morning for twenty years until knee pain stopped her. After injections and physical therapy failed, her orthopedic surgeon recommended a total knee replacement and said he could perform it at the system's main hospital or at an independent surgery center where he was a part owner. She had traditional Medicare with a supplemental plan from her former employer.

Influence One: The Surgeon

Her first and strongest influence was her surgeon. She trusted him because he had treated her husband, and she assumed he would choose well. Patients rarely choose a surgeon and a facility separately; the surgeon's privileges and preferences often decide where surgery happens.

Influence Two: Coverage

Her Medicare coverage allowed either site. A neighbor with a Medicare Advantage plan had been limited to in-network facilities, which narrowed the choice considerably.

Influence Three: Other Patients

A friend's story about a painful night in the hospital after hip surgery made her lean toward going home the same day. She read online reviews of both facilities, focusing on comments about nurses, pain control and how quickly calls were returned after patients went home.

Influence Four: Price

Her daughter found the system's online price estimator. The teacher never used it. Her supplemental plan covered most costs, and she assumed the difference would be small.

What National Evidence Shows About Price

Her behavior is typical. In a nationally representative survey of 2,996 adults who had received care in the prior year, only 13% of those with out-of-pocket spending had sought information about expected costs before care and 3% had compared costs across providers, although most believed price shopping was important and did not believe higher prices meant higher quality; barriers included difficulty getting price information and reluctance to disrupt relationships with providers (Mehrotra et al., 2017). Patients say price matters and then choose by trust, which is why marketing built on price alone misses how people decide.

What Online Reviews Reveal

Patients increasingly read reviews. A study of online reviews of U.S. hospitals found that they covered most domains of the standard federal patient experience survey and 12 additional domains, such as cost of hospital visits, insurance and billing and staff attitudes, and that many topics most strongly associated with positive or negative reviews were not measured by the standard survey (Ranard et al., 2016). Reviews tell a system what patients notice and remember.

The Size of the Market

Demand is growing. One projection based on Medicare data estimated that by 2040 annual primary knee replacements among Medicare patients would reach about 1.2 million and hip replacements about 719,000, with continued growth to 2060 (Shichman et al., 2023). In the system's market, the planning team estimates about 4,100 knee and hip replacements a year, rising with the aging population.

The System's Own Survey

The marketing director surveyed 400 of the system's recent joint replacement patients. When asked what most influenced where they had surgery, 71% named their surgeon, 38% insurance coverage, 34% location and convenience, 29% a family member or friend and 18% online reviews; 4% named price. Asked what they would want to know before choosing, most named infection and complication rates, whether they could go home the same day and who to call after surgery.

Why Health Care Is Not an Ordinary Market

Economists have long noted features that make health care different from ordinary purchases. Patients often cannot judge quality before or even after care; the need for care is unpredictable and sometimes urgent; insurance separates the person choosing from the person paying; and the expert advising the patient may also earn money from the choice. Each feature showed up in the teacher's decision: she could not judge surgical quality herself, her insurer paid most of the bill and her surgeon had a financial stake in one of the sites. Marketing in such a market carries special responsibilities.

The Surgeon's Financial Interest

The teacher's surgeon owned part of the independent surgery center. Physician ownership is legal when arrangements meet federal rules, and it can bring efficiency and physician engagement. But it means the advice patients trust most may be shaped by the advisor's income. The system's marketing cannot change competitors' arrangements, but it can make sure patients have clear information about both sites and that its own surgeons disclose their interests.

What Patients Remember Afterward

The survey also asked what patients remembered most about their experience. Their answers rarely mentioned the facility's appearance or advertising; they named the nurse who called the night of surgery, how pain was controlled on the first night and whether anyone answered when they called with a question. These moments become the stories patients tell neighbors and write in reviews, which in turn influence the next patient's choice.

Families as Decision Makers

Adult children often shape decisions for older parents, researching options, driving to appointments and caring for the patient afterward. Nearly half of survey respondents said a family member helped them decide. Marketing that ignores caregivers misses a key audience.

When Patients Are Vulnerable

Patients facing surgery are often in pain, worried and dependent on experts. That vulnerability creates ethical limits: marketing should inform decisions rather than exploit fear, avoid overstating benefits and never pressure patients toward a site because it earns more.

Implications for the Program

The findings point toward marketing that works through surgeons and primary care physicians, informs family caregivers, answers the questions patients ask about safety and recovery, uses honest outcome data and treats reviews as feedback to improve care. Price information should be clear and easy to find even if few use it, because it builds trust and helps those who do.

Limits of This Analysis

The system's survey reached only patients who chose the system; patients who went elsewhere may value different things. The director plans to interview patients referred to competitors and to repeat the survey after the program opens.

Conclusion

A retired teacher chose her surgery site by trusting her surgeon, listening to a friend and reading reviews, not by comparing prices, and national evidence shows she is typical. Online reviews reveal what patients value, demand for joint replacement is growing and the system's own survey confirms that trust, safety and recovery matter most. Ethical marketing for the program will inform these decisions rather than manipulate them.

References

Mehrotra, A., Dean, K. M., Sinaiko, A. D., & Sood, N. (2017). Americans support price shopping for health care, but few actually seek out price information. Health Affairs, 36(8), 1392-1400. https://doi.org/10.1377/hlthaff.2016.1471

Ranard, B. L., Werner, R. M., Antanavicius, T., Schwartz, H. A., Smith, R. J., Meisel, Z. F., Asch, D. A., Ungar, L. H., & Merchant, R. M. (2016). Yelp reviews of hospital care can supplement and inform traditional surveys of the patient experience of care. Health Affairs, 35(4), 697-705. https://doi.org/10.1377/hlthaff.2015.1030

Shichman, I., Roof, M., Askew, N., Nherera, L., Rozell, J. C., Seyler, T. M., & Schwarzkopf, R. (2023). Projections and epidemiology of primary hip and knee arthroplasty in Medicare patients to 2040-2060. JBJS Open Access, 8(1), e22.00112. https://doi.org/10.2106/JBJS.OA.22.00112