Impact of Healthcare Service Guarantees HMQ Final

8/13/2019 Impact of Healthcare Service Guarantees HMQ Final

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THE IMPACT OF HEALTHCARE SERVICE GUARANTEES ON CONSUMER

DECISION-MAKING: AN EXPERIMENTAL INVESTIGATION

ABSTRACT

While examples of the successful use of service guarantees in healthcare do exist, to-date,

researchers have yet to examine this industry-specific application beyond a case study

perspective. The results of this experiment begin to shed light on whether or not guarantees

should be used, and if so, under what conditions are they appropriate. Respondents indicate that

the thoughtful use of service guarantees can positively impact their perceptions of the healthcare

providers reputation and, ultimately, their behavioral intentions towards the same provider.

However, consideration must be given to the type of guarantee being offered and to whom the

guarantee is targeted.

Keywords: Ser!"e #$%r%&'ees( #$%r%&'ee s"o)e( e*)er!+e&'%, des!#&( e+er#e&"y roo+(

)ys!"%, 'er%)y( os)!'%, +%r.e'!

R$&&! e%d: I+)%"' o/ He%,'"%re Ser!"e G$%r%&'ees


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THE IMPACT OF HEALTHCARE SERVICE GUARANTEES ON CONSUMER

DECISION-MAKING: AN EXPERIMENTAL INVESTIGATION

INTRODUCTION

ervice guarantees, in essence, are !a policy, express or implied, advertised or

unadvertised, that commits the operation to ma"ing its guests happy# $%vans, &lar", and 'nutson

())*, p. +. ncreasingly, many guarantees also ma"e mention of compensation if a level of

service is not achieved $&hen et al. /00). ince &hristopher Hart first wrote about the !1ower

of 2nconditional ervice 3uarantees# in theHarvard Business Reviewin ()44, service

guarantees have received increasingly significant attention in the mar"eting literature $see

Hogreve and 3remler /00) for a comprehensive review. 3iven the abundance of real-world

examples of the successful use of service guarantees by various companies $e.g., 5erry and

1arasuraman ())(6 %vans et al. ())*6 Hart ()44, ())(, ())76 Hart, chlesinger and 8ayer ())/6

9affe ())06 :iden and anden /00;6 8aher ())(6 Winston ())+, it is not surprising that

mar"eting academics turned their attentions towards investigating exactly how and why these

service guarantees wor".

nterestingly, despite /0< years of research, consistent findings have yet to emerge

$Hogreve and 3remler /00), and a gap between practice and theory has presented itself $=abien

/00+. The impact of a guarantee, and thus what guarantee would be most effective for a given

company, seems to vary based on a host of internal and external factors including industry,

company and purchase characteristics $=abien /00+6 'ashyap /00(. 2nfortunately, for a

company wanting to benefit from this stream of research, this inconclusiveness is problematic.

ervice guarantees as applied in some industry settings $e.g., hospitality and tourism, overnight

mail, and traditional retailing have been well-researched, helping those industries fine-tune their

uses of service guarantees. >t the same time, other industries have been neglected. 3iven this

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ramifications. Healthcare industry experts have Euestioned whether mar"eting messages such as

guarantees elevate customer expectations to an unrealistic level which escalates the volume of

malpractice lawsuits $8actravic ()4).

E*),!"!' G$%r%&'ees

Bespite these valid reservations concerning the use of service guarantees in this industry,

some healthcare providers do offer explicit guarantees. ?ne of the first documented uses is the

Belta Bental 1lan of 8assachusetts offer of a !3uarantee of ervice %xcellence# $Hart,

chlesinger, and 8aher ())/. >ccording to Belta Bentals comprehensive service guarantee

program, patients receive refunds when they experience dissatisfaction, including situations

where their Euestion is not immediately resolved, when their transition to Belta Bental is not

smooth, or even when their B card is not accurately and Euic"ly delivered. >nother example is

discussed by 1aEuette $/00( who examines the use of service guarantees by assisted living

facilities. These facilities guarantee residents on-going care regardless of the level needed. n

other words, as a residents health declines, he or she will be allowed to continue to stay at the

assisted living facility and not have to see" new healthcare options. :evy $())) outlines several

examples of service guarantees offered by various healthcare providers. The 2nited Weight

&ontrol &orporation implemented a service guarantee card system whereby instances of

dissatisfaction could be reported and awards of up to @(0 handed out as compensation. 5lue

&ross and 5lue hield of 8assachusetts offered a guarantee that compensated members

expressing dissatisfaction through a written letter up to the cost of ( month of insurance

premiums. 'aiser 1ermanentes outheast region guaranteed service received at the chec"-in

des" and in the waiting rooms. Bissatisfied customers were offered a variety of compensation

including, but not limited to, a telephone call from the offending employee to having their co-pay

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refunded to them. The 8ission ?a"s Hospital in :os 3atos, &alifornia guarantees the wait in its

emergency room. f your wait is more than + minutes, /+A of your bill will be refunded.

imilarly, 8ercy Hospital in 8iami, =lorida guarantees an emergency room wait time of under

70 minutes to see a healthcare professional. f a patient waits longer than 70 minutes, he or she

will receive a letter of apology from the 1resident and &%? along with a first aid "it $8ercy

Hospital /0((.

>s can be seen from the above examples, these service guarantees run the gamut from

limited $e.g., the 8ission ?a"s Hospitals and 8ercy Hospitals emergency room wait to

unlimited $e.g., the Belta Bental 1lans service excellence guarantee, thus highlighting the

scope of the guarantee. The scope refers to what is covered by the guarantee. > guarantee can

be unlimited in nature, and, hence, customer satisfaction pertaining to all aspects of the service is

guaranteed. > guarantee can also be limited in nature. > limited guarantee only guarantees

certain aspects of the service $Hart ())7. These explicit guarantees also highlight variability in

the outcome of invoking the guarantee. f a consumer is not satisfied with the guaranteed aspects

of the service, what will the service provider do to rectify the situation

I+),!ed G$%r%&'ees

n addition to explicit guarantees, many in the healthcare industry choose to offer what

are essentially implicit guarantees of service. n other words, while the service guarantee is not

expressly stated, consumers perceive that a guarantee is still being offered. mplicit guarantees

are usually offered by companies that have built a strong positive reputation for offering Euality

service and for caring about their customers satisfaction. =or instance, the RitD-&arlton does not

offer an explicit service guarantee, but at the same time, its customers perceive the existence of

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an implicit guarantee of service. These customers assume that if they are dissatisfied for any

reason that the RitD-&arlton will remedy the situation.

5asically, many companies are striving to be the RitD-&arlton of the healthcare industry

by putting the mechanisms in place to establish an implicit guarantee in the minds of its current

and future customers. =or instance, the Iorth ?a"s Health ystem in outhern :ouisiana

received significant publicity resulting from achieving the 3old eal of >pproval for healthcare

Euality accreditation from the 9oint &ommission on >ccreditation of Healthcare ?rganiDation

$Hammond Daily Star/007. This 3old eal announcement wor"s to build up Iorth ?a"s

image in the consumers minds. n an informal Euery of consumers who were as"ed to read a

newspaper article discussing the 3old eal, it was uncovered that most felt that they would

receive higher Euality healthcare from this organiDation. ?ther hospitals, such as :a"eside

Hospital in 8etairie, :ouisiana, hint at a guarantee in their advertising, but do not come out and

actually explicitly state one. !&onsidering the time some hospitals ma"e you wait, its no

wonder they call you the patient# is one :a"eside Hospital advertising slogan. :a"eside does not

promise that a patient would have a shorter wait at :a"eside, but it is most certainly implied

$:a"eside Hospital advertisement /007.

H0POTHESES

:i"e their counterparts in other service industries, healthcare mar"eters are constantly

see"ing means by which to differentiate themselves from their competition, to improve the

Euality of their offerings, and to increase customer satisfaction. ervice guarantees offer the

potential to accomplish these obCectives $Hays and Hills /00*6 Hogreve and 3remler /00)6

:ewis ())7. n order to better understand the use of service guarantees in todays competitive

healthcare industry, three hypothesiDed relationships are presented. These relationships, in

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totality, focus on what drives the consumers intention to choose a given healthcare service

provider and are rooted, in part, in economic and mar"et signaling theory which suggests that

warranties and guarantees can serve as cues for reliability and Euality $'elley ()446 'ennett,

neath, and 8enon ()))6 Tsuar and Wang /0(0. n their review of twenty years of service

guarantee research, Hogreve and 3remler $/00) note that only + of (0) studies examine a

guarantees impact on purchase intention despite the Fcritical nature of this relationship.

The bottom line is that a healthcare mar"eter has to decide what type of guarantee to

offer. These choices often include whether to offer a limited explicit guarantee, unlimited

explicit guarantee, or an implied guarantee. The success or failure of a guarantee as a

mar"etplace signal depends, in part, on whether or not the target mar"et finds the guarantee to be

believable. >n unbelievable guarantee may result in the guarantee having no impact, or even a

negative impact, on the consumers evaluation process while a believable guarantee has the

potential to positively impact the consumers choice process. n the context of healthcare, an

unlimited guarantee such as a hospitals promise to guarantee a patients complete satisfaction

seems more li"ely to be perceived as being !too-good-to-be true# $or T3T5T than a hospitals

guarantee that an emergency room wait will be less than 70 minutes. The T3T5T perception is

rooted in cognitive response theory which states that defensive cognitive responses will arise

when a guarantee exceeds or deviates from the consumers standard $3reenwald ()*46 himp

and 5earden ()4/6 Wright ()7.

n addition, a limited explicit guarantee is expected to have a more positive influence on

consumer intention than an implied guarantee. >s documented in the consumer learning and

inference literature, consumers generally rely on information that is salient at the time of

decision ma"ing unless they deliberately see" particular information $Hutchinson and %isenstein


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/004. 5ecause information becomes more salient when it is explicitly, as opposed to implicitly,

presented, it is predicted that the limited explicit guarantee will be more effective than the

implied guarantee. Therefore, the following relationship between the type of guarantee and

intention to choose the promoted healthcare service is hypothesiDedJ

H1: Consumers intention to choose the promoted healthcare service will be higher in the

presence of a limited eplicit !versus unlimited eplicit and implicit" service guarantee.

>n important issue when offering a service guarantee is to ensure that the guarantee

covers aspects of the service that are important to the targeted customer $?strom and acobucci

())4. &onsumers understanding of a service and their needs with respect to a service should

evolve with experience $8urray ())(6 1arasuraman, Keithaml, and 5erry ()4+6 Largo and

:usch /004. Iot surprisingly, experience plays a moderating role in many consumer studies

$e.g., 5ennett, Hartel, and 8c&oll-'ennedy /00+6 &astaneda, 8unoD-:eiva and :uEue /006

harma and 1atterson /000. t is hypothesiDed that a consumers healthcare experience will

moderate the relationship between type of guarantee and purchase intention. > more

experienced healthcare consumer will have more "nowledge on which to rely when assessing a

guarantee.

H2:#he influence of a limited eplicit !versus unlimited eplicit and implicit" service guarantee

on consumers intention to choose the promoted healthcare service will be moderated by

their healthcare service usage $uantity in the past as follows%

H2a:&or consumers with high healthcare service usage' their intention to choose the

promoted healthcare service will be positively impacted by an limited eplicit !versus

unlimited eplicit and implicit" service guarantee

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H2b:&or consumers with low healthcare service usage' their intention to choose the

promoted healthcare service will be less likely to be impacted by a limited eplicit

!versus unlimited eplicit and implicit" service guarantee.

3iven the role of reputation and image in the healthcare decision $%xworthy and

1ec"ham /00*6 'im et al. /004, the reputation of the healthcare provider offering a given

guarantee is included as a final, critical consideration. &onsumers form reputations based on

information and experience $&arauana ()). Reputation, in turn, has been shown to impact

buyer response $Torres, LasEueD-1arraga, and 5arra /00)6 Moon, 3uffey, and 'iCews"i ())7.

ervice guarantee researchers have documented the role of company reputation on the evaluation

process $i.e., :iden and %dvardsson /0076 WirtD, 'um, and :ee /000 and conclude that firm

reputation does impact the ability of service guarantees to influence customer evaluations both

positively or negatively $'ashyap /00(. 5ecause, compared to naNve healthcare consumers,

more experienced healthcare consumers are more li"ely to understand the diagnostic value of

corporate reputation in assessing service guarantees, they should be expected to be more

sensitive to the role of reputation and image $%lbei" ()4*6 'im et al. /004, and as such, the

following hypothesis is proposedJ

H3:#he influence of a limited eplicit !versus unlimited eplicit and implicit" service guarantee

on consumers intention to choose the promoted healthcare service will be more likely to be

mediated by their perceived reputation of the hospital if their healthcare service usage

$uantity was high' rather than low as follows%

H3a:&or consumers with high healthcare service usage' the influence of a limited eplicit

guarantee on consumers behavioral intention will be mediated by their perceived

reputation of the hospital

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H3b:&or consumers with low healthcare service usage' the influence of a limited eplicit

guarantee on consumers behavioral intention will be less likely to be mediated by their

perceived reputation of the hospital

METHOD

P%r'!"!)%&'s %&d Des!#&

Three hundred six people participated in this study. Bata was collected using a variation

of snowball sampling in which undergraduate students at two outheastern 2.. universities

were given extra credit for securing responses from Eualifying adults. The students, themselves,

were not allowed to participate in the research. Random chec"s to ensure reliability of responses

received were employed. The demographic profile of the participants is summariDed in Table (.

> maCority of them were &aucasian and aged /+ or higher with an annual household income of

@;),))) or less. >bout half of the participants were females and singles.

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1lace Table ( about here-------------------------------------------

The current study used a 7 $service guarantee typeJ implicit vs. limited explicit vs.

unlimited explicit x / $healthcare service usage EuantityJ high vs. low x / $healthcare settingJ

emergency care vs. physical therapy rehab between-subCects design. The service guarantee type

and healthcare setting were manipulated while participants healthcare service usage Euantity

was measured.

The service guarantee type was manipulated using three scenarios that differed in

explicitness and scope of the service guarantee of a promoted hospital. 1articipants in the

implicit service guarantee condition in the emergency care$physical therapy setting readJ

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!When you need emergency care$physical therapy, turn to the(mergency Care Center

$)hysical Rehab Center at River 1ar" Regional Hospital. We offer high-Euality, caring nurses

and doctors $therapists and state-of-the-art triage rooms$rehabilitation facilities and

eEuipment to the citiDens of southeastern :ouisiana. ?ur personnel are professionally Eualified

and board-certified, and our award-winning hospital is fully accredited by the >merican Hospital

>ssociation.#

n contrast, participants in the two different explicit service guarantee conditions were

presented with an additional statement that openly guaranteed a certain level of services provided

by a hospital. While Hill and 9oonas $/00+ find that patients wait time negatively influences

their Euality perception and satisfaction, a maCority of them considered 70 minutes or less an

acceptable amount of wait time to see a doctor. To maintain the perceived attractiveness of the

service guarantee within a reasonable range, the current study used 70 minutes and (0 minutes as

thresholds for the guaranteed wait time in the emergency care and physical therapy settings,

respectively. Thus, participants in the limited explicit service guarantee condition were informed

that the hospital guaranteed that they would not have to wait more than *+ minutes$,+ minutes

when they needed emergency care treatment$physical therapy. Those in the unlimited explicit

service guarantee condition, on the other hand, were notified that the hospital guaranteed that

they would feel assured by its caring, professional staff when they needed emergency care

treatment$physical therapy.

>dditionally, healthcare service usage Euantity was measured by how often participants

visited their doctors office over the last year. 1eople in the high healthcare service usage

condition were defined as those who visited the doctors office multiple times while people in

the low healthcare service usage condition were defined as those who visited the doctors office

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no more than once in the previous year. This dichotomiDation procedure led to a larger number

of consumers in the high $-O */A, as opposed to low $-O 74A, healthcare service usage

conditions. Met, these categorical distinctions mirror the modal number of healthcare visits

within a (/ month period by 2.. citiDens where ;A of the interview respondents actually

visited the doctors office ( to 7 times in /00) $2.. Bepartment of Health and Human ervices

/0(0.

Pro"ed$re

1articipants were told to read a scenario and then provide their thoughts about a hospital

described in the scenario. To ensure that respondents opinions reflected their genuine reactions

to the information presented, a hypothetical hospital name, River 1ar" Regional Hospital, was

used. >fter participants read the scenario, they were presented with Euestions about the hospital

and its service guarantee messages. =irst, perceived explicitness of the guarantee was measured

by an open-ended Euestion $!f you are not satisfied with the Euality of care received and you

expressed your dissatisfaction to management, what do you thin" would happen#.

1articipants responses were recorded on a dichotomiDed scale, ranging from ( $problems are

examined and corrected, ll get refunded, ll be satisfied to 0 $nothing will happen.

econd, perceived scope of the service guarantee was measured on a -point semantic

differential scale with ; items $! feel that the hospital in this scenario isPhas QQQ# to see if an

unlimited explicit service guarantee was perceived to offer a broader range of caring and

professional services than a limited explicit service guarantee. The scale ranged from ( $lac"s

complete services, uncaring reverse scaledS, unprofessional reverse scaledS, incompetent

physicians to $offers complete services, caring, professional, competent physicians

$&ronbachs O .0.

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Third, perceived reputation of a hospital was measured on a -point semantic differential

scale with ; items $! feel that the hospital in this scenario isPhas QQQ#. t ranged from ( $poor

reputation, uninvolved in the health concerns of the community, inconvenient to use,

discourteous employees to $excellent reputation, involved in the health concerns of the

community, convenient to use, courteous employees $&ronbachs O .*4. These measures are

adapted from the hospital image measures employed by 'im et al. $/004.

=ourth, behavioral intention to select a promoted hospital was measured on an ((-point

semantic differential scale with one item $!f you needed emergency care$physical therapy,

how li"ely would you be to choose this particular hospital#. t ranged from 0 $very unli"ely to

(0 $very li"ely.

=inally, various demographic Euestions were measured. >mong them, participants age

and the presence of a primary $personal or family physician were included as covariates in the

hypothesis test below.

RESULTS

M%&!)$,%'!o& Ce".s

To chec" for a manipulation of explicitness of the service guarantee, a logistic regression

analysis was run on perceived explicitness of the guarantee. >s expected, the result showed that

the participants in the explicit service guarantee conditions $-O *+.7A were more li"ely to

mention successful resolution when their dissatisfaction was brought to the hospitals attention

than those in the implicit service guarantee condition $-O +;.*A,

/

O 7.0;,pU .0). This

finding was consistent with the manipulation of explicitness of the service guarantee of the

study.

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To chec" for a manipulation of scope of the service guarantee, perceived scope of the

service guarantee was assessed. >s anticipated, the participants in the unlimited explicit service

condition $-O +.+, SDO .) felt that the service guarantee coverage was generally broader

than those in the limited explicit service guarantee condition $-O +.;*, SDO (.0;,& $(, ()) O

;.(;,pU .0+. Thus, the manipulation of the service guarantee scope was also successful.

The results below were collapsed across two different scenario settings $emergency room

and physical therapy because they did not interact with "ey predictors of behavioral intention.

A& I&/,$e&"e o/ % Ser!"e G$%r%&'ee Ty)e o& % Be%!or%, I&'e&'!o& 1H23

>s predicted, a limited explicit service guarantee positively influenced consumers

li"elihood to choose the promoted healthcare service, compared to unlimited explicit and implicit

service guarantees. &onsumers were more li"ely to pic" the promoted healthcare service when

they were presented with the limited explicit service guarantee $-O .*+, SDO (.4;, rather than

the other service guarantees $-O .//, SDO /.0+,& $(, 700 O 7.7/,pU .0. Thus, H( was

marginally supported.

A Moder%'! Ro,e o/ % He%,'"%re Ser!"e Us%#e 4$%&'!'y 1H53

> / $service guarantee typeJ limited explicit vs. unlimited explicit and implicit x /

$healthcare service usage EuantityJ high vs. low >I?L> was conducted to test H/. >s

expected, the influence of a service guarantee type on consumers behavioral intention depended

on their healthcare service usage Euantity in the past $&$(, /) O 7.0/,pU .0).

&onsistent with H/a, for consumers with high healthcare service usage, their intention to

choose the promoted healthcare service increased when they were presented with a limited

explicit guarantee $-O .)*, SDO (.)*, rather than unlimited explicit and implicit guarantees

$-O .(*, SDO /./, $&$(, (+) O +.0;,pU .07. Thus, H/a was supported. > post-hoc

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comparison was performed to understand the source of the difference in behavioral intention. t

revealed that consumers in the limited explicit guarantee condition exhibited significantly higher

behavioral intention than those in the implicit guarantee condition $-O *.;, SDO /.*/,&$(,

(0* O .+,pU .00* $see Table /.

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1lace Table / about here-------------------------------------------

=urthermore, consistent with H/b, for consumers with low healthcare service usage, their

intention to choose the promoted healthcare service did not change, regardless of the service

guarantee type $limited explicit guaranteeJ-O .70, SDO (.*76 unlimited explicit and implicit

guaranteesJ-O .7/, SDO (.+6&$(, (7* U (,pV .) $see Table /. Thus, H/b was also

supported.

A Med!%'! Ro,e o/ Per"e!ed Re)$'%'!o& 1H63

2sing the analytic procedure suggested by 5aron and 'enny $()4*, the current study

tested whether consumers perceived reputation of the promoted healthcare service would

mediate the impact of a service guarantee type $limited explicit guarantee vs. unlimited explicit

and implicit guarantees on behavioral intention. This study examined if the mediating role of

perceived reputation would be Eualified by the Euantity of consumers healthcare service usage

in the past $i.e., mediated moderation. >s expected, the interaction between the service

guarantee type and healthcare service usage Euantity had a significant influence on consumers

perceived reputation $bO .(/, S(O .0*, tO /.04,pU .0; and behavioral intention $bO ./(, S(

O .(/, tO (.;,pU .0). 1erceived reputation also increased behavioral intention $bO (.0+, S(O

.(0, tO (0.0;,pU .000(. The direct interactive effect between the service guarantee type and

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healthcare service usage Euantity on behavioral intention became insignificant $bO .04, S(O .((,

tO .7,pV .; after controlling for perceived reputation $obelsO (.)*,pO .0+.

pecifically, it was predicted that the meditating relationship would be observed only

when consumers healthcare service usage Euantity was high, but not when it was low. The

results of a series of regression analyses to test H7a and H7b are presented in =igure (.

-------------------------------------------

1lace =igure ( about here-------------------------------------------

=or consumers with high healthcare service usage, the presence of the limited explicit

service guarantee, compared to the unlimited explicit and implicit guarantees, significantly

increased consumers perceived reputation $bO .(4, S(O .04, tO /./+,pU .07 and behavioral

intention $bO .;0, S(O .(4, tO /./+,pU .07. 1erceived reputation also showed a significant

effect on behavioral intention $bO (.0, S(O .(*, tO *.4/,pU .000(. The direct effect of the

service guarantee type on behavioral intention became insignificant $bO .//, S(O .(*, tO (.7;,

pV .( after controlling for perceived reputation $obelsO /.(/,pU .0;. Thus, the tests

supported full mediation consistent with H7a.

=or consumers with low healthcare service usage, the service guarantee type did not

influence consumers perceived reputation $bO -.0*, S(O .04, t U (,pV .; and behavioral

intention $bO -.0(, S(O .(+, t U (,pV .*. 1erceptual reputation did not mediate the influence

of the service guarantee type on behavioral intention. Thus, H7b was also supported.

DISCUSSION AND IMPLICATIONS

ervice guarantees have long been viewed as beneficial mar"eting tools. However, the

use of these guarantees in healthcare is considered ris"y due to the nature of the industry. While

examples of the successful use of guarantees in healthcare do exist, to-date, researchers have yet

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to examine this industry-specific application beyond a case study perspective. The results of this

study begin to shed light on whether or not healthcare service guarantees should be used, and if

so, under what conditions are they appropriate.

The findings suggest that the thoughtful use of service guarantees can positively impact

the consumers perceptions of the healthcare providers reputation and ultimately, their

behavioral intentions towards the same healthcare provider. However, consideration must be

given to the type of guarantee being offered and to whom the guarantee is targeted. >s seen in

H(, a limited explicit guarantee results in higher behavioral intention. This is not surprising

since a limited explicit guarantee intuitively seems more believable. &ognitive response theory

suggests that consumers will discount unbelievable guarantees and that unbelievable guarantees

can even negatively impact the decision process $3reenwald ()*46 himp and 5earden ()4/6

Wright ()7. >lso, a limited explicit guarantee is the most concrete of the guarantee offerings

resulting in a higher li"elihood of inclusion of the guarantee in this same decision process as

shown in consumer learning and inference literature $Hutchinson and %isenstein /004. :astly,

as manipulated in this study, the limited explicit service guarantee is focused on the business-

oriented aspects of the service offering as opposed to the medicine-oriented applications $:ewis

())7. t will always be critical for healthcare mar"eters to guarantee what can be controlled. n

general, the results of this study indicate that healthcare providers should gravitate toward the

offering of a limited explicit guarantee.

The impact of this limited explicit guarantee on purchase intention is moderated by the

consumers healthcare service usage. &onsumers categoriDed as having high healthcare usage

were more positively swayed by the limited explicit service guarantee than those consumers who

reported low healthcare service usage. Therefore, the use of a guarantee may be particularly

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meaningful when targeting the experienced healthcare consumer and less successful when

targeting consumers with limited experience.

imilarly, the experienced healthcare consumer seems to rely on the service guarantee as

an indicator of the providers reputation which in turn impacts behavioral intention. The

mediating effect of provider reputation is not apparent for consumers with little to no healthcare

experience. f targeting experienced healthcare consumers, healthcare providers that have

established reputations in a mar"etplace must thin" about how the guarantee interacts with

existing reputation. However, this interaction is less of an issue if targeting inexperienced

consumers andPor if the provider has no discernable reputation. 2nder the right conditions, a

service guarantee can serve not only to increase immediate purchase intention, but to enhance

image.

>ccording to the &enters for Bisease &ontrol and 1revention $/004, the number of visits

to physician offices and hospital outpatient and emergency departments has increased by twenty-

six percent over a ten year period. The result of this trend is more experienced healthcare

consumers. :ogically, healthcare mar"eters should be able to leverage the use of service

guarantees to attract this experienced populace. =urther examination of trends among specific

segments of the mar"et $i.e., HispanicP :atino and >frican->merican healthcare consumers

should help to craft relevant guarantees and ma"e related promotional decisions $e.g., >s"im-

:ovseth and >ldana /0(06 5all, :iang, and :ee /00).

:astly, results of this study also indicate the ability to generaliDe the findings across

various healthcare settings. The experiment was conducted using emergency room and physical

therapy applications. Io differences in results were found across settings. The impact of the

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limited service guarantee should be relevant for all healthcare mar"eters regardless of the

specific services they are mar"eting.

LIMITATIONS AND FUTURE RESEARCH

The current study assesses the impact of the scope of the guarantee on discernible

consumer perceptions and behaviors. t does not examine the outcome of invo"ing the guarantee

and how it impacts these same variables. =uture researchers are encouraged to extend the current

experimental design to include an outcome of invo"ing the guarantee manipulation. 1revious

research indicates that this manipulation and its interaction with the scope of the guarantee can

be meaningful $'ennett, 5ernhardt and neath ())). t would be enlightening to extend the

current research to examine not only what type of guarantee should be offered, but also to

understand what a healthcare provider should offer if the guarantee is invo"ed. f, for instance,

someone waits longer than 70 minutes in an emergency room, how should the consumer be made

whole s an apology sufficient hould a co-pay be refunded ?r should no outcome be

mentioned

=uture researchers are also encouraged to replicate the existing research using consumers

in other geographical settings. t is plausible that uniEue mar"eting approaches employed by

healthcare providers in a given geographic mar"et might heighten or lessen the impact of a

guarantee. =or instance, respondents in this study live in a mar"et in which healthcare service

guarantees have been employed. Would consumers in a mar"et in which healthcare service

guarantees are not employed react differently to the introduction of a guarantee t is

conceivable that consumer experience not only with healthcare in general, but with healthcare

guarantees, is an important moderating variable.

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REFERENCES

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//
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Moon, %ungsang, Hugh 9. 3uffey, and Laleria 'iCews"i. !The %ffects of nformation and&ompany Reputation on ntentions to 5uy a 5usiness ervice.#0ournal of BusinessResearch/, no. 7 $())7J /(+-/4.

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http://www.plunkettresearch.com/health%20care%20medical%20market%20research/industry%20overviewhttp://www.plunkettresearch.com/health%20care%20medical%20market%20research/industry%20overviewhttp://www.plunkettresearch.com/health%20care%20medical%20market%20research/industry%20overviewhttp://web.ebscohost.com.ezproxy.uno.edu/ehost/viewarticle?data=dGJyMPPp44rp2%2FdV0%2Bnjisfk5Ie46bZQtaiuS7Wk63nn5Kx95uXxjL6prUqupbBIr6eeUbimrlKupp5oy5zyit%2Fk8Xnh6ueH7N%2FiVaunsk%2Bzr65QsKuuPurX7H%2B72%2Bw%2B4ti7evLepIzf3btZzJzfhruqsk2uprJKsJzkh%2FDj34y73POE6urjkPIA&hid=17http://web.ebscohost.com.ezproxy.uno.edu/ehost/viewarticle?data=dGJyMPPp44rp2%2FdV0%2Bnjisfk5Ie46bZQtaiuS7Wk63nn5Kx95uXxjL6prUqupbBIr6eeUbimrlKupp5oy5zyit%2Fk8Xnh6ueH7N%2FiVaunsk%2Bzr65QsKuuPurX7H%2B72%2Bw%2B4ti7evLepIzf3btZzJzfhruqsk2uprJKsJzkh%2FDj34y73POE6urjkPIA&hid=17http://www.cdc.gov/nchs/data/hus/hus10.pdf#079http://www.bls.gov/oco/cg/cgs035.htmhttp://www.plunkettresearch.com/health%20care%20medical%20market%20research/industry%20overviewhttp://www.plunkettresearch.com/health%20care%20medical%20market%20research/industry%20overviewhttp://web.ebscohost.com.ezproxy.uno.edu/ehost/viewarticle?data=dGJyMPPp44rp2%2FdV0%2Bnjisfk5Ie46bZQtaiuS7Wk63nn5Kx95uXxjL6prUqupbBIr6eeUbimrlKupp5oy5zyit%2Fk8Xnh6ueH7N%2FiVaunsk%2Bzr65QsKuuPurX7H%2B72%2Bw%2B4ti7evLepIzf3btZzJzfhruqsk2uprJKsJzkh%2FDj34y73POE6urjkPIA&hid=17http://web.ebscohost.com.ezproxy.uno.edu/ehost/viewarticle?data=dGJyMPPp44rp2%2FdV0%2Bnjisfk5Ie46bZQtaiuS7Wk63nn5Kx95uXxjL6prUqupbBIr6eeUbimrlKupp5oy5zyit%2Fk8Xnh6ueH7N%2FiVaunsk%2Bzr65QsKuuPurX7H%2B72%2Bw%2B4ti7evLepIzf3btZzJzfhruqsk2uprJKsJzkh%2FDj34y73POE6urjkPIA&hid=17http://www.cdc.gov/nchs/data/hus/hus10.pdf#079http://www.bls.gov/oco/cg/cgs035.htm


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Impact of Healthcare Service Guarantees HMQ Final

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