A Complete Guide to NPS in Healthcare

Learn what NPS is, how to calculate it, what is a good NPS score, and how healthcare organizations use it to measure and improve customer satisfaction and loyalty.
May 24, 2024
6 min

Companies across industries use the Net Promoter Score (NPS) to continuously track customer satisfaction and ultimately drive growth by turning satisfied customers into loyal advocates.

Healthcare providers use NPS surveys to better understand patient experiences and continuously measure and improve their satisfaction and loyalty.

When combined with gathering feedback, NPS indicates how well the changes and improvements you made in your clinic are resonating with your patients.  

What is the Net Promoter Score?

NPS is a metric that measures customer loyalty and satisfaction by asking how likely customers are to recommend a product or service to others.

An infographic showing what is NPS, how to calculate it, and what is a good NPS score.

Imagine asking a friend or a family member if they would recommend their dental clinic to you. Their enthusiastic or hesitant answer will tell you a lot about how much they trust and appreciate the dental care they receive.

NPS is measured through a single, straightforward question:

On a scale from 0 to 10, how likely are you to recommend our product or service to a friend or colleague?

The NPS question is often followed by an open-ended question in which the person can explain why they gave the score they gave. Together, these two questions provide invaluable insight into patient experience and satisfaction.

Based on the score they give, customers are categorized into three groups:

  • Promoters (scores 9-10): Your biggest fans who will spread positive word-of-mouth.
  • Passives (scores 7-8): Satisfied but not enthusiastic customers who might easily switch to competitors.
  • Detractors (scores 0-6): Unhappy customers who could potentially harm your brand’s reputation through negative reviews.

The reasoning behind the creation of the three categories, as well as their respective scoring brackets, were all based on extensive research into customer behavior and its correlation with business growth.

The formula for calculating NPS

To calculate NPS, just subtract the percentage of Detractors from the percentage of Promoters.

For example, imagine you survey 200 customers and get the following results:

  • 100 Promoters (50%)
  • 60 Passives (30%)
  • 40 Detractors (20%)

Your NPS would be:

NPS = %Promoters − %Detractors

NPS = 50% − 20% 

NPS = 30

What is a good NPS for healthcare providers?

The scale for NPS ranges from -100 to +100. Generally, a positive NPS is considered good, with anything above 0 indicating more promoters than detractors. A score above 30 is considered strong, and a score above 50 is excellent​​.

In healthcare, the average NPS varies depending on the source, but it is generally reported to be around 38​ ​. This suggests that, on average, healthcare providers have more promoters than detractors, reflecting a reasonably high level of patient satisfaction. 

The three NPS categories in more detail

The three-category system simplifies the understanding and analysis of feedback, making it easier for organizations to identify and act on areas needing improvement. The categorization and scoring were based on empirical data showing that these groups correlated well with future customer behaviors critical to growth — e.g., repurchases and referrals.

Categorizing customers into these three groups helps organizations tailor their strategies to address the needs and behaviors of each segment. For instance, efforts can be made on converting Passives to Promoters — a frequently overlooked method, often overshadowed by Detractor numbers.

The Promoters

With their scores being 9 or 10, Promoters are highly satisfied and enthusiastic customers who are likely to exhibit behaviors that drive growth. 

They are loyal and enthusiastic supporters who will keep buying and referring others, fueling organic growth. Promoters tend to have a high lifetime value, engage in positive word-of-mouth marketing, and often provide constructive feedback that helps improve the business.

The Passives

Passives are generally satisfied but lack the enthusiasm to actively promote the product or service. They are vulnerable to competitive offerings and might switch if they find a better option. 

The scores of 7 and 8 indicate satisfaction but not strong loyalty or enthusiasm. These customers are content with the product or service but do not feel a strong connection to the brand which would drive them to actively promote it. They are at risk of churn if not adequately engaged and converted into Promoters.

The Detractors

Detractors are unhappy customers who can damage the brand and impede growth through negative word-of-mouth. Their scores range from 0 to 6, reflecting varying degrees of dissatisfaction.

Detractors are likely to churn, discourage others from purchasing, and may even generate negative publicity, which can be detrimental. With varying levels of negative feelings towards the product or service — from mild dissatisfaction to strong discontent — Detractors are likely to detract (pun intended) from the brand's reputation.

Now, this is all very practical, but how and when was NPS first introduced? And, most importantly, why?

The history of NPS

NPS was developed by Fred Reichheld, a partner at the management consulting firm Bain & Company, along with the company Satmetrix. The concept was introduced in Reichheld's 2003 Harvard Business Review article titled "The One Number You Need to Grow."

Reichheld and his colleagues conducted extensive research to determine the most effective way to measure customer loyalty. They found that a single question about the likelihood of recommending a company was strongly correlated with customer behavior and business growth. 

There were a number of customer satisfaction metrics in use before the advent of NPS like:

  • Customer Satisfaction Surveys (CSAT) 
  • Customer Loyalty Index (CLI)
  • Customer Effort Score (CES) 
  • Customer Retention Rate 

These traditional metrics were good at measuring current or past customer satisfaction but fell short in predicting future behavior such as loyalty and advocacy. 

What changed with NPS was that it boiled down customer sentiment to a single, straightforward question. This simplicity made it easy to understand and act upon.

The open-ended follow-up question ("What is the primary reason for your score?") provided qualitative information that helped understand the drivers behind the score. 

Finally, dividing respondents into Promoters, Passives, and Detractors, is highly indicative of the customer base's overall health and allows organizations to tailor their strategies to each group.

Net Promoter Score in the healthcare industry

Systematically and continuously monitoring NPS brings a host of benefits for organizations, and the healthcare sector is no exception. Clinics can use it to:

  • Track patient satisfaction and loyalty over time: Healthcare providers can keep a pulse on how patients feel about their care at different points in time. Patient sentiments can change due to various factors like wait times or facility conditions; tracking NPS helps providers detect these changes early and respond accordingly.
  • Identify trends and patterns: Identify what aspects of care are working well and what needs improvement (for example, a declining NPS may signal emerging issues).
  • Respond to patient feedback promptly: Systematic monitoring ensures that healthcare providers can promptly address patient concerns and feedback. This  improves patient satisfaction, reduces complaints, and fosters trust.
  • Drive patient loyalty and referrals: High NPS is linked to patient loyalty, repeat visits, and referrals. Monitoring NPS helps identify and nurture Promoters who are likely to recommend the healthcare provider to others, leading to organic growth through word-of-mouth referrals.
  • Measure the impact of changes: Tracking NPS before and after implementing changes helps measure the impact of those changes. This enables healthcare providers to understand which initiatives are effective in improving patient satisfaction.
  • Benchmark performance: NPS monitoring allows healthcare providers to benchmark their performance over time and against industry standards, as well as set realistic goals for improvement.
  • Foster a patient-centric culture: A focus on NPS instills a patient-centric mindset. When medical staff are aware that patient feedback is consistently monitored and acted upon, they are more likely to prioritize patient satisfaction in their daily tasks.
  • Improve patient retention: Continuously addressing the needs and concerns of patients can enhance retention rates. And retaining existing patients is often more cost-effective than attracting new ones.

Regularly tracking and responding to NPS and patient feedback will ensure that healthcare providers are en route to their end goal — meeting patient expectations and continuously improving the quality of care.

Use InsiderCX to run NPS surveys

InsiderCX is a comprehensive patient experience platform designed to help healthcare providers systematically collect, analyze, and implement improvements based on patient feedback

The platform automatically sends white-labeled surveys to patients 24 to 48 hours after their visits through mobile channels like SMS, WhatsApp, or Viber. Most of the surveys we help clinics design and send contain the NPS question, followed up by an open-ended question in which patients can explain why they gave that score. 

The platform immediately processes the collected feedback and classified patients into one of the three groups. All collected feedback, including the NPS score and explanation, is accessible in real-time inside our simplistic dashboard:

A screenshot of the InsiderCX platform dashboard.

Lastly, InsiderCX integrates with basically any CRM or EHR system out there which helps you keep all captured patient interactions and feedback in one place.

Learn how Affidea, one of the largest healthcare providers in Europe, used InsiderCX to improve their NPS score from 64 to 81  

The key takeaway

Understanding and actually using NPS can transform the way healthcare providers connect with their customers and patients, building stronger, more loyal relationships.

Based on our extensive experience in the healthcare industry, we can boil down our advice to two words: start today

Make sending patient satisfaction surveys a regular part of your quality control workflow. Listen to what your Promoters are praising, understand what makes your Passives indifferent, and address the concerns of your Detractors.

NPS can guide you towards a future where each and every patient feels valued, heard, and cared for. And the journey starts with one single question!

InsiderCX Editorial Team
This article was researched, written, polished, and published by the InsiderCX editorial team.

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