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It Starts With a Question

It Starts With a Question

The need for an answer usually starts with a question. In this case, it was “How does proactively educating clients about pet health insurance impact veterinary teams, pet owners and patient care?”

Why that question? In 2017, I accepted a position as an executive at Crum & Forster Pet Insurance Group. In the new role, I wanted to understand “Why pet health insurance?” I quickly realized that the explanation did not exist.

To find the answer, and with the support of the ASPCA Pet Health Insurance program, I designed and implemented a two-year study. It had three distinct parts:

  • The impact of proactive pet insurance conversations on pet owners and veterinary team members.
  • The influence of insured pets on hospital revenue and patient visits.
  • The significant barriers to having proactive cost-of-care conversations with pet owners and how the barriers were overcome during the study.

How the Study Was Done

Attitudinal surveys of clients and veterinary team members, as well as financial and patient data collection from four geographically diverse, independently owned small animal veterinary hospitals, were conducted. The training of veterinary teams included a conversation about pet health insurance, how insurance works and how insurance can help clients accept clinical recommendations by lessening the financial impact of veterinary care. The training allowed for open discussion, including the veterinary teams’ feelings about proactively discussing insurance. When the veterinary staff raised concerns, ideas were generated on how best to overcome potential challenges. Here’s what was found.

1. The impact on pet owners and veterinary team members.

The study was the first to evaluate the consequences of when veterinary teams proactively educate clients about pet health insurance. Two attitudinal surveys of veterinary teams and clients were done — one in the month the study began and the second in the month after the conclusion of the study.

Notable findings included a 5.3% post-study increase in client satisfaction with their veterinary hospitals. Surveyed clients also reported statistically significant increases in their belief that veterinary teams “care a great deal.”

The results came as no surprise, as clients in prior studies expressed a preference to have proactive cost-of-care conversations. Human studies have found that physicians who educate patients about costs are perceived as caring more.

The positive findings of the study I led were attributed to veterinary teams’ proactive approach to educating clients about pet insurance as a financial solution to future health care needs.

An interesting and unexpected finding was the perception by team members that an increased number of clients accepted medical recommendations. In response to the question “How often do you feel that clients accept the recommendations that you and your team make?” 33% of team members in the post-study period stated “‘almost always” compared to only 3% in the initial survey. Those who felt that clients “almost never” accepted medical recommendations decreased from 40% to 6%.

By using pet insurance education to create a culture where proactive cost-of-care discussions were the norm, team members were empowered to change the narrative from one where they felt their recommendations were constantly rejected or challenged to one where they effectively partnered with clients to find solutions.

2. The influence of insured pets on hospital revenue and patient visits.

This section of the study differed from prior studies in two important ways:

  • Each of the four study hospitals was taught to proactively educate clients about pet health insurance.
  • Client spending and patient visits were tracked by extracting data from each hospital’s practice management software system. This method of financial data collection reflected actual historical spending and provided a more objective measurement of the impact of pet insurance on spending and patient visits. As a control, 50 anonymized hospitals per geographic region were compared against the study data, for a total of 150 benchmarked hospitals.

An unexpected finding over the two-year period was a 30.5% increase in total gross revenue at the four study hospitals. In comparison, the benchmarked hospitals had increased gross revenue of 9.8%. Additionally, the study group’s canine and feline patient numbers substantially outpaced the benchmarked hospitals.

Part of the growth in revenue and patient numbers at the study hospitals likely was related to the improved satisfaction that clients felt toward their hospitals. One of the strongest drivers of new veterinary clients is word-of-mouth referrals, which makes sense given that satisfied clients are more likely to recommend their veterinary hospitals to friends and acquaintances.

Comparing canine patients at the four study hospitals, we found that insured clients spent 12.4% more per dog. Compared to the benchmarked patients, spending on insured hospital dogs was 23% higher.

Visits by insured dogs were 23.8% higher at the four hospitals and 35% more frequent than the benchmarked dogs. At the conclusion of the study, insured canine visits per year averaged six, nearly two more than the non-insured dogs.

By the end of the study, non-insured felines presented 2.8 visits a year at the study hospitals compared with 3.4 visits a year by insured cats.

3. The barriers to proactive cost-of-care conversations and how they were overcome.

The management team at each hospital participated in 30-minute monthly phone calls with the principal study investigator and the study sponsor’s veterinary services manager. We identified five key barriers to proactively educating clients about pet health insurance.

  • Discomfort in talking with clients about insurance. The unease centered not on the cost of care but rather on the lack of competence felt by team members when pet owners asked questions. Confidence grew through training and by gaining the team’s commitment about who would own each part of the conversation.
  • The time requirement and the need for team engagement. Both were necessary to form new habits in support of proactive pet insurance conversations were clients.
  • A lack of ownership in having the insurance conversation with pet owners. Despite the belief that pet insurance would help clients and their pets, many team members were resistant and even resentful about having a client education change dictated to them. The lack of engagement was overcome when teams were empowered to find their own solutions.
  • The need to continually train or retrain team members about pet insurance. Initial and ongoing support is needed to create new habits around proactive insurance conversations. This was especially important for employees hired after the initial team training had occurred.
  • A lack of role modeling by veterinarians. The study hospitals that succeeded most in patient enrollments in pet health insurance had veterinarians who communicated its value to the client. This had the added benefit of reinforcing the importance of the initiative to veterinary teams.

By honoring clients’ wishes to talk about the cost of care, having pet insurance conversations improved the hospital culture, as shown by enhanced client satisfaction. The conversations served as a tool that helped veterinary team members feel empowered when discussing the cost of care.

It is undeniable that insured pets received more care, as proven by increased revenue and patient visits. So, the question I ask you is, “Why not pet health insurance?”

Dr. Wendy Hauser is assistant vice president of veterinary relations at Crum & Forster Pet Insurance Group. She has practiced for 30-plus years as an associate veterinarian, practice owner and relief veterinarian. The founder of Peak Veterinary Consulting, she is passionate about education and innovation.


For additional information about the study and to learn how hospital managers helped teams overcome the five barriers, visit bit.ly/2WGaBnt.