Patient Engagement Will Be Healthcare’s Next Breakthrough
Editor’s note: This is part of a series of articles on patient engagement.
Healthcare has transformed over the past 50 years — through public insurance, managed care, sweeping policy shifts, digitization, and a pandemic-driven push to adopt technologies like virtual care. Each wave reshaped how care is financed, delivered, and scaled. Yet none has redefined the patient as a strategic driver of value.
We believe the next decade will be marked by a shift toward patient-driven value, where patient engagement is not a downstream side effect, but a central, intentional lever that is designed, activated, and measured from the start.
A focus on the patient isn't new
It’s been over 100 years since William J. Mayo, MD, famously said, “The best interest of the patient is the only interest to be considered.” Yet as healthcare scaled in complexity, the patient’s best interest became increasingly entangled with the demands of system performance and economic viability. Some might say the patient was gradually — and perhaps unintentionally — pushed out of the bed.
There’s been no shortage of patient-centric movements — from satisfaction metrics to digital access to shared decision-making. While each added value and the industry has made progress in improving experience, none fundamentally redefined the patient’s role in influencing affordability and delivering outcomes.
As the cost of care climbs and clinical performance stalls, patient centricity, particularly patient engagement, can no longer be treated as a soft metric or downstream benefit. Whether in fee-for-service environments where revenue depends on timely utilization, or in value-based contracts tied to outcomes and cost, engagement is a multiplier. We've identified six domains of patient action that health systems can use today and that patients themselves are signaling they want help with.
When combined with existing transformation efforts, these domains offer a force multiplier: Provider innovation + patient engagement = exponential return.
The six domains of patient engagement
Three tailwinds are accelerating what’s possible. First, healthcare systems have invested in digital tools, analytics platforms, and community partnerships, but these assets have been underutilized and misaligned in driving patient action. Second, artificial intelligence (AI) has matured, enabling personalized outreach, predictive risk modeling, and real-time support at scale. Third, an ecosystem of capable partners now exists — from startups to research institutions to big tech — offering ready-made, plug-in solutions that can close capability gaps and accelerate implementation. Combined, these forces make it not only possible, but practical, to drive engagement as a core lever of system performance.
These domains are practical levers that can be designed for, measured, and scaled. Each unlocks value when patients are supported to act.
1. Adhering to Treatment Plans: Adherence remains one of the most persistent barriers to quality and efficiency in healthcare. In both value-based and fee-for-service environments, nonadherence drives inefficiency – through avoidable readmissions in the former and missed billable encounters in the latter. Roughly half of all patients fail to fully adhere to their prescribed course of care. Based on a review of various studies, medication non-adherence results in between $100 billion to $290 billion in avoidable spending annually, including preventable hospitalizations, disease progression, emergency department visits, and unnecessary testing. The infrastructure to address it already exists, but is not aligned to support patient action. AI tools are starting to identify who is at risk of falling off track and trigger timely, personalized interventions. This will increase in scale and accuracy, but we also need a cultural shift from adherence being seen as a patient failing to a design challenge where the existing infrastructure enables more timely, personalized, and actionable interactions.
2. Self-Managing and Monitoring: Patients who actively observe and respond to their own health have a greater impact on clinical stability, avoid unnecessary care, and reduce the total cost of care. This is especially relevant for chronic diseases, which account for nearly 90% of total healthcare spending in the US, with a significant portion stemming from inadequate self-management. If just 10% of people with a chronic disease participated in self-management programs, $6.6 billion would be saved annually. A growing ecosystem of digital health companies offers turnkey solutions to assist patients in managing their health from home. We need a shift to align these resources with AI driven alerts and recommendations and view this as a clinical asset rather than solely a patient responsibility.
3. Engaging in Preventative Care: Encouraging preventative care has long been the most elusive form of patient engagement. Despite near-universal insurance coverage for most preventive services, uptake remains low, with studies showing that only 8% of US adults receiving all recommended services. That is shifting, albeit slowly and unevenly. Financial incentives tied to prevention have increased, particularly in Medicare Advantage, accountable care organizations, and shared-risk arrangements. The infrastructure exists — registries, portals, customer relationship management tools — but often fails to change behavior. What’s needed now is smarter segmentation and dynamic prioritization. The next generation of preventative care depends not just on knowing who needs care, but on knowing when, why, and how they’re most likely to act. Shifting toward real patient engagement as a lever of system performance will unlock the full potential of prevention.
4. Becoming Informed and Educated: Only 12% of US adults are proficient in health literacy, 88% of US adults lack the skills needed to navigate the health system and make appropriate health decisions. That means nearly 9 in 10 adults struggle to understand health-related instructions, insurance benefits, or test results. The consequences are real: higher hospitalization rates, lower medication adherence, and increased mortality. It also drives up avoidable utilization which costs the US healthcare system an estimated $238 billion annually. The infrastructure now exists to address these gaps with AI and natural language processing tools can now simplify medical language in real time, while intelligent learning platforms can tailor content to patient knowledge levels and preferences. Activating this kind of innovation will shift patient education from simply sending information to helping patients absorb it, contextualize it, and use it to better manage their care.
5. Actively Communicating with Providers: Communication failures are responsible for an estimated 30% of malpractice claims, costing the industry over $1.7 billion annually. In care transitions, breakdowns in communication drive a significant portion of hospital readmissions with estimates suggesting that up to 20% of readmissions could be prevented through clearer discharge instructions and structured follow-up. Things are shifting as digital tools now enable more scalable, proactive, and bi-directional communication. AI-enabled tools can detect language associated with clinical deterioration, flag urgency in message content, or help triage questions to the right team member. The big opportunity is to reframe communication as a core competency in care delivery. Communication isn’t just about empathy. It’s about system resilience and cost control.
6. Participating in Care Coordination: While care coordination is often treated as a clinical or operational task, much of its success hinges on what the patient does and whether the system is designed to help them do it. The opportunity is to make participating in coordination both easier and expected. True progress requires shifting the orientation from “care coordination on behalf of patients” to “care coordination with patients.” As risk-bearing models expand and care decentralizes, coordination will depend not just on network integration, but on engaging patients to be active, informed partners in their own care journeys.
A new mandate for healthcare leaders
Across these six domains, the message is clear: patient engagement is no longer a soft measure or philosophical ideal. It’s a practical, performance-driving lever — one that directly influences clinical quality, total cost of care, and system sustainability. The behaviors outlined here aren’t new, but the ability to activate them at scale is.
The infrastructure is in place. The technology is ready. Patients are signaling they want more support, more clarity, and more connection. What’s needed is leadership that treats engagement as a design requirement that’s embedded into care models, workflows, incentives, and performance measures.
For a typical mid-sized health system managing a few hundred thousand patients, the opportunity is substantial. We estimate that $20 million to $50 million annually is left on the table due to disengaged patients. Improvements in adherence, follow-through, screening rates, and early interventions can unlock real value. These aren’t speculative returns; they’re grounded in national benchmarks and proven initiatives. What’s missing is a coherent, enterprise-level strategy to capture them. The next phase of healthcare transformation will be built not just on innovation, but on partnership. And the patient is the partner we’ve been underutilizing all along.