Calling the Shots
Many Americans are no longer satisfied with the U.S. health care system and want to exert significant control over their own medical care. They are no longer patients in the traditional sense, but consumers who are adopting a new, more active approach to making decisions about health care treatments, services and products. They demand greater access to information, online tools and services from their physicians. They want to explore alternatives to conventional treatments. And they want to share decision-making with their doctors.
These changing dynamics are confirmed in the 2008 Survey of Health Care Consumers conducted through the Deloitte Center for Health Solutions. The survey reveals an increased desire to use technology to communicate with health care providers regarding records, appointments and answers to questions, and to gather health-related information. Findings in Arizona showed that 14 percent are willing to pay more for Internet access in order to make same-day appointments, and 22 percent want e-mail capability to ask their doctors health-related questions or treatment options. In all, consumers are interested in using in-home monitoring devices to allow them to be more active in their care; are open to new treatment approaches; and are increasingly comfortable with alternative therapies, retail health care clinics, and even traveling abroad for elective procedures.
The American health care market is far more complicated than previously thought, and is best interpreted through six consumer segments. These distinct consumer segments present opportunities — and risks — for all stakeholders in the U.S. health care industry.
The first consumer group is Content & Compliant, which accounts for 29 percent of the U.S. health care consumer market. These consumers report annual household incomes of $100,000 or higher and prefer traditional approaches to care. For this group, what the doctor says usually goes.
This is not the same for the Sick & Savvy, which make up 24 percent of the consumer market. Proportionally more consumers in this group, compared to others, report having one or more chronic conditions (52 percent). They also take greater charge of their care, are more self-reliant decision-makers and less dependent on their physicians.
Online & Onboard (8 percent) are frequent users of the system and prefer traditional approaches, but are receptive to care provided in non-conventional settings. They tend to rely more on themselves in making decisions, and use online tools and value-added services more than any other segment. They seek information and are sensitive to quality differences.
The smallest contingent — Shop & Save (2 percent) — tends to switch doctors, treatment and health plans, and make changes to their insurance more frequently than others. They are the most sensitive to the cost of health care services. They tend to prefer doctors who use traditional approaches, but are amenable to alternative and unconventional treatments. They’re more likely than others to purchase prescription drugs by mail order or online, use a retail clinic, and travel beyond their community and the United States for care.
Out & About (9 percent) are independent, preferring to make their own decisions. They use alternative approaches, consult alternative health care practitioners and substitute alternative or natural therapies for prescription medicines more than any other segment. They are sensitive to quality, seek information, use some value-added services and want to shop for and customize their insurance.
Casual & Cautious (28 percent) is the healthiest group — only 19 percent report having one or more chronic conditions. Younger than most segments, they are also the least-insured.
In broad strokes, consumers are seeking change in three main ways:
- Mass personalization — Consumers want their health care and insurance customized to meet their needs.
- Evidence-based care — Consumers believe payments to doctors should be linked to evidence-based practices.
- Disruptive innovation — Disruptive health care innovations such as medical tourism and retail clinics are giving rise to new players, new delivery models, new ways of partnering and new value propositions.
The doctor’s role and the status quo are changing, and hospitals, physicians and health plans will need to quickly adapt to capture market success. Consumers are taking greater control of decision-making and they demand better value, better service, increased transparency and personalization of services. For these reasons, the players who take the unique attitudes and preferences of consumers into account as they make strategic decisions will have a huge opportunity to win the consumer market.
Paul Keckley, Ph.D., is executive director of the Deloitte Center for Health Solutions. Kevin Wijayawickrama is a principal at Deloitte & Touche’s Arizona practice.