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Hospitals, Marketing, and the ACA: Preparing for Consumerism

empty hospital bedLet's face it: none of us have a magic crystal ball that will allow us to see how the market will ultimately shake out as the Affordable Care Act continues to roll. But segmented, in-depth healthcare market research can help you to make an educated forecast of the effect this legislation is likely to have on your hospital, ACO, or practice.

The rollout of the new Health Insurance Exchanges has a direct effect on your facility.

As the ACA increases the number of Americans who have health insurance coverage, the increased benefit to some consumers must necessarily come at the expense of others — a fact that will affect how these Americans will seek out medical care.

Right now, the lowest-priced Exchange-based policies cover only about 60% of medical costs, and consumers who do not qualify for subsidies and credits are faced with high premiums and deductibles.

This is of great concern for hospitals and other care providers.

Higher out-of-pocket costs have the potential to drive some consumers to delay or avoid seeking care or opt for more self-management through over-the-counter medications or alternative and holistic remedies, rather than a pricey visit to a physician with mounting bills on the back end.

It isn’t just the uninsured who may be disappearing from doctors’ offices.

We are already seeing an uptick in the number of small to medium-sized companies who are electing to forego the provision of health benefits, thus forcing their employees onto the Exchanges.

If companies continue to follow this trend, the result would be a flood of consumers into Exchange-based coverage plans. This could be a dramatic shift, as we found that 46% of respondents reported they currently receive employer-provided coverage either through their own job, or through their spouse's employment.

It is unclear at this time what the effect will be on patient outcomes, but it seems fairly certain that hospitals will see fewer patients among those groups who suffer more cost-shifting burdens.

Early examples seem to indicate that more people covered may mean lessened volume.

Though the ramifications for morbidity and mortality in those unsubsidized demographic groups are hard to predict, we may already have indicators about usage rates.

If the results experienced post-reform in Massachusetts (upon whose health reform program much of the ACA was based), volumes are very likely to fall — especially in ED — among individuals who will bear greater cost-shifted burdens, and this could lead to an overall downtrend in your department or facility.

Granted, a decrease in inappropriate use of the ED for non-emergency care is a good thing, but a trend toward forgoing care because of cost-bearing is something to be watched.

Americans are increasingly viewing health care as a right, and this view will drive consumer decisions.

A little less than half of those surveyed in our research (40%) claimed that health care should be an inherent right protected and ensured by the government. At the same time, however, 43% of respondents believed that the government has no business in their health care — very polarized points of view.

In the aggregate, the American public seems to favor a model in which the government will force private entities to provide care, but will not interfere in consumers' access to the care that they choose.

It's a bit manic, but it’s a dichotomy that can and must be addressed in your marketing — chiefly by offering the consumer choice.

That is where psychographic segmentation research can be so valuable. Targeting consumers by their hard-wired motivations and positioning your proposition to appeal to this hard-wiring is essential to a winning (and efficient) marketing strategy.

American healthcare is making an unprecedented shift toward a consumer-driven model, and as we are finding, that consumer expresses strong desires, but all too often lacks sound understanding of the market.

By breaking down your system's target consumers, understanding their needs and desires for healthcare services, and positioning your offerings in a manner in which they can relate will help a healthcare provider thrive in the ACA environment.

Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change

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