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Closing Gaps in Care: What Health Insurance Companies Need to Know About Psychographic Segmentation


One of the best ways to maximize profit is to minimize cost—and for health insurance companies, that means closing gaps in care. Members with modifiable health risks not only have poorer health outcomes but also account for a substantial amount of healthcare spending. Healthy members, on the other hand, have better outcomes and are more profitable because they are less likely to accrue large medical bills. However, closing gaps in care is easier said than done.

What is a Gap in Care?

The Kettering Health Network defines a gap in care as “the discrepancy between recommended best practices and the care that’s actually provided.” These gaps can manifest in several ways, including:

  • Individuals overdue for age-based or seasonal screenings and vaccines
  • Individuals not taking a medication that meets evidence-based guidelines
  • Individuals not consulting with their doctor regarding a prescription that might conflict with another medication

Closing gaps in healthcare can be achieved when health insurance companies empower patients through condition management programs and wellness interventions. These measures keep customers healthy and informed. They also improve HEDIS and STAR ratings, which can be leveraged to market health plans to new beneficiaries as well as cut costs.  

Members may not know they have access to these programs or feel inclined to use them. It’s up to providers to encourage beneficiaries to take advantage of these offerings and improve their health outcomes. That’s where having a deep understanding of your audience becomes essential.

How Psychographic Segmentation Closes Gaps in Care

Psychographic segmentation can help you more effectively communicate with your customers and close gaps in care. This proprietary model puts healthcare consumers into one of five groups: Self Achievers, Priority Jugglers, Willful Endurers, Balance Seekers and Direction Takers. Each segment has unique preferences, values and motivations.

Self Achievers, for example, are proactive in their healthcare and like to hear messages that encourage them to reach their objectives. Direction Takers value their healthcare providers’ advice above all else, so they are likely to respond well to messages that include proof or reasoning from physicians.

According to the 2018 PatientBond Consumer Diagnostic, a nationally-representative study of healthcare consumers in the U.S., 35 percent of consumers said they’d like to receive information about services paid for by insurance and what they owe once a month. If you’re only going to communicate with segments once a month, the message has to make an impression.

Psychographic insights help health insurance companies send the right messaging via the right channel to increase the customer’s rate of follow-through as well as participation in screenings, preventative care, etc. This strategy works with any gap in care, including telemedicine, diabetes and more.

Recently, a large, regional health insurance provider tested PatientBond’s digital engagement platform against a notable health maintenance organization (HMO). The HMO sent generic, one-size-fits-all communications to the provider’s beneficiaries. PatientBond, on the other hand, knows that everyone has different communication preferences, and we used psychographic messaging crafted with each patient’s segment in mind. We also leveraged multiple channels, like emails and text messages.

The health insurance company achieved a 5x increase in click-through rate with PatientBond’s tool compared to the HMO campaign. Their members were making screening appointments, confirming appointments and more.

Multi-wave, segmented campaigns like this appeal to healthcare consumers’ unique wants and needs. In turn, they encourage healthy behaviors and close 4x the number of gaps in care. As more people participate in condition management programs and wellness interventions, HEDIS and STAR ratings increase, resulting in not only better health outcomes but also increased revenue and patient loyalty.  

When you engage consumers in meaningful ways, everyone wins.

For more on psychographic segmentation and how it improves health outcomes, download our case study.

How Psychographic Segmentation & Digital Engagement Improve Health Outcomes



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