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Whatever the Fate of the ACA, Here's Why Healthcare Consumerism is Here to Stay


Passage of the Patient Protection and Affordable Care Act (ACA) may have accelerated healthcare consumerism, but as HealthLeaders Media pointed out last year, “Consumerism has been making inroads into the healthcare industry for at least a decade, with patients increasingly acting like consumers who have a choice in their healthcare options, trying to make the best decisions for quality and cost just as they do with any other commodity.”

Yet a survey of 100 U.S. hospitals and health systems conducted last year found that while 66 percent of respondents admitted that understanding patients’ behaviors and expectations is crucial, only 25 percent actually have relevant patient data to help them transform to a more consumer-centric organization. Here are a couple reasons why healthcare consumerism is here to stay—and healthcare providers need to evolve, the sooner, the better.

Cost sensitivity drives healthcare consumerism

Seeing patients as consumers goes beyond a simple change in vocabulary. Hospitals and other healthcare providers need to embrace the tactics used by other consumer-centric industries to deliver value, quality, and convenience.

Ongoing uncertainty about what the ACA may become—or be replaced with—is unlikely to change consumer expectations for quality, affordable and convenient healthcare. It could, in fact, add fuel to the healthcare consumerism fire as consumers wonder how further healthcare reform will impact their wallets.

In just two years, enrollment in High deductible healthcare plans (HDHPs) has grown from 21 to 29 percent of all health plans.

Kaiser Family Foundation research

High deductible healthcare plans (HDHPs) through employers and on the health insurance exchanges are more common than ever. In just two years, says Kaiser Family Foundation research, enrollment in HDHPs has grown from 21 to 29 percent of all health plans. Insurers and employers expect that with greater exposure to the costs of care, healthcare consumers will shop around for quality healthcare at a better price.

Unfortunately, consumers lack the information needed to make those types of decisions. Healthcare engagement strategist Frank Hone notes: “We’ve definitely seen a strong uptick in consumer interest to shop for various medical services. Price transparency was a foundational pillar of health care consumerism from the early days of the mid-2000s.” While there is more data today when it comes to both the prices and quality of care, it isn’t enough—especially because consumers are more comfortable shopping for HDTVs than MRIs.   

Plus, the fact is, the U.S. still has the highest healthcare cost per person compared to other countries, and healthcare organizations need to address the issue—not just to meet patient demands. The Centers for Medicare and Medicaid may have started the value-based reimbursement ball rolling, but private health insurers and large self-insured organizations have embraced value-based programs as well.

According to an article in Forbes earlier this year, nearly 50 percent of payments by three of the country’s largest insurers—Aetna, Anthem, and UnitedHealth—are through value-based care models, and they are looking to increase those numbers by 25 percent or more by 2020. Getting costs under control and improving price and quality transparency will go a long way toward transforming healthcare in America.

Healthcare consumers expect data-informed care

When consumers visit Amazon, they don’t see a one-size-fits-all website. Each interaction with Amazon is captured, stored, and mined to personalize the next experience. Amazon recommends products related to previous purchases, books and movies based on preferred genres.

Largely due to patient privacy regulations, the healthcare industry has dragged its feet when it comes to embracing healthcare data and analytics fully. But since other highly-regulated industries like Banking have found a way to marry using customer data and analytics to improve experience and maintain appropriate data privacy to meet regulatory expectations, hospitals and other healthcare organizations need to get their digital customer experience in gear. It’s a huge challenge to be sure, given interoperability and data sharing issues that make it difficult to capture a holistic view of the healthcare consumer journey, rather than a series of disjointed interactions.

By leveraging psychographic segmentation to understand how individuals feel about healthcare—who they turn to for advice, where they look for information, and what motivates engagement and behavior change—hospitals can adapt their marketing, patient outreach, and face-to-face engagement to give patients relevant, personalized experiences that build loyalty and trust.


The 5 Psychographic Segments

As Matthew Chambers, CIO of Baylor Scott & White Health, told Modern Healthcare, “Medicine is a vastly different industry from retail, but we can learn from it and other industries to provide a more engaging and convenient experience.”

And if hospitals and other healthcare providers succeed in improved engagement among individual patients and broader populations, the ultimate goal of better health outcomes could be the most satisfying result of all.

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


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