In the United States, the ongoing growth of cost-sharing levels has given consumers greater influence over healthcare delivery. Between 2006 and 2015, for example, the average deductible for employees with employer-sponsored insurance grew by more than 120%.1 Consumers now directly control $330 billion annually in out-of-pocket healthcare expenses,2 and the choices they make have the potential to affect 61% of all healthcare spending.3
Although true healthcare consumerism is still growing slowly, there are pockets in which it has taken hold. For example, consumers are beginning to actively engage in making decisions about their health and healthcare. Also, consumer preferences are becoming more sophisticated. Since the launch of the public insurance exchanges, for example, a growing number of consumers have been selecting their health insurance plans for reasons other than price alone.4 Similarly, we have seen Medicare Advantage (MA) purchase patterns shift as consumers make more sophisticated trade-offs among up-front premiums, total costs, and network configurations.5
Both payors and providers could benefit by more deeply engaging healthcare consumers. Greater consumer engagement could help them improve customer acquisition and retention, strengthen brand premium, lower administrative costs, and develop competitive advantages. Perhaps most important, enhanced consumer engagement has the potential to improve health outcomes. To enable healthcare consumers to fully emerge, payors and providers must deliver in four areas:
- Know consumers and what drives their behaviors
- Guide consumers toward the information they need to make better decisions
- Engage consumers to help prepare them for and enable behavior change
- Inspire consumers to build loyalty
Admittedly, the journey from education to engagement to behavior change is not always a straight line. But mastering these four actions will go a long way to increase the likelihood that consumers will change their behavior.
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Know consumers
Develop a more nuanced understanding of consumers’ needs, preferences, and values
We often hear several common refrains about healthcare consumers—who they are, what they’re looking for, and how they act. Indeed, a number of myths about healthcare consumers are widely cited (see “Debunking common myths about healthcare consumerism”).6
The reality is different; there is no “average” healthcare consumer. Rather, consumers come from a wide range of backgrounds, have differing clinical and lifestyle needs, and hold a variety of attitudes and expectations about healthcare. Thus, understanding the average healthcare consumer provides limited information. Segmentation can provide greater insights, but segmentation without a discrete goal can waste time and energy. For game-changing insights, payors and providers must determine their objectives and then segment consumers accordingly so they can develop practical actions to address the needs of those segments. For example, we built a segmentation model to understand how consumers’ beliefs, attitudes, and values influence how they interact with the healthcare system at large. The results enabled us to divide the US population into six archetypes of healthcare engagement (Exhibit 1).
Date: September 24, 2019
Source: McKinsey