Understanding How Consumers Make Healthcare Decisions
It’s day two of my eight-year-old niece’s fever and it won’t break. Before her parents went on vacation, I promised to take care of her. Sure, she wasn’t feeling well, but it was just a fever and we were doing all the right things: Tylenol, rest and fluids. But as day two progressed, she grew more despondent and refused to drink anything. Now what?
We’ve all had to make choices about where to seek care for an unplanned health event, but today we have more choices about where to go.
Whether it’s extended hours, virtual visits or money-back guarantees, choices are transforming care delivery. Understanding how these choices shape decisions will make or break marketing strategies seeking to increase usage. That is why Market Strategies focused its latest self-funded research study on how people choose where to go when someone is sick. What we learned will help answer a question salient in the minds of every health system professional: “How do we maximize the likelihood that consumers will choose us, when deciding where to go for care?”
Ensuring that patients understand, accept and follow recommended treatment plans is the first step towards the best possible outcome—medically for the patient and financially for the healthcare delivery system. Similarly, physicians are in the best position to individualize this treatment plan to one that is optimal for the patient.
Yet all too often patients resist their physician’s recommendation immediately or at the pharmacy, or they initially accept only to abandon treatment later. Why does this happen and what can be done about it?
How we “talk” and interact has changed. Heads down. Headphones on. Thumbs moving. It’s ironic that the more we focus on our small, handheld smartphone, the more we have access to the larger world around us. When sitting on a park bench, we can call loved ones, shop at Amazon, watch Netflix, listen to Spotify and schedule appointments. Indeed, it’s not a stretch to think that most people (especially Millennials) could pretty much operate their whole world on a smartphone.
As part of our continued focus on consumerism in healthcare, Market Strategies monitors and tracks how consumers use technology. In this article, we explore telehealth with an emphasis on virtual healthcare—an attractive option to busy consumers who are now accustomed to getting what they need, the moment they need it. For healthcare consumers, this means convenient, high-quality, immediate access to care for themselves and family members that costs less than traditional office visits.
What we’re learning from our own research is helping healthcare providers, health systems and insurers offer the right tools at the right time to connect consumers with the care they expect.
In the 1951 Disney adaptation of Lewis Carroll’s Alice in Wonderland, our protagonist finds herself in a bit of a predicament. Eager to catch the White Rabbit as he scurries off, Alice is too large to squeeze through the door to continue her pursuit. In frustration, she calls out to the doorknob, “I simply must get through!” The doorknob replies, “Sorry, you’re much too big. Simply impassible.” Confused, Alice responds, “You mean impossible?” Doorknob: “No, impassible. Nothing’s impossible.”
Impassible versus impossible. It’s easy to see how Alice was confounded by these two very similar looking and sounding words. However, the dialogue between the doorknob and Alice is more than clever wordplay; it’s sage advice. If a path meets an obstacle, change the perspective and try again. Seemingly impassible problems are opportunities for adaptation, creative thinking and novel solutions.
Sixty percent of Americans suffer from a chronic disease, making the need for affordable treatment options critical. Even with health insurance, sufferers struggle to manage their condition as prescription costs continue to rise and shift to the patient. The repercussions of this trend cascade through the patient-provider relationship, which now includes insurance and pharmaceutical companies.
Market Strategies International recently conducted a study of more than 1,000 adults age 18 and older to understand the impact of rising prescription costs in three key areas:
- Intentional prescription non-compliance
- Consumer attitudes towards healthcare providers, health insurance providers and pharmaceutical companies
- Consumer awareness and enrollment in patient assistance programs (PAPs)
What we found is a huge gap between needs and value as well as a strong indication that PAPs may be the panacea for improving compliance and attitudes towards pharmaceutical companies.
Shopping. It’s as American as apple pie. When we shop, we want deals. We want value. We don’t want to get ripped off. With more information at our fingertips (literally), we rely on a wide variety of information sources to make decisions and maximize the value of our purchases. From downloading coupons and talking to friends to reading online reviews and researching product features, there are a myriad of ways to get the deal we want.
Historically, most American workers didn’t shop for health insurance—it was something employers provided to attract the right people. That has changed. Based on data from the National Health Information Survey, it’s clear that personal healthcare costs have increased each year since 2008 (see table below), and more and more consumers are relying on high-deductible health plans that have low monthly premiums. The assumption has always been that the by-product of higher out-of-pocket costs is a savvier healthcare shopper.
As a first-time mom to an 11-week-old girl, the growing concern about the Zika virus has captured my attention. Daily, I count my blessings that both she and I are healthy, having come through pregnancy and labor safely. As a researcher focusing primarily on pharmaceuticals and healthcare, I spend a significant amount of time learning about devastating diseases, but this one has really hit home.
It was almost exactly a year ago, while traveling for in-situ research with healthcare providers, that I called my husband from a hotel room early in the morning to tell him that we were finally pregnant. That same week, I flew to four different states as my research continued, and the next week three more. Within a month, I was onto another project and literally circling the globe to conduct interviews with oncologists in Asia and Europe.
Travel has always been–and will continue to be–an integral part of my life and work. I was fortunate that morning sickness was the only ailment that I had to worry about while traveling so broadly. What would I have done if the Zika virus had been spreading then? How would I react if research was going to take me to South America? I can only imagine I would have immediately begun doing the thing I’m probably best at – asking questions.
In 2013, actress Angelina Jolie announced that she had a preventive double mastectomy after genetic testing revealed she carries the BRCA gene, putting her at an 87% risk of developing breast cancer and a 50% risk of developing ovarian cancer. The announcement, shared as an essay in The New York Times, sparked a national conversation about genetic testing. Since then, there seem to be daily news reports suggesting the findings of new genetic mutations that may be linked to risk for certain diseases or used for diagnosis of a disease.
We were curious how the populace is feeling about genetic testing—do they see value in knowing the future, or do they find peace in not knowing? To find out, we conducted our own study with 1,006 people in the US to understand what they know about genetic testing and what they think of it—what we learned surprised us.
As my friends and family spread out around the globe, my community is moving steadily from meeting in coffee houses to meeting up online on SnapChat and WhatsApp. I prefer the semi-impermanence of SnapChat. It’s like my best friend taps me on the shoulder and says, “Hey, look what I just saw? What do you think of that?” even though he’s living thousands of miles away in rural Africa. My online world is only a shade less vibrant than my “real” life. If I were to invite you into my home, introduce you to my family, neighbors or friends, you would only be seeing half of my life. With international relatives and most friends living over an hour away, I am increasingly living my life online.
Online Communities as Sources of Comfort & Friendship
I’m not alone. The mass migration to digital life can be seen everywhere. The diversity of idea sharing comes to life online—look at the richness of any comment section associated with a major newspaper and our conceptions of community can only grow broader. We are constantly presented with voices that dissent from and endorse our world view. In our private lives, online communities are sources of comfort and friendship. Take for example patients or caregivers in the health-medical space where it can be difficult to gain access to others with similar experiences in their “real life.” Having a rare disease can be isolating when there are no other patients in the region to connect with in-person. Increasingly, people are relying on online communities for information and human connection.
A Practical Approach to Improving Your Hospital’s Image
In many US markets, it is common to find a dominant Academic Medical Center (AMC) whose image is so strong that other AMCs, large hospitals and small community hospitals struggle to compare. In some markets, the image gap between the leading AMC and other hospitals is so large that the notion of closing it seems futile. Yet, we live in a world where consumers are more involved in healthcare choices, including which health system to join and which hospital to use. Improving hospital image is critical no matter where you rank in a community. Hospital executives must realize that while their hospital may never be perceived as the best, they must always strive to improve their hospital’s image.
How can they make headway? First, they must understand their position in the market and find opportunities to improve.
Market Strategies recently released its Hospital Brandscape® report in four major markets—Boston, Chicago, Philadelphia and Atlanta—to help hospital executives understand how consumers perceive their brand.