A deeper understanding of consumers’ decision-making processes can equip health care stakeholders to better retain and engage them as well as attract new ones. With this in mind, the Deloitte Center for Health Solutions recently surveyed 4,530 US consumers to assess their attitudes, behaviors, and preferences when making decisions about health insurance, health care, and well-being. A segmentation analysis of this data, focusing on health care attitudinal and behavior questions rather than demographics, offered us a far richer understanding of consumers than analysis focused solely on demographics.
The analysis results categorized individuals into four distinct groups that reflect their differences in preferences for managing their health and interacting with various health care stakeholders (figure 1). Given its changing—and sometimes unknown—landscape, the US health care system draws parallels with the Wild West of the 19th century. We therefore used personalities of individuals from the American frontier during that time period to describe the results of our segmentation as follows:
Our analysis showed that each of these four groups has unique needs and expectations and navigates the health care system differently (figure 2). Such segmentation can help health plans, health systems, clinicians, and life sciences companies tailor their interaction with consumers, whether they are looking for a new health plan, doctor, or support in dealing with a chronic condition—just to name a few examples. The report offers suggestions for interacting with consumers from each of the four groups.
To help illustrate each of the consumer segments that emerged from our analysis, we created four fictional personas. Meet Ryan, Noelia, Devika, and Warren.
Ryan is an avid cyclist and runner who recently ruptured his Achilles tendon during a pick-up basketball game with other overly competitive 30-year-olds. Although there is a hospital just three blocks from the recreation center, a quick internet scan turned up several negative reviews from former patients. Ryan identified a small suburban hospital on the other side of town that had excellent scores. His friends suggested calling an ambulance, but Ryan opted for the ridesharing app on his phone instead. While researching the injury during the ride, he determined that surgery would probably be needed, so he went to his insurer’s website to make sure the hospital was in-network. An emergency room doctor told him about the hospital’s new app that gives patients access to their medical records along with information about postoperative care. It also sends reminders to patients about upcoming virtual and in-person appointments. Ryan downloaded the app so that he could share health information with his regular doctor and with his new physical therapist. Ryan also likes the hospital’s virtual-care option because he travels quite a bit for work. He has had several online physical therapy appointments in his hotel room.
It has been nearly a year since Noelia and Nick rushed their six-year-old daughter to the emergency room. The pediatrician diagnosed her with asthma, prescribed an inhaler, and recommended a clinic that specializes in pediatric asthma. One of their daughter’s friends is also a patient at this clinic, and her parents have been happy with the level of care. While Noelia likes meeting with clinicians in person, the clinic is more than an hour’s drive away, and her daughter prefers meeting the doctor at home via her tablet. Noelia’s health plan covers both in-person and virtual visits. Noelia has also joined a Facebook group for parents of asthmatic children, and she finds it helpful to see how other parents manage the condition. She recently read about smart inhalers with a sensor that communicates with a smartphone app via Bluetooth and helps track her inhaler usage. This piqued Noelia’s interest because both she and the doctor could view the data and make sure her daughter is taking her medication correctly. She needs to check if this device is covered by her health insurance.
Devika is a married 50-year-old manager of a downtown retail store. She tries to eat healthy and exercise, but with two children in high school, she often doesn’t have time to go to the gym and lunch tends to be takeout. She is overweight, has diabetes, and has been seeing the same physician since she started her job six years ago. The doctor’s office is just two blocks away and offers evening appointments once a week. She doesn’t always agree with her doctor or understand the prescribed treatment, but is reluctant to look for someone new. She gets health insurance through her job, and chose her health plan over two other options because an in-network medical practice was close to work. The premiums are higher, but Devika sees value in convenience. Her doctor suggested she wear a device that can track her glucose levels and transmit the information to the office, but she is comfortable neither with the device nor with sharing personal information. She doesn’t mind the idea of virtual care, but for now she prefers meeting with her doctor and the physician assistant in person. The stress of balancing her home life and job and managing her diabetes sometimes leaves her feeling depressed. She thinks this is probably normal and doesn’t want to ask her doctor about it.
Warren is a 71-year-old retired high school teacher with a Medicare supplemental policy. While most of the premium cost is covered by the school system, he has heard that budget reductions might result in cuts to retiree benefits. He hopes his son will sign him up for similar coverage if that happens. Warren has been with the same carrier for the last six years and hasn’t had any problems with his health coverage.
Although he hasn’t been to a doctor in two years, he is pretty sure his cholesterol level is too high. During his last visit, his doctor wrote prescriptions for drugs to bring his cholesterol and blood pressure under control, but Warren stuffed the prescriptions in a drawer and forgot about them. He worries about the potential side-effects of the drugs and is not willing to alter his diet. Warren knows he is overweight, but other than walking his dog, he doesn’t exercise. He has a computer that his son gave him as a birthday present, but he only uses it to look at pictures of the grandkids. He is not interested in learning how to navigate the internet.
Every consumer makes decisions differently—whether deciding on which movie to watch, what type of car to buy, or where to stay or eat during a vacation. Consumers also have different approaches to determining which health plan offers the most appropriate coverage, when and where to seek care at a hospital, how to choose a doctor, and whether a pharmaceutical product or medical device offers value.
Our analysis provides insights into how attitudinal and behavioral segmentation can provide a more refined approach to understanding consumers across different stages of the patient journey. Organizations can use data beyond just demographics to identify which segment their population or consumers fall into—and thus better target, attract, and retain consumers.
To succeed in their consumer strategy, health care stakeholders should consider the following:
Since 2008, the Deloitte Center of Health Solutions (DCHS) has surveyed a nationally representative sample of US adults (18 and older) about their experiences and attitudes related to their health, health insurance, and health care. The national sample is representative of the US Census with respect to age, gender, race/ethnicity, income, geography, and insurance source. As part of this effort, in February and March 2018, DCHS conducted an online survey of 4,530 US adults.
Using the 2018 consumer survey data, we selected 158 of the 347 variables to use in a segmentation analysis. Broadly speaking, these 158 variables fit into 12 themes:
After exploring multiple approaches, we used a K-Means approach which resulted in a four-cluster solution.
Deloitte is working with clients across all sectors of the health care industry to adapt to the age of the empowered consumer and find winning solutions. With the right strategy, customer understanding, financial modeling, and anticipatory preparation, health care organizations can adjust to the changing climate. Further, we’ve found that our clients can also invest in new retail-oriented capabilities, especially in the areas of digital, analytics, talent, process enhancements, and new operational systems to address the new demands of the empowered individual.