Healthcare Consumerism

Healthcare Consumerism

How to adjust to a changing healthcare marketplace

What is healthcare consumerism?

Healthcare consumerism is the concept that patients are savvy consumers who take an active role in purchasing and consuming healthcare services, and also bear more of the cost burden. In the wake of nationwide healthcare reforms, patients have more choices, buying power and control over their own healthcare decisions than ever before. Patients can now shop for their own health insurance, just as they would shop for household appliances or a new car, and they expect the same levels of quality and service as they would experience when shopping for other consumer goods


healthcare consumerism


How the healthcare marketplace is changing

The healthcare marketplace is rapidly changing, with many factors driving it toward a model of consumerism. A seismic consumer shift took place with the passage of healthcare reform legislation. The Patient Protection and Affordable Care Act (ACA) — the legislation behind healthcare reform — passed into federal law in March 2010, and was upheld by the U.S. Supreme Court in the summer of 2012.

Moreover, rising costs have compelled employers and payers to shift more of the coverage burden to employees and members. With consumers taking charge of their healthcare spending — and leveraging the power of the internet, social media, and advertising — healthcare organizations face a more-informed public that expects more choice.


The impacts of healthcare consumerism

The intent of healthcare reform has been to expand access to healthcare coverage for all U.S. citizens. Beginning in 2014, individual consumers were required to have health insurance, either covered by their employer or purchased directly from health insurance companies on “Exchanges” managed by the states or federal government—or pay a penalty. A new administration in Washington DC is trying to institute changes to the ACA legislation, but the extent of these changes is not yet understood or realized.  

This has created an environment of both confusion and opportunity for consumers and healthcare providers. While consumers and providers face ongoing uncertainty due to legislative efforts to repeal or replace the ACA, the market continues to rapidly evolve, and healthcare organizations must become more consumer-focused in order to successfully drive health and wellness behaviors.


How healthcare stakeholders must adjust to healthcare consumerism

Healthcare providers must become more consumer-centric in a bid to succeed in this dynamic, experience-focused environment and change their mindset from patients to consumers. For example:

  • Health insurance companies — historically focused on marketing to employers, groups and other large healthcare intermediaries — must now focus their efforts directly toward consumers on the healthcare exchanges and Medicare Advantage market
  • Hospitals, Integrated Delivery Systems, and ACOs (Accountable Care Organizations) must deliver patient-desired experiences in order to realize maximum reimbursement, and to motivate positive health behaviors to prevent hospital readmissions and associated penalties.
  • Pharmaceutical manufacturers must differentiate in a me-too marketplace and deliver new value propositions to consumers and Payers with efficient selection and use of products—or be prepared to deliver maximum rebates.
  • Employers need to consider and position their employee coverage strategies carefully to mitigate negative response or to attract and retain top talent.
  • Retailers are driving self-directed care, linking front-end Treatment, Prevention, and Wellness solutions with pharmacy services


Healthcare consumerism and psychographic segmentation

Healthcare organizations must design products, services, and experiences that deliver against patient needs and expectations. “One size fits all” approaches to patient education and consumer advertising, with a singular message and shotgun delivery to a target population, have limited effect. All consumers are not alike – even if they share a common health condition – and are motivated by different things.

Successfully driving behavior change requires a deep understanding of the healthcare consumer and how to best influence their choices. Traditional market research, both qualitative (focus groups) and quantitative (surveys), is a step in the right direction. However, these methods may only provide limited insight if all consumer participants are considered a uniform population with aggregated perceptions, beliefs, and attitudes.

That’s where psychographic segmentation — which identifies groups of people according to their motivations, priorities and communication preferences — comes in. Segmenting healthcare consumers according to these shared characteristics allows healthcare organizations to customize patient engagement and drive efficiencies in targeting and messaging




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Segmentation and the
Health Care Consumer