With the ACA now in place since 2010, a wave of new health-centered consumer technologies such as wearables and smartphone apps and price transparency software to help consumers make informed care purchase decisions, healthcare consumers should be empowered to take ownership of their health. But have healthcare consumers really changed? Not as much as you may think.
Though technology may be changing at lightning speed, people are still people. The changing variables are scientific discovery, technology advancement and the costs associated with healthcare delivery.
There may be no better example of how many people are unchanging than the obesity epidemic.
There have always been sedentary people.
Obesity is a modern epidemic. It may in fact be one of the most insidious epidemics in the course of human history. But it’s more symptomatic of our economic systems than changes in the mindset or genetic makeup of the populace. As humanity moved away from a subsistence culture, sedentary work became a viable means of obtaining the necessities of survival. And our population grew — not only in numbers, but in girth. The tendency to eschew hard labor was always present in populations.
If you want to understand things about the modern healthcare consumer, you need to understand the core psychographic segments of humanity.
There will always be workaholics. There will always be sedentary people. There will always be couplers and parents. There will always be people who value solitude and want no children. The fearful, the brave. The introverted, the extroverted. The wellness-oriented and the health-disengaged. Understanding the modern healthcare consumer is understanding the spectrum of human emotions and personality types.
Segmentation is not a new concept; it’s a freshly-described concept.
You could say that the science of consumer segmentation traces back to the first campfire stories. Humans observed character traits in their fellow man and used those to develop character archetypes. And character archetypes exist because, at their core, they are based on cultural truths and psychological groupings.
Consumer segmentation is, in a way, a new spin on the old Greek chorus. It’s reading a Shakespearian playbill. It’s the recognition of archetype tendencies in individuals, through the lenses of psychology and data science.
People aren’t all that different, but our abilities to quantify, classify and provoke predictable responses have evolved. Our abilities to track responses and predict long-term trends are different. And our data storage capacity and communication methods have changed.
So what do you need to know about the modern healthcare consumer?
Three things. The best predictors of a person’s willingness and ability to properly manage their own health care are as follows:
How are these quantified? How do we figure out which cohort(s) an individual belongs to within the bounds of a given scenario? It’s sophisticated, but not complicated. We ask questions. We track response patterns.
Psychographic segmentation, at its base level, is a blend of psychological profiling, aptitude testing and recognition of the cultural, social and other factors that shape an individual’s personality and world view. That might sound like voodoo — it’s not. It’s a technique that used to be something like voodoo, before the advent of electronic computation forever changed data science.
Before the development of computers, much of this work was performed by philosophers, poets and artists, and psychiatric theorists. We knew there were behavior patterns manifested in the species, but we didn’t have the tools and analytical models to clearly define those patterns, much less to predict outcomes. The work was intuitive. It was messy. It was often completely wrong.
Now, though, we have spreadsheets. We have graphing tools. We have 4-D mass communications. We have cloud storage and supercomputers. We finally have the tools that allow us to recognize patterns that previously seemed hazy and elusive. We also have techniques evolved and refined over the past couple decades that have allowed us to segment people according to a handful of questions with high confidence, and predictive analytics to project these segments onto the entire population.
Psychographics pertain to consumers’ values, beliefs, priorities and personality, and are a key to behavior change. Each psychographic segment has its own motivations and communication preferences, and messaging – whether patient education, marketing, or one-to-one engagement between healthcare professional and patient – should be customized accordingly.
c2b solutions’ health-focused psychographic segmentation model was developed after the founders led such work at P&G since the early 2000’s, and classifies healthcare consumers as one of five segments with 91.1% accuracy. c2b solutions has successfully applied psychographic segmentation in patient engagement initiatives for many of its clients.
The amount of readily available, plus anticipated future resources, will shape a person’s immediate actions. If a person has little, he can do little. If he thinks he will have little in the future, he’ll usually take fewer risks now.
The converse is also usually true. If a person has much now, he will likely risk more.
Thus, socioeconomic factors — employment status, current wealth, per capita household income and future earning potential — are powerful motivators (or discouragers) for healthcare consumers. Earnings-limiting barriers (i.e., education level, language barriers, disabilities and chronic disease conditions; and yes, unfortunately, historical discrimination points like race/ethnicity/nationality, religious and political beliefs) are also strong influencers on healthcare consumer behaviors and patient outcomes.
Wealth disparity is such a powerful outcome influencer, in fact, that some experts have called on the government to risk-adjust hospitals’ performance measures for socioeconomic factors. Hospitals in poverty-stricken rural areas and some urban cores have patient populations that are so economically disadvantaged that they cannot compete with outcome goals of their suburban and uptown counterparts.
To effectively influence your patient population’s behaviors and outcomes, you need to understand how much they have, how much they will have and what barriers prevent them from seeking care when they need it. Psychographics can also help here, as income alone does not dictate whether a person prioritizes spending on health and wellness.
When I was at P&G, I helped with some marketing issues at MDVIP, a concierge medicine network that was a subsidiary of P&G at the time. When one hears “concierge medicine,” one often pictures business executives and the financially elite as patients, though MDVIP’s membership fee was $125 - $140 per month, depending on geography.
One might also be surprised that one of the most common occupations among consumer members of MDVIP was educator. Teachers certainly do not make a business executive’s salary, but many prioritize health and wellness, choosing to allocate hard-earned dollars accordingly. Not surprisingly, MDVIP’s target consumer was akin to c2b’s Self Achiever psychographic segment, which is the most proactive and wellness-oriented segment.
A person is not a computer. There is a certain amount of base programming, sure — some nature, some nurture — but continuing education, life experiences and technological training/comfort level will modify a person’s responses over time.
Let’s think about this. Imagine two patients with diabetes, of the same psychographic segment (Balance Seekers) and socioeconomic status: both women, both have two children, both suburban, Asian-American and middle class, both attended college and majored in business administration. But one is a 34-year-old wife; the other is an 87-year-old widowed grandmother.
Besides the obvious 53-year age difference, we can dive a bit deeper and learn more about each woman’s formative experiences. We learn the 87-year-old came of age in a Mad Men business world; she earned far less by age 34, adjusted for real dollars, than her counterpart has.
Our 87-year-old is familiar with the same basic communication technologies as our younger woman — phone and computer — but we find that she uses a landline telephone and a desktop computer. She’s not yet comfortable using text messaging and isn’t ready to tackle smartphone apps or touchscreen tablet interfaces.
By the same token, the 87-year-old has far more life experience than the younger woman. She’s more world-wise. She’s less apt to make decisions based on a single person’s say-so.
Even though many of the psychographic and socioeconomic factors are the same, the experiential factors aren’t. Enough is different on the experiential section of the equation that these consumers need to be approached and managed differently.
Healthcare consumerism benefits from our understanding of it and the tools for harnessing it.
Medicine is not simply a scientific endeavor; it is also a consumer-facing industry.
Now that medicine can no longer afford to operate under a doctor-to-patient command model, we need to look at the institution with a fresh set of eyes. The healthcare industry must employ data science and marketing science to develop a C2B model, bringing consumer insights into strategy and patient engagement efforts.
Consumers must be allowed to take a more active role in defining what it is that they need from the healthcare industry. And the healthcare industry must develop a better understanding of the delivery and engagement methods that best serve those needs.