Consumer health experience radar 2015

www.pwc.com
Personal health
management
The rise of the
empowered consumer
Consumer Health
Experience Radar 2015

Contents
The changing expectations of healthcare consumers 1
Today’s consumers want to take charge of their health 1
What consumers told us 3
The seven healthcare trends underlying our research 5
Meet your plan members 6
Overview of the health plan groups 7
Private insurance – Single 7
Private insurance – Family 8
Medicare Advantage 9
Exchange customers 10
How to reach today’s healthcare consumers 28
Alternative care providers/new entrants: Increase your visibility, move
beyond primary care 29
Wearables manufacturers: Expand your target market 29
About our research 30
How we developed our insights 30
Who we surveyed 30
Why these consumers? 30
Contributors 32

Personal health management ⏐ The rise of the empowered consumer 1
The changing expectations of
healthcare consumers
Today’s consumers want to take charge of their health
We asked: What do you value most about your healthcare experience,
and how much more responsibility would you accept in exchange for
lower premiums?
Based on feedback from the roughly 2,300 consumers we surveyed, it’s clear that
consumers want to rely more on themselves for managing their health. And as they
assume a larger share of costs, consumers also want to get the best value for their
healthcare dollars, whether through the traditional healthcare system or via alternative
service providers that are new entrants to the healthcare market (e.g., retail clinics,
telemedicine service providers, etc.).
They answered: Proactive health management, value for dollars,
excellent service
Consumers are getting smarter and more proactive about managing their health
themselves. Armed with the Internet and a growing array of digital tools to monitor
and improve their health, they’re no longer content to rely solely on a doctor’s advice.
While almost half still go straight to the doctor when they face a health issue, one-third
go online to research their symptoms before seeking medical care. Some visit urgent
care clinics or pursue other forms of alternative care— an option customers love once
they try it, but is unfamiliar to most due to a lack of mainstream advertising and
promotion.
Today’s healthcare consumers are also focused on value. If given the choice, they are
willing to take on more risk and responsibility for managing their health in exchange
for lower monthly health insurance premiums. But while most consumers are cost-
conscious, there’s a split between those who want to pay more for higher quality care
and those who prefer to spend less for “good enough” care.
Whether focused on quality or value, healthcare consumers expect to be treated well.
Trained by the retail industry to expect top-notch service, and empowered with tools to
manage their own health, consumers have little patience for a poor healthcare
experience. And when it occurs, they’ll often blame the brand or institution, not the
person who provided the care.
How can you reach these empowered consumers?
No single approach will appeal to all healthcare consumers. Each segment has unique
characteristics that require tailored solutions. But our research suggests that payers
and providers can apply three key approaches that will have broad consumer appeal:

Give them tools to manage their health. Make it easier for consumers to
monitor their health stats, track their fitness activity and progress, and manage chronic
illnesses. Encourage or even subsidize the use of wearables, and enable plan members
to share their fitness and wellness data with their doctors, making healthcare a team
effort. Provide self-diagnosis tools and telemedicine options, to help consumers
determine if they need to seek in-person care for their illness and to reduce care costs.
Offer self-service options that enable consumers to perform common health-related
tasks on their own, such as refilling prescriptions and scheduling follow-up visits.
Help them to be proactive. Allow consumers to opt in to more comprehensive,
proactive disease testing to maintain their health and avoid problems in exchange for a
discount on their health insurance premiums. Provide proactive health warnings or
alerts based on their activity data so they can avoid making potentially damaging
lifestyle choices.
Make care convenient. Adopt lessons from retail clinics, which succeed in part by
catering to customers’ busy schedules—and in the process, delivering great customer
experiences. Making care convenient (e.g., by offering scheduled or drop-in
appointments on evenings and weekends) can help strengthen brand loyalty and
attract new customers. Even more important, making care convenient can help to
eliminate bad customer experiences, which play a more important role in shaping
brand perceptions and determining customer loyalty.

What consumers told us
Passive is out, proactive is in.
Consumer health intelligence is increasing rapidly. The traditional concept of passive,
qualitative “wellness” is being replaced by a proactive, quantitative approach called
personal health management (PHM), with empowered consumers taking more
responsibility for their healthcare.
Armed with digital devices, consumers are monitoring key health stats on a regular
basis, from weight and blood pressure to the number of steps they take each day. And
they are proactive about maintaining their health: three in five of those we surveyed
push themselves with challenging health goals, and almost half (46%) frequently reach
their goals. In striving to achieve their goals, they are driven by personal satisfaction
(89%), the ability to track progress quantitatively (71%), and validation from their
doctors that they’re on the right track (69%).
Customer satisfaction is fragile, and brands get blamed for
bad experiences.
Based on our research, consumers generally like the people and institutions involved
with their healthcare, but only two in five are satisfied with the medical advice they
receive, and 45% say they have never had a great healthcare experience. Positive
experiences are overwhelmingly credited to the person who administered care (63%),
while poor experiences are blamed on the institution—either the organization itself
(44%) or the fees it charged (38%).
Brands get little credit for great care but most of the blame when care
is poor.
Consumers agree on what they can and can’t accept in healthcare…
We delved into what consumers value the most about their healthcare, and what
changes they would be willing to make in exchange for lower premiums. When asked
to create their ideal healthcare plan, consumers agreed on the most important feature:
being able to see a doctor within 24 hours of getting sick. They also value the ability to
choose their doctors. However, they showed a willingness to take on more risk and
responsibility for managing their health in exchange for a lower premium (~5%
average savings per consumer). That includes accepting more preventive screening
tests (and the collection of additional personal information that accompanies testing);
virtual consultations for follow-up appointments; and online self-service
tools for simple tasks like prescription refills in exchange for a discounted health
insurance premium.
…but are split on how to approach it
The majority of consumers (56%) are cost-conscious when it comes to care, but a
sizable segment of the population (38%) is willing to pay for the highest quality care
they can get. In addition, consumers fall into two camps when handling health issues:
almost half (48%) go straight to their doctor, but nearly a third (32%) research their
symptoms online first before seeking medical care.
What do you track monthly?
83% weight
55%
blood
pressure
55%
caloric
intake
30%
sleep
patterns
24% steps
What they want…
See a doctor within 24 hours24
Get care in a doctor’s
office from reputed health
company
Choose any doctor they
want
Receive health advice only
when requested
What they don’t want…
Limits on which doctors
they can choose for care
2 Unsolicited health alerts/
warnings from doctors
Retail brands/facilities
replacing doctors/hospitals

While most consumers are proactive about managing their health, 9% don’t engage in
any preventive care, and 7% of consumers who purchased coverage through healthcare
exchanges avoid care altogether because of the costs involved. As the cost of healthcare
becomes increasingly prohibitive, this care-apathetic population is likely to
grow quickly.
Alternative care and wearable devices: Just outside the mainstream
Consumers of alternative care1 —in particular, those who receive care at non-
traditional facilities such as walk-in clinics (the most popular venue)— generally love
the experience, but more than half of patients (53%) have never visited an alternative
care facility. Lack of awareness is the main reason. Only one in five customers learn
about alternative care options through marketing; instead, they find this option most
often through word of mouth (40%) and online research (28%).
Like alternative care, wearable devices have not yet reached the mainstream, but this is
likely to change as comfort with technology grows. Less than 10% of the consumers we
surveyed own a health-related wearable device, but of the 90%+ who don’t, one in five
have considered buying such a device. In addition, while 84% of those interested would
prefer a sub-$100 wearable, 15% would be willing to pay $200 for a more stylish model
with advanced features.
Most consumers are digitally savvy: 74% of those we surveyed go online
multiple times a day, 83% say they have some comfort with mobile
technology, and more than half (52%) consider themselves active
mobile users.
1 For purposes of our research, we defined alternative care as follows: "Companies not normally
associated with healthcare offering health-related services. Examples include drugstores &
supermarkets with walk-in medical clinics, phone/online-based services that allow customers to
virtually consult with a licensed doctor at any time, etc."
How many feel that alternative
care options are the same or
better than typical
doctors/hospitals in the
following categories?
94%
Proximity
91%
Customer
Service
88%
Quality
81%
Aesthetics
89%
Convenience
82%
Cost
$

The seven healthcare trends underlying our research
PwC identified seven major trends that are influencing changes in health-related
consumer behavior. These trends served as the foundation for the development of our
survey questions:
1. Care as commodity: A new generation of value-conscious consumers is treating
healthcare like any other purchase. They are seeking the “best deal,” with little
loyalty to brands or providers.
2. More empowered healthcare consumers: Today’s empowered consumers
track their vitals, research symptoms online, and self-diagnose rather than rely
solely on providers to diagnose and treat illnesses.
3. Higher share of cost burden: Healthcare is getting more expensive and
consumers are sharing more of the cost burden. For many consumers, healthcare is
changing from a given to a discretionary expense requiring a cost-benefit analysis.
4. More alternative care services from non-traditional players:
Telemedicine start-ups, retail clinics, at-home medical kits, and more: Consumers
have a growing number of options for managing their care.
5. Proliferation of health-tracking technology: The exploding wearables
industry is enabling consumers to analyze their health with a level of precision
traditionally reserved for doctors, and it’s changing the definition and capabilities
of remote patient monitoring (RPM).
6. More insured consumers, thanks to the ACA: Millions of first-time
customers are now buying health insurance, creating an opportunity for established
payers and providers to grow their customer bases—and for non-traditional
companies to disrupt the industry by offering innovative services at compelling
price points.
7. Increased demand for primary care: With more doctors choosing
specializations over general medicine, the demands on primary care practitioners
have never been greater. This is forcing many states to expand PCP laws to enable
RNs and pharmacists to diagnose illnesses and prescribe treatments.

Meet your plan members
Different consumers, unique needs and preferences
Understanding the differences among healthcare consumers, in terms of needs,
preferences, and approaches to healthcare, is essential to attracting and retaining
customers. To help payers and providers gain an understanding of the needs of
healthcare consumers, we leveraged our Experience Radar methodology to identify
four categories of consumers, based on the type of health insurance plans they
purchased. We hypothesized, and our research confirmed, that each of the four groups
represents a different approach to healthcare. We also found important differences in
the responses of consumer segments within each of these groups:
• Private health insurance customers (single person)
• Private health insurance customers (family)
• Medicare Advantage customers
• Health Insurance Exchange customers
We explored how consumers in each segment within the four plan groups currently
manage their health, what they value most in healthcare, where they’re willing to accept
more risk, and what customer experience features would most resonate with them.
Their responses, detailed on the following pages, provide insights that payers and
providers can use to tailor their marketing efforts and the customer experience efforts to
meet the unique needs and preferences of each segment within each health plan group.

Overview of the health plan groups
Private health insurance customers (single person)
Fitness-focused Fay
Fay is primarily a Millennial who lives in a major southern city. She’s digitally savvy,
passionate about staying healthy, and searching for value.
Wary Walter
Walter is primarily a Baby Boomer who lives in a rural town. He tracks metrics to
manage his chronic illness and visits a traditional provider when there’s a problem. He
wants the best quality of care he can afford on his limited income.
Trusting Terri
Terri lives mainly in suburbs on the West Coast. He’s healthy, tracks metrics such as
weight and calories, and is considering using a wearable. Health is a priority, so he
seeks the best care his insurance allows, from traditional providers.
Preoccupied Paolo
Paulo is mostly Gen X living in the Midwest. He’s focused on his financial problems,
and health isn’t a priority for him. He’s unhappy with his insurance and avoids care
because of the cost, though he has visited a low-cost urgent care clinic.
Fitness-focused Fay
Healthy and cost-conscious
27%
of consumers in this plan group
Wary Walter
Focused on managing illness
25%
Trusting Terri
Healthiness = happiness
24%
Preoccupied Paolo
Healthy but at risk
23%

Private health insurance customers (family)
Driven Darin
Darin is a largely a healthy Gen X consumer living in a Southern suburb. He tracks
his health stats closely, often using wearables. He’s happy with traditional care but
also with new entrants such as the retail clinic he visited. He wants the best quality
care available.
Conventional Carl
Carl is predominantly a Baby Boomer who lives in a Midwestern town and has a
chronic illness that’s easy to manage. He’s “old school,” preferring traditional care.
He handles non-urgent health issues on his own and visits his doctor only in
an emergency.
Try-it-out Tori
Tori is a mainly a healthy Baby Boomer or Gen X consumer who lives in a Midwestern
suburb. He’s casual about monitoring his health and ambivalent about his current
care. He’s pleased with alternative care but had to be convinced of its value.
Savvy Sam
Sam is typically a healthy Millennial who lives in a moderate-sized city. She uses
wearables to monitor her health and partly because of their “cool factor.” She values
the social aspects of health. She’s rarely ill, so it’s unclear how she would manage
health issues.
Novice Natalie
Natalie is mainly a healthy Millennial who lives in a Northeastern town. She uses
wearables to monitor her fitness. Because of her age, she has limited experience with
healthcare, but she thinks the walk-in clinic she visited was inferior to a traditional
doctor’s office. She researches health issues online and seeks the lowest-cost care.
Driven Darin
Will pay for quality
24%
Conventional Carl
“Old school”
23%
Try-it-out Tori
Healthy but ambivalent about care
22%
Savvy Sam
Trend-setter
17%
Novice Natalie
Stressed student
14%

Medicare Advantage customers
Healthy Hogan
Hogan is mainly a healthy Baby Boomer who lives in a Midwestern suburb. She’s
digitally savvy and monitors her health stats regularly. She’s ambivalent about
traditional care and was impressed with the urgent-care clinic she visited. When
possible, she’ll search online to find self-treatments.
Disengaged Dani
Dani is mainly a Baby Boomer who lives in a rural town in the Northeast. He has a
chronic condition, but it’s easy to manage, and he doesn’t monitor his health. He seeks
the cheapest care available but has never tried alternative options like retail clinics.
Health is just not a priority for him.
Chronic-Care Cam
Cam is typically a Baby Boomer who lives in a mid-size Southern city. She stays active
and monitors her health stats often to manage her chronic illness. She likes to share
her health data and would considering using a wearable. She’s happy with her
traditional care provider, and she seeks the most cost-effective care options that her
insurance covers.
Spiritual Sai
Sai is largely a Baby Boomer who lives in a metropolitan region in the West. He doesn’t
actively monitor his health stats but he stays active to ensure his health, which he
views as the path to happiness. He’s satisfied with his traditional care provider and has
no interest in seeking alternative care.
Healthy Hogan
Low-maintenance
41%
Disengaged Dani
Apathetic with chronic illness
21%
Chronic-Care Cam
Focused on managing chronic illness
20%
Spiritual Sai
Values quality care to ensure happiness
18%

Health Insurance Exchange customers
Premium Paul
Paul is typically a healthy Baby Boomer who lives in a small Northeastern town. He’s
retired but not yet on Medicare. He stays fit, pays for premium coverage, and is
pleased with the care he receives from his traditional providers. He has no interest in
alternative care options.
Struggling Sue
Sue is mostly a Millennial with a chronic illness. She only monitors her weight and
blood pressure, but she’s digitally savvy and has considered wearables. She sets easy
fitness goals and values encouragement. She likes her doctors but not her
low-cost insurance plan, which limits her options. She visits walk-in clinics but finds
them disappointing.
Restarting Rita
Rita is typically a healthy Gen X consumer who lives in a Midwestern suburb.
She only tracks her weight, and she has no interest in wearables. Rita is unhappy
with the limited options her bare-bones insurance policy covers, but she can’t afford
the additional cost to visit a walk-in clinic. She tries to handle most health issues on
her own.
Aspirational Annie
Annie is mostly a healthy Millennial who lives in a suburb near a mid-size Southern
city. She monitors her fitness and has a strong interest in wearables, but she struggles
to meet her health goals. She’s more impressed with alternative care than with her
traditional providers. To keep costs low, she tries to deal with health issues on her own
or visit a low-cost clinic.
Premium Paul
Successful, wants the best
31%
Struggling Sue
26%
Restarting Rita
Competing life priorities
24%
Aspirational Annie
Wants to improve her health
20%

Fitness-focused Fay
Healthy and cost-conscious
Consumers like Fitness-focused Fay are passionate about monitoring their fitness and
maintaining a healthy lifestyle. They frequently track health stats, including calories
and steps taken, monthly sleep patterns, and BMI, and they set and often meet
challenging health goals. These digitally savvy consumers use wearables to monitor
their health, and they appreciate the social features of the technology.
Consumers like Fay are generally happy with their doctors, specialists, pharmacists,
and local drug stores, but they also want the cheapest care possible. They prefer to
research their symptoms online before seeking care and to self-treat their issues when
possible. They have sampled alternative care in the form of walk-in clinics but have
been disappointed by the cost and aesthetics of the facilities.
How can you reach consumers like Fitness-focused Fay?
• Make it easier for them to track their fitness and determine if they’re on
track with their goals through remote monitoring of their wearables data.
• Empower them with self-diagnosis tools to help them determine if they
need to seek in-person care for their illness (versus making that decision on
their own).
• Give them more self-service and telemedicine options so they can
perform common health-related tasks (e.g., refilling prescriptions and scheduling
follow-up appointments) quickly and easily.
• Allow them to opt in to more comprehensive, proactive disease testing
in exchange for a discount on their health insurance premiums.
1 In our survey, the features of the “typical plan” were the same for each of the four plan groups.
Only the cost of the typical plan differed, reflecting the varying demographics and risk profiles of
consumers in each plan group. Hypothetical discounts were offered to consumers in exchange
for taking on more responsibility/accountability – for instance, agreeing to more preventive
screening or accepting telemedicine rather than in-person doctor visits.
Meet Fitness-focused Fay
(27% of consumers in this segment)
Age 18-34
(Millennial)
Gender Female
Ethnicity African-American
Education Graduate degree
Employment Newly employed
Income $50-$100K
Digital literacy High
Lives in Major southern
city
Health status Healthy
Religious No
These details are representative of the typical healthcare
consumer in this segment.
20-50% more likely to be
somewhat satisfied w/current careì
50% more likely to be
cost-conscious with care$
2.8%cost difference
between ideal (discounted) and
typical plan1
★
1.4X likely to be healthy w/no
chronic issues✜

Wary Walter
Focused on managing illness
Wary Walter and consumers like him track their weight and blood pressure daily to
manage their chronic illness. They also track calories occasionally when urged by a
doctor. These consumers go online for health information but they’re not mobile-
savvy. They set and achieve modest fitness goals now and then, but they’re focused
mainly on managing their illness.
Consumers like Walter are extremely satisfied with their doctors, specialists,
pharmacists, drug efficacy, hospitals, health insurance, and advice they receive. They
value analyzing their vitals and appreciate the encouragement that their doctors
provide. They have never seen an alternative care practitioner, since alternative care
clinics aren’t equipped to handle complex chronic illnesses like theirs.
Consumers in this segment go straight to the doctor when they have a health issue.
Despite limited means, they want the best quality care possible so they can prevent
additional health problems.
How can you reach consumers like Wary Walter?
• Make it easier for them to manage their chronic illness and determine if
their tracked vitals are within healthy limits, possibly with the help of simplified
wearable technology.
• Offer them more frequent check-ins with a doctor via telemedicine to
promote better adherence to treatment plans and provide positive encouragement.
• Give them more self-service options to perform common health-related
tasks (e.g., refilling a prescription) simply and quickly.
• Offer them more comprehensive, proactive disease testing in exchange
for a discount on their health insurance premiums, in order to prevent additional
chronic health issues from arising.
Meet Wary Walter
Age 55+ (Baby
Boomer)
Gender Male
Ethnicity Caucasian
Education High school
Employment Retired
Income $25-50K
Digital literacy Low
Lives in Rural town
Health status Chronic illness
Religious Yes
very satisfied w/current careì
70% more likely to want the
highest quality care possible$
4.4%cost difference
typical plan
★
3.1X likely to have a difficult
to manage chronic condition✜

Trusting Terri
Healthiness = happiness
Consumers like Trusting Terri monitor their health carefully. They track their weight
and calories weekly, and their steps and BMI regularly, and have strongly considered
using wearables. These consumers are highly motivated to reach their health goals and
often do so. They value the encouragement of their friends, family, and doctors, and
they like being able to track their progress. Their health has a major effect on their
happiness, so when faced with a health issue, they seek the best care available through
their insurance.
Consumers in this segment are very pleased with their current healthcare. They trust
their doctors, and they’re satisfied with the advice they receive, treatments prescribed,
and specialists they consult. They have visited alternative care clinics on the advice of
their doctors, but saw no difference in cost or convenience and felt that the quality of
care was lower than the care they receive from their regular doctors.
How can you reach consumers like Trusting Terri?
• Subsidize wearables so that health tracking is integrated into their
regular fitness/wellness routines and their data is made available to their doctors.
• Provide proactive health warnings or alerts based on their activity data so
they can avoid making potentially damaging lifestyle choices.
• Give them more telemedicine options so they can connect with their doctors
more conveniently when needed and complete simple tasks (e.g., refilling
prescriptions and scheduling follow-up appointments) quickly and easily.
• Offer them more comprehensive/proactive disease testing so they can
continue maintaining their healthy lifestyles.
Meet Trusting Terri
Age Indeterminate*
Gender Indeterminate*
Ethnicity Asian
Employment Indeterminate*
Income $75-$150K
Lives in West Coast
suburb
Religious Yes
* Data does not support a single classification.
4.6%cost difference
typical plan
★
chronic issues✜

Preoccupied Paolo
Healthy but at risk
Consumers like Preoccupied Paolo don’t have the time or energy to monitor their
health, although they occasionally check their weight. They don’t value motivating
tactics, such as encouragement or incentives, because maintaining health and fitness is
simply not a priority for them. They’re focused mainly on staying afloat financially.
Paolo and his cohorts are healthy but generally avoid care because of the costs
involved. This could make them vulnerable to chronic health issues down the line.
Consumers like Paolo are not satisfied with their current healthcare. They’re
ambivalent about the people and institutions involved and dissatisfied with their
health insurance, which makes them reluctant to seek care. On the recommendation of
family members, they do visit urgent care clinics, and they value the proximity and
lower cost of these facilities.
How can you reach consumers like Preoccupied Paolo?
• Offer them cost-effective and simple options for engaging in preventive
care, possibly by offering coverage of their visits to walk-in clinics or providing
remote support.
• Give them low- or no-cost self-service resources that enhance their health
intelligence and help them to manage their lifestyles with a minimal time
commitment.
• Sell them on the benefits of telemedicine in terms of cost and speed so
they become more engaged customers and make their health a higher priority.
• Explain to them the long-term benefit of comprehensive, proactive
disease testing to help prevent complex (and costly) chronic illness.
Meet Preoccupied Paolo
Age 45-54 (Gen X)
Gender Male
Ethnicity Hispanic
Education Four-year
college degree
Employment Employed
Income $0-$50K
Lives in Midwest
Religious Indeterminate*
60-100% more likely to
feel ambivalent about current careì
66% are cost-conscious
with care$
4.2%cost difference
typical plan
★
chronic issues✜

Driven Darin
Willing to pay for quality
Consumers in Driven Darin’s segment monitor their health stats closely, often tracking
weight, blood pressure, steps, sleep patterns, and calories. These digitally-savvy
consumers are interested in using wearables for self-improvement, and they value the
ability to analyze their health data. They desire encouragement, which helps them to
achieve their goals, but see little value in social incentives or progress sharing.
Consumers like Darin are generally happy with their current care and fairly satisfied
with the total healthcare experience; they like the institutions they visit, doctors they
see, and advice they receive. But they’re also satisfied with alternative care, and feel
that the cost, convenience, and customer service are superior to those provided by the
typical doctor and hospital. They prefer to research non-threatening health issues
online before seeking medical care, but when care is needed, they want the highest
quality available.
How can you reach consumers like Driven Darin?
• Show them how to extract maximum value from wearables as tools to
help them monitor their health stats and achieve their health goals.
• Allow them to automatically share their activity data with their doctors
to enable more precise feedback, health coaching, and proactive health alerts.
• Give them robust self-service and telemedicine tools that enable them to
perform common tasks (e.g., refilling prescriptions and scheduling follow-up
appointments) quickly and easily and to access their primary care physicians
easily when needed.
• Offer them more comprehensive, proactive disease testing so they feel
that they’re doing all they can to maintain their health and prevent the emergence
of chronic health issues.
Meet Driven Darin
Age 35-54 (Gen X)
Gender Male
Ethnicity Asian
Employment Employed
Income $150K+
Lives in Southern suburb
Religious Ambivalent
4.2%cost difference
typical plan
★
chronic issues✜

Conventional Carl
“Old school,” values traditional care
Consumers like Conventional Carl are not concerned about or interested in tracking
health stats. Occasionally they monitor their blood pressure to manage their chronic
illness, but they are not tech-savvy.
Carl and his peers are very happy with all aspects of their current care (doctors,
hospitals, etc.). They are “old school” consumers who prefer to use traditional
healthcare to address issues. They are dissatisfied with alternative care, associating it
with inferior quality and customer service compared to traditional care.
Consumers like Carl rarely set health goals, but if they do, it’s for their own personal
satisfaction, nothing more. For major health issues, they will seek the best care
possible, but they’ll let non-emergency issues pass.
How can you reach consumers like Conventional Carl?
• Offer them simple self-service tools and telemedicine support to help
them manage their chronic illness and reach their doctors when needed.
• Engage them in health education around the importance of maintaining their
fitness to avoid further complications from their chronic illness.
• Make it easier for them to determine if their vitals are within healthy
limits, possibly with the aid of simplified wearable technology.
for a discount on their health insurance premiums, to help prevent additional
chronic issues from arising.
Meet Conventional Carl
Age 55+ (Baby
Boomer)
Gender Male
Ethnicity Caucasian
Employment Retired
Income $25-$75K
Lives in Midwestern town
(easy to
manage)
Religious Ambivalent
5.2%cost difference
typical plan
★
1.6X likely to have an easy-to-
manage chronic condition✜

Try-it-out Tori
Healthy but ambivalent about care
Consumers like Try-it-out Tori don’t focus on tracking their health, but they’re
somewhat tech-savvy, and they do monitor their blood pressure and sleep patterns
sporadically. These consumers are ambivalent about the care they’re receiving and in
some cases are unsatisfied when compared to other segments. They’re willing to try
other options, and they’re pleased with alternative care facilities such as walk-in
clinics, finding them superior to traditional care in terms of quality, cost, proximity,
aesthetics, and customer service.
Consumers like Tori don’t often set health goals, and the ones they do set are easy to
achieve without any support. When facing a medical issue, these consumers seek out
the most cost-effective treatment possible.
How can you reach consumers like Try-it-out Tori?
• Give them simple, low-cost self-service tools that will empower and
encourage them to more closely monitor their health, possibly with the help of
subsidized wearables.
• Adopt the convenience and customer service features of retail clinics to
provide a compelling experience that can win their business.
• Give them more telemedicine options so they can connect with their doctors
more conveniently when needed and complete simple tasks (e.g., refilling
prescriptions and scheduling follow-up appointments) quickly and easily.
for a discount on their health insurance premiums, to help prevent chronic health
issues from developing.
Meet Try-it-out Tori
Age 45-64 (Gen X,
Baby Boomer)
Ethnicity African-American
Education Two-year college
degree
Employment Employed
Income $25-$75K
Digital literacy Moderate
Lives in Midwestern
suburb
Religious Yes
satisfied w/current careì
5.8%cost difference
typical plan
★
chronic issues✜

Savvy Sam
Trend-setter
Consumers like Savvy Sam use wearables to monitor their health stats more precisely,
maintain their fitness, and because of the devices’ “cool factor.” These consumers value
the social aspects of fitness, such as sharing, incentives, encouragement, and peer
competition. They also value the ability to analyze their wearable data to help them
achieve their health goals.
Because consumers in this segment have no chronic illness and rarely get sick, their
approach to treating health issues is unclear. Some are ambivalent about their current
healthcare experience while others are somewhat satisfied, especially with their local
pharmacies and hospitals. Based on their doctors’ recommendations, consumers in
this segment have visited alternative care facilities. They liked the aesthetics of the
facilities but otherwise were indifferent about the experience.
How can you reach consumers like Savvy Sam?
• Allow them to automatically share their activity data with their doctors
to enable more precise feedback, health coaching, and proactive health alerts.
• Provide simple tools for self-reporting key health metrics to their
doctors, to improve wellness tracking and enable proactive issue resolution.
• Give them robust self-service and telemedicine tools so they can complete
simple tasks (e.g., refilling prescriptions and scheduling follow-up appointments)
quickly and easily and connect with their doctors more conveniently when needed.
for a discount on their health insurance premiums, to help prevent chronic illness
from arising.
Meet Savvy Sam
Age 25-34
(Millennial)
Ethnicity Asian
degree
Income $25-$50K
Lives in Moderate-sized
city
with care$
4.2%cost difference
typical plan
★
chronic issues✜

Novice Natalie
Stressed student
Consumers like Novice Natalie focus on tracking calories regularly and checking
weight and BMI monthly to ensure healthiness. They are digitally savvy and use
wearables to monitor their fitness levels. These consumers set easy fitness goals. They
value the social aspects of fitness – including incentives, competition, and
encouragement – sharing their progress to keep them motivated.
Consumers in this segment are somewhat satisfied with their doctors and pharmacies,
but given their age, they don’t have many points of comparison. They have visited
urgent care clinics based on the recommendation of family or friends, but felt that the
cost and aesthetics of these alternative care facilities were inferior to those of a
traditional doctor’s office.
Natalie and her peers are cost-conscious about their care. They will research their
symptoms online before seeking care, and if they need treatment, they’ll pursue the
cheapest option available.
How can you reach consumers like Novice Natalie?
• Subsidize wearables so they can track their fitness more effectively,
and allow them to share activity data with their doctors, to enable better health
coaching and proactive health alerts.
• Empower them with self-diagnosis tools that help them determine if they
need to seek in-person treatment for their illness (versus making that decision on
their own).
• Give them more telemedicine and self-service options so they can
complete common health-related tasks (e.g., refilling prescriptions and scheduling
follow-up appointments) quickly and easily.
• Allow them to opt in to more comprehensive, proactive disease testing
in exchange for a discount on their health insurance premiums.
Meet Novice Natalie
Age 18-24
(Millennial)
Gender Female
Ethnicity Caucasian
Education Some college
Employment Student
Income < $25K
Lives in Northeastern
town
Religious No
3.6%cost difference
typical plan
★
chronic issues✜

Healthy Hogan
Low maintenance
Consumers like Healthy Hogan diligently track many health stats, including BMI, steps
taken, and especially caloric intake, which they monitor daily. These consumers are
ambivalent about their current care and only somewhat satisfied with their primary
hospital and the medical advice they receive. However, they are highly impressed with
alternative care services. They have used urgent care clinics and found the experience
to be equivalent to or better than traditional care in all aspects.
Consumers in this segment are committed to their health goals and consider access to
their health data critical to achieving those goals. They like to analyze data, and they
value encouragement. These digitally savvy consumers rely on online research to help
them find self-treatments for non-life-threatening health issues and avoid major
medical costs.
How can you reach consumers like Healthy Hogan?
• Make it easier for them to track key fitness metrics by subsidizing
wearables and integrating the devices into their wellness programs.
• Give them low- or no-cost self-service and telemedicine tools that make
it easier for them to access health resources, diagnose issues, and contact their
doctors.
• Consider offering coverage for walk-in clinics to help reduce their
healthcare bills and generate loyalty for covering a service they value.
for a discount on their health insurance premiums, to prevent the development of
chronic health issues.
Meet Healthy Hogan
Age 65+ (Baby
Boomer)
Ethnicity Caucasian
Education Four-year
college degree
Employment Retired
Income $50-$65K
Lives in Midwestern
suburb
20% more likely to be somewhat
satisfied w/current careì
with care$
8.7%cost difference
typical plan
★
chronic issues, but occasionally sick✜

Disengaged Dani
Apathetic with chronic illness
Disengaged Dani and his segment peers don’t monitor their health at all; they never
track BMI, steps taken, sleep patterns, or weight. They do go online, but they’re not
mobile-savvy. They have little motivation to pursue health goals, although they
occasionally set and reach easy goals. They rely solely on personal satisfaction to
motivate them.
Consumers like Dani typically are dealing with a chronic condition that is easy to
manage, and they seek the cheapest health care options available. These consumers are
ambivalent about their current care, and only somewhat satisfied with their primary
hospital and advice they receive. Given the low priority they assign to their health, it’s
not surprising that they’ve never pursued alternative care.
How can you reach consumers like Disengaged Dani?
• Give them low- or no-cost self-service resources that improve their health
intelligence and help them to manage their chronic illness with a minimal time
commitment.
• Engage them in health education around the importance of maintaining their
fitness, to avoid further complications from their chronic illness.
• Sell them on the benefits of telemedicine, in terms of cost and speed, so
they become more engaged customers and make their health a higher priority.
• Explain to them the long-term benefit of comprehensive, proactive
disease testing to help them avoid costly complications from their chronic
illness.
Meet Disengaged Dani
Age 65+ (Baby
Boomer)
Ethnicity Indeterminate*
(no degree)
Employment Retired
Income < $50K
Lives in Rural
Northeastern
town
(easy to
manage)
Religious Yes
60% are generally satisfied
w/current careì
30% more likely to want
cheapest care option possible$
10.9%cost difference
typical plan
★

Chronic-Care Cam
Consumers like Chronic-Care Cam track their health stats regularly (including daily
weight checks) and make sure they stay active in order to manage their difficult
chronic illness. These consumers are digitally savvy and would be interested in using
wearables. They value the ability to analyze their health stats to ensure treatments are
successful, and they like sharing their health data with their loved ones.
Cam and her cohorts are highly satisfied with the care they receive, including the
advice they’re given by their doctors and pharmacists. They do not use alternative care
services, since they require the care of specialists to manage their chronic illness.
Consumers like Cam are cost-conscious about their healthcare. Due to the complexity
of their health conditions and the expenses involved, they seek out the most cost-
effective treatment options covered by their insurance.
How can you reach consumers like Chronic-Care Cam?
• Make it easier for them to manage their chronic illness and determine if
their tracked vitals are within healthy limits—possibly with the aid of subsidized
wearable technology
• Offer them more frequent, lower-cost check-ins with a doctor via
telemedicine to assess their progress toward achieving health-related goals.
• Give them more self-service options to enable them to perform common
health-related tasks (e.g., refilling prescriptions and scheduling follow-up
appointments) quickly and easily, and to share their progress with their families.
for a discount on their health care premiums, to prevent complications from their
chronic illness.
Meet Chronic-Care Cam
Age 65+ (Baby
Boomer)
(no degree)
Employment Retired
Income $65-$95K
Lives in Mid-size
Southern city
(difficult to
manage)
8.2%cost difference
typical plan
★
1.2X likely to have a difficult
to manage chronic condition✜

Spiritual Sai
Values quality care to ensure happiness
Consumers like Spiritual Sai do not actively track much health data, but they ensure
that they maintain an active lifestyle by monitoring their steps monthly. They view
health as a path to happiness, and set goals accordingly. They value encouragement
from their doctors and the ability to analyze their health data to ensure they are
on track.
Consumers in this segment are very satisfied with their care, especially the quality of
their specialists, medical advice, and health insurance. They usually seek the highest
quality of care from their doctors, and they’re willing to pay a premium for it.
Because of their satisfaction with their current care, they do not pursue alternative
care services.
How can you reach consumers like Spiritual Sai?
• Educate them on the value of regularly tracking health stats as a means
of better monitoring their chronic illness. Possibly recommend the use of
wearables.
• Offer them more frequent check-ins with their doctor via telemedicine
to assess their progress against their health goals and encourage healthy behavior.
health-related tasks (e.g., refilling prescriptions and scheduling follow-up
appointments) quickly and easily.
for a discount on their health insurance premiums, to prevent complications from
their chronic illness.
Meet Spiritual Sai
Age 65+ (Baby
Boomer)
Education Indeterminate*
Employment Retired
Income $95K+
Lives in Western
metropolitan
region
Health status Indeterminate*
Religious Yes
8.1%cost difference
typical plan
★
58% have a chronic condition
✜

Premium Paul
Successful in life, wants the best
Consumers like Premium Paul are retired but not yet eligible for Medicare. These
consumers are fitness-focused and self-motivated. They are comfortable with mobile
technology and use it to check their weight and log their steps taken.
Paul and consumers like him have paid for premium coverage, and they love their
current care—the hospitals they visit, the doctors and specialists they see, the advice
they receive, and the treatments they’re prescribed. When a health issue arises, they go
straight to the doctor to determine the best treatment option. Because they’re satisfied
with the care they receive, they see no need to visit an alternative care facility.
How can you reach consumers like Premium Paul?
• Show them how to extract maximum value from wearables as tools to
help them monitor their health stats and achieve their health goals.
• Offer them more frequent check-ins with their doctors via
telemedicine to assess their progress toward achieving their health goals.
health- related tasks (e.g., refilling prescriptions and scheduling follow-up
appointments) quickly and easily.
• Offer them more comprehensive, proactive disease testing to help
prevent any chronic health issues from arising.
Meet Premium Paul
Age 55+ (Baby
Boomer)
Gender Male
Ethnicity Caucasian
Employment Retired
Income $80K+
Lives in Small
Northeastern
town
Religious No
8.1%cost difference
typical plan
★
58% have a chronic condition
✜

Struggling Sue
Struggling Sue and consumers like her don’t have time to track fitness-oriented
metrics, but they do monitor their blood pressure and weight in order to manage their
chronic illness. They are digitally savvy and have considered using wearables.
Given their chronic illness, consumers like Sue have to set easy fitness goals. They
value sharing and encouragement, and they rely on family and friends to keep them
motivated.
Consumers in this segment are satisfied with the level of care they receive from their
physicians but are dissatisfied with their insurance plans, due to limited coverage.
This coverage, and their low incomes, limit their options for dealing with health
issues. They use walk-in clinics to reduce costs but are generally disappointed with
the experience.
How can you reach consumers like Struggling Sue?
• Subsidize wearables so they can more easily and effectively track their
fitness and progress against goals specific to managing their chronic illness.
• Offer them more frequent, lower-cost check-ins with a doctor via
telemedicine to check the status of their illness.
• Give them low- or no-cost self-service tools that make it easier for them to
access health resources, diagnose issues, and determine if they need to seek in-
person care.
for a discount on their health insurance premiums, to help prevent complications
from their chronic illness.
Meet Struggling Sue
Age 18-34
(Millennial)
Gender Female
Ethnicity Caucasian
Education 2- or 4-year
degree
Income $35-$50K
Lives in Indeterminate*
* Data does not support a single classification.20-40% more likely to be
with care$
3.7%cost difference
typical plan
★

Restarting Rita
Competing life priorities
Consumers like Restarting Rita have little free time to actively monitor their health,
but they try to track their weight monthly, at a minimum. These consumers have a
moderate level of digital literacy but no interest in wearables.
Consumers in this segment are dissatisfied with their insurance coverage—specifically,
the limited options it provides and the doctors they are forced to see. They have never
tried a walk-in clinic because it is not covered by their insurance; with low incomes,
they must limit their out-of-pocket expenses.
Because consumers in this segment are cash-strapped, they deal with most health
issues themselves or reach out to friends and family for help. For these consumers,
struggling economically, setting health and fitness goals is not a priority.
How can you reach consumers like Restarting Rita?
• Engage them in health education around the importance of tracking their
fitness as they grow older and become at greater risk for chronic health issues.
it easier and cheaper for them to access health resources and diagnose issues on
their own.
• Consider offering coverage for walk-in clinics to give them a low-cost
option for seeking care for non-emergency issues (versus avoiding care
altogether).
for a discount on their health insurance premiums, to help prevent chronic health
issues from arising.
Meet Restarting Rita
Age 45-54 (Gen X)
Gender Female
Ethnicity Caucasian
degree
Employment Employed
Income $0-$50K
Lives in Midwestern
suburb
Religious No
ambivalent about current careì
2.8%cost difference
typical plan
★

Aspirational Annie
Wants to improve health
Consumers like Aspirational Annie actively track their weight, steps taken, and sleep
patterns. They are mobile power users and are very interested in wearables as a means
to obtain more accurate estimates of their health status.
Consumers in this segment are ambivalent about their current care. They are
unimpressed by the doctors and specialists they have seen and the hospitals and
pharmacies they have visited. By contrast, they are impressed with the customer
service and value of alternative care.
Historically these consumers have struggled to meet their health goals. They value
encouragement from their friends, family, and doctors.
Annie and consumers like her are extremely cost-conscious in managing their health,
and they search for the cheapest options available. They will research their symptoms
before seeking care and will try to manage health issues on their own, or they’ll visit a
local clinic for cost-effective care.
How can you reach consumers like Aspirational Annie?
• Subsidize wearables so these consumers they can track their fitness
and progress against their personal health goals more easily and effectively.
for a discount on their health insurance premiums, to help prevent any chronic
health issues from arising in the future.
it easier and cheaper for them to access health resources and diagnose issues on
their own.
• Give them the option of seeing a nurse or physician’s assistant as their
primary caregiver for non-emergency issues in exchange for a discount on their
health insurance premiums.
Meet Aspirational Annie
Age 25-34
(Millennial)
Gender Female
Income $50-100K
Lives in Suburb near
mid-size
Southern city
Religious No
*Data does not support a single classification.
ambivalent about current careì
3.9%cost difference
typical plan
★

How to reach today’s
healthcare consumers
1. Learn from retail clinics.
While retail clinics have not yet gained mainstream appeal, customers give them high
marks for value, quality, aesthetics, service, and convenience. Adopt these retail
lessons to increase customer satisfaction: Streamline paperwork, make costs
transparent, install upscale design and fixtures in facilities, make customer service
highly responsive, and forge strong brand partnerships with well-known hospital and
healthcare groups.
2. Make the customer’s life easier.
Focus on delivering the basics exceptionally well to win the trust and loyalty of
healthcare consumers. To make the customer’s life easier, provide user-friendly health
monitoring tools and services; make common health-related tasks simple to complete
(e.g., online prescription refills, appointment scheduling, claims filing), and deliver
world-class customer service—including streamlined issue resolution.
3. Care about each customer.
Move away from a one-size-fits-all approach to care. Identify your customer segments
and leverage the segment insights outlined above to understand their priorities. Tailor
your offerings to meet the needs and preferences of each segment, and invest in
customer analytics to offer more personalized products, services, and support.
4. Offer next-gen services.
To move customer satisfaction to the next level, offer next-gen services. Leverage the
rise of PHM and the increasing capabilities of wearables to incorporate voluntary
remote patient monitoring into treatment and wellness programs, letting early
adopters drive mainstream adoption.
Consumers aren’t ready to accept a fully automated/self-service care model, even if it
saves them money. Instead, position automated services as a supplement to, not a
replacement for, existing care options.
5. Give consumers choice.
Our research shows that consumers are willing to accept more risk and responsibility
for healthcare and lead a healthier lifestyle in exchange for discounts on their health
insurance premiums. To capitalize on this finding, create discount tiers, offer more
options for customizing health plans, and promote cost-saving opportunities.

Alternative care providers & new entrants: Increase
your visibility, move beyond primary care
1. Educate the public.
Alternative care providers (retail clinics, telemedicine providers, etc.) enjoy stellar
reviews from their customers, but most consumers are unaware of alternative care
services. Use advertising, community outreach, and other means to raise consumer
awareness and increase market visibility.
2. Get the message right.
To attract consumers, ensure that your value proposition emphasizes quality,
convenience, and customer support. Tout the credentials of your physicians, co-brand
with respected health companies/institutions, emphasize cost savings, and address
consumers’ quality concerns.
3. Go beyond primary care.
Offer value-added services on top of primary care to promote "stickiness" and
encourage repeat business. Provide tools to analyze personal health data, track
progress against health goals, and share status with friends and family. Provide
incentives for reaching milestones and for sharing of data with clinics, to help
clinicians to improve the accuracy of diagnoses and effectiveness of treatments.
Wearables manufacturers: Expand your target market
1. Look beyond Millennials.
Wearables have the potential to be attractive to Gen Xers and Baby Boomers if the
devices are positioned as essential personal health management tools. To address these
potential customers, lower the barrier to entry by adding simplified, lower-price
devices to your product mix; partner with payers; and integrate wearables into
treatment plans.
2. Price it right.
Not all customers are budget-conscious. Our research shows that 85% of consumers
want a sub-$100 wearable, but 15% would prefer an advanced model and are willing to
pay as much as $200 for it. Broaden your customer base by offering sub-$100
wearables to appeal to most consumers and higher-end models to attract early
adopters and less budget-conscious consumers.

About our research
Personal health management: The rise of the empowered consumer is a consumer
study prepared by PwC to investigate how behavioral, regulatory, and technological
disruptions are changing consumers’ approaches to managing their health.
How we developed our insights
Our findings are based on an assessment of the needs and preferences of healthcare
consumers across the United States. Our methodology combined primary market
research, conjoint-based trade-off analysis, consumer segmentation analysis, and
industry knowledge to gain insights into what consumers value most when managing
their health, and how much additional responsibility they’re willing to accept in
exchange for reducing the cost of their healthcare.
Who we surveyed
PwC surveyed approximately 2,300 consumers over the age of 18 across the United
States. The survey was administered online in June 2014.
Why these consumers?
Respondents were chosen based on their inclusion in one of four distinct consumer
groups: Single people who have private insurance plans, families with private plans,
seniors with Medicare Advantage plans, and individuals who purchased health
insurance on an exchange such as HealthCare.gov. The distribution of the respondent
pool mirrors percentages drawn from the 2010 US Census in terms of age, income,
education, region, urbanicity, and other demographic categories.

PwC's Experience Radar
A different class of insights
To learn more about our detailed analysis of healthcare consumers and how PwC can
apply this knowledge or our Experience Radar methodology to your business, contact
one of our customer experience practice leads:
Paul D’Alessandro
Healthcare Data Science and Consumerism Leader
+1 312 298 6810
pmd@us.pwc.com
Ceci Connolly
Managing Director, Health Research Institute
+1 202 312 7910
ceci.connolly@us.pwc.com
For more information on the Experience Radar and survey methodology, visit:
http://www.pwc.com/us/en/advisory/customer/pwc-experience-radar.jhtml

Contributors
Pradeep Giri
Manager
Nick Bafaloukos
Director
Anirban Bhaumik
Manager
Apoorv Singh
Associate

© 2015 PricewaterhouseCoopers LLP. All rights reserved. PwC refers to the United States member firm, and may sometimes refer to the PwC
network. Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details.
www.pwc.com
© 2015 PricewaterhouseCoopers LLP, a Delaware limited liability partnership. All rights reserved. PwC refers to the United States member firm, and may sometimes refer to the
PwC network. Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details.
PricewaterhouseCoopers has exercised reasonable care in the collecting, processing, and reporting of this information but has not independently verified, validated, or audited the
data to verify the accuracy or completeness of the information. PricewaterhouseCoopers gives no express or implied warranties, including but not limited to any warranties of
merchantability or fitness for a particular purpose or use and shall not be liable to any entity or person using this document, or have any liability with respect to this document.
This report is for general purposes only, and is not a substitute for consultation with professional advisors.
.

Consumer health experience radar 2015

Recommandé

Recommandé

Contenu connexe

Tendances

Tendances (20)

En vedette

En vedette (20)

Similaire à Consumer health experience radar 2015

Similaire à Consumer health experience radar 2015 (20)

Plus de PwC

Plus de PwC (20)

Dernier

Dernier (20)

Consumer health experience radar 2015