personal health management

Personal Health ManagementThe rise of the empowered health consumer

April 2015

www.pwc.com

Contents

• Study Introduction

• Major trends in healthcare we focused on

• What consumers told us: Survey results & insights

• What it means (payers/providers)

- Get smarter about consumers

- Offer next-gen services

• What it means (new entrants)

- Alternative care providers

- Wearable manufacturers

• Segmentation overview

• Comparing the plan groups

• Meet your plan members

- Private/Single

- Private/Family

- Medicare Advantage

- Exchange

• Appendix: Segment profiles

2Personal Health Management

Survey Method

Introduction

Understand what consumers value most when managing their health and how much additional responsibility they’re willing to take on to reduce the cost of their healthcare

Study Objective

4 Consumer Groups Surveyed

~2300 people

Private Insurance (Single People)~690 respondents

Private Insurance (Families)

~640 respondents

Medicare Advantage

~560 respondents

Health Insurance Exchange

~410 respondents

A B C D

Survey Section 1 (Standard)

Captured respondent’s demographic profile, health behavioral tendencies, & current healthcare satisfaction levels

Survey Section 2 (Conjoint)

Trade-off exercise to determine what features respondent’s most value in their healthcare coverage, what those features would cost

Understand the Industry

Survey Healthcare Consumers

Identify Experience Improvements

Customer Segmentation

Identify the major trends currently shaping healthcare

Determine how these trends are influencing consumer approaches to healthcare

Using survey data, recommend how to improve

the health CX & how new entrants can be more

disruptive

1

Analyze each of the plan groups to identify unique

customer segments

2 3 4

Analysis Framework


Co

ns

um

er

Be

ha

vio

rs

Care as commodity: A new generation of value-conscious consumers are treating healthcare like any other purchase – seeking out the “best deal” w/ little loyalty to specific brands/providers

More empowered health consumers: They track their vitals, research symptoms online, and self-diagnose rather than rely solely on providers to diagnose and treat illnesses

Higher share of cost burden: Healthcare is getting more expensive and consumers are paying for more of it – changing healthcare from a given to a cost/benefit analysis for many consumers

Te

ch

no

log

y

Alternative care services from non-traditional players: Telemedicine start-ups, retail clinics, at-home medical kits, etc. – consumers have more options than ever to handle their care

Proliferation of health-tracking technology: The exploding wearables industry is allowing consumers to analyze their health with a level of precision traditionally reserved for doctors, and is changing the definition/capabilities of Remote Patient Monitoring (RPM)

Ind

us

try

Ch

an

ge The ACA: Millions of first-time customers are now buying insurance, creating an opportunity for

established payers/providers to grow their customer base, but also for non-traditional companies to disrupt the industry by offering innovative services at compelling price points

Increased demand for primary care: As more new doctors choose specializations over general medicine, the demand on PCPs’ time has never been higher, forcing states to expand PCP laws to include RNs & Pharmacists who can now diagnose illnesses & prescribe treatments

Major trends in healthcare we focused on

1. Understand the Industry


What consumers told us: Survey results & insights

Consumer health intelligence is rapidly increasing, and the traditional notion

of passive, qualitative “wellness” is being replaced by a proactive/quantitative

approach we call “Personal Health Management” (PHM), with data-

enabled consumers taking more responsibility in their healthcare.

83% weight

What do you track monthly?

55%

24% steps

bloodpressure

55%caloricintake

30%sleeppatterns

Consumers like the people/institutions involved with their healthcare, but they’re unimpressed by the

advice they receive and the overall experience. Plus, brands get little credit for great care, but

most of the blame when it’s poor.

80%69%

72%75%75%

59%74%

41%

Primary DoctorSpecialists

PharmacistsDrug Efficacy

PharmaciesHospitalsInsurance

Advice Received

Consumer Satisfaction w/ Healthcare

• Multiple key health statistics are now regularly monitored by consumers

• 3 in 5 push themselves with challenging health goals, and half (46%) frequently reach those goals

• Personal satisfaction (89%), being able to quantitatively track their progress (71%), and validation

from their doctor that they’re on the right track (69%) – these are what consumers value most

when trying to reach a health goal

Ke

y S

tats

Ke

y S

tats

• Nearly half (45%) 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 company itself (44%) or the fees charged (38%)

• Only 2 in 5 are satisfied with the actual medical advice they receive

Passive is out – proactive is in

Customer satisfaction is fragile and brands get blamed

2. Survey Healthcare Consumers

Impacting Trends:

Impacting Trends:

1

2

5


Most consumers are cost-conscious when it comes to care (56%).

However, a sizable portion of the population is willing to pay

for the highest quality care they can get (38%).

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. However, they also showed a willingness to

take on more risk/responsibility in managing their health in

exchange for a lower premium (~5% average savings per consumer)

What they want…

See a doctor in 24 hrs

Get care in a doc office from reputed health co.

Pick any doctor I want

Receive health advice only when requested

What they don’t want…

Retail brands/facilities replacing docs/hospitals

Limits on which docs they can pick for care

Unsolicited health alerts/warnings from doc

Trend Watch: Care Apathy

9% of consumers don’t engage in preventative care, and 7% of Exchange consumers avoid care altogether because of the costs involved. As the cost of healthcare becomes increasingly prohibitive, the care-apathetic population is likely to grow quickly.

Ke

y S

tat

• People are willing to accept more invasive diagnostic testing and virtual consultations

for follow-up appointments & prescription refill requests (in place of in-person visits)

in exchange for a discount on their insurance premium

Ke

y S

tat

• Consumers fall into two camps when handling a health issue: most go straight to their

doctor (48%), but nearly a third (32%) research their symptoms online first before

seeking medical care

Consumers agree on what they can/can’t accept in healthcare…

…but are split on how to approach it


Impacting Trends:

Impacting Trends:

3

4

6


Less than 10% of consumers surveyed own a wearable, but of those who don’t, 1 in 5 have

considered buying one, drawn to their fitness and overall self-improvement features. In

addition, while 84% of those interested would prefer a value-focused, sub-$100 model, 15% would

be willing to pay $200 for a more stylish model with advanced features.

Alternative care customers love the experience (most popular type: walk-in clinics), but more than

half the country (53%) has never used one. Awareness is the primary culprit as only 1 in 5

customers learn about alt care from marketing - word-of-mouth (40%) and online research (28%) were

by far the most commonly cited sources.

How many feel alternative care is the same or better than typical doctors/hospitals in these categories?

94%Proximity

91%CustService

89%Convenience

82%Cost

81%Aesthetics

88%Quality

Trend Watch: Digitally Savvy Public

83% of consumers say they have some comfort with mobile technology, 74% are online multiple times a day, and a majority consider themselves active mobile users (52%). Across all demographics, public digital intelligence continues to rise.

Wearables & Alternative Care: Just outside the mainstream


Impacting Trends:5

Alternative Care Services

Wearables


Make their life easier

What it means (payers/providers): Get smarter about consumers

Learn from retail Payers/Providers looking to create the next-generation patient experience need look no further than their local walk-in clinic for best practices on how to engage and simplify life for customers

What

Although retail clinics have not yet gone mainstream, consumers who’ve used them rave about their value, quality, aesthetics, service, and convenience

Why

Streamlined paperwork

Transparent costing

Upscale design/fixtures

Responsive cust service

Strong brand partners

How

BConsumer satisfaction in healthcare is fickle and doesn’t translate into loyalty towards a brand – so focus less on winning loyalty and more on having world-class tools and customer service

Consumers give little credit to healthcare institutions for good experiences, but most of the blame for bad ones. One poor interaction can ruin their perception of an entire brand.

Care about each customer

Move away from a one-size-fits-all approach to care and use our segment insights to identify the specific needs of your individual customers

While some consumer segments have similar healthcare preferences, the underlying motivations, priorities, and decision-making rationale that inform those preferences are often very different

What

Why

How

What

Why

How

A

C

3. Identify Experience Improvements

Related Findings

Related Findings

Provide tools for PHM

Automate common tasks

Simple issue resolution

Identify your segments

Understand priorities

Create relevant services

Tailor offers/marketing

Related Findings8

Self-service: And not Or

What it means (payers/providers): Offer next-gen services

RPM 2.0Leverage rise of PHM and increasing capabilities of wearables to incorporate voluntary remote health monitoring into treatment/wellness programs; let early adopters drive mainstream adoption

What

More frequently engage patients, proactively identify/manage issues before they become chronic, more accurately track treatment adherence, and create a more educated/informed consumer base

Why

How

EConsumers are NOT ready to accept a fully automated/self-service driven care model even if it saves them money; instead, offer self-service tools as supplement to existing care options

Consumers want peace of mind of being able to reach a person/doctor when needed, likely because of the devastating potential consequences of poorly administered care

What

Why

How

D


Give consumers choiceFGive consumers more customization options when picking an insurance plan, specifically the ability to decrease their coverage levels in exchange for a discount

Consumers show a willingness to take on more risk/responsibility in healthcare and lead a healthier lifestyle in exchange for a premium discount, when given the chance

What

Why

How

Insight on tracked data

Voluntary opt-in/out

Target PHM evangelists

Incentivize milestones

Subsidize devices

Related Findings

Related Findings

Related Findings

Automate basic tasks

Incentivize tools

Maintain human services

Prepare for new entrants

Diversify plan options

Create discount tiers

Enable plan customization

Promote cost savings

9

What it means (new entrants): Alternative care providers

Get the message right

Educate the publicAlternative care providers have a chance to become the solution of choice for basic illnesses for a large portion of the population if they can increase their visibility in the market

What

Alternative care providers enjoy stellar reviews from those who’ve used their services; however, most consumers simply don’t know that these services exist or what solutions they offer

Why

How

BA value prop of doctor-quality service with retail-quality convenience/value/support would prove compelling to a large segment of the population, especially those w/out chronic issues

Americans value speed & quality most in healthcare, while things like location and brand take on lesser importance (except for those on Medicare Advantage)

Go beyond primary care

There are large potential customer bases for non-industry players offering services that supplement traditional care

Strong public interest in non-care health services: tools to analyze personal health data, track progress against health goals, share status with friends/family, earn incentives for reaching milestones, etc.

What

Why

How

What

Why

How

A

C

Related Findings:


Improve marketing

Increase local presence

Tailor offers to segments

Partner w/ payers

Articulate value prop

Related Findings

Related Findings

Related Findings

Tout credentials of docs

Co-brand w/ health co’s

Emphasize cost savings

Address quality concerns

Remote health analysis

Progress tracking

Data sharing

Incentivize milestones

Integration w/ clinics

10

Price it right

What it means (new entrants): Wearable manufacturers

Look beyond MillennialsWearables have the potential to be very attractive to Gen X’ers and Baby Boomers if they are positioned as essential personal health management tools –align device marketing w/ priorities of generation

What

Many older consumers are digitally savvy, prioritize managing their health, and regularly monitor health stats like weight, steps taken, caloric intake since they are at increased risk for chronic issues

Why

How

FOffer budget devices at a sub-$100 price point t0 appeal to most consumers, but also higher-end models w/ advanced features to appeal to early adopters – they will drive mainstream adoption

Nearly a fifth of the country is interested in a Wearable - 85% want a sub-$100 model, 15% want an advanced model and are willing to pay for it ($200)

What

Why

How

E


Millennials: Gamification

Gen X: Health Mgmt

Boomers: Disease Mgmt

Related Findings

Lower barrier to entry

Partner w/ payers

Integrate w/ treatment

Expand product line

Related Findings


Segmentation overview

The four targeted plan groups were compared against each other to

identify group-specific trends

Private Insurance (Single People)~690 respondents

A

Private Insurance (Families)

~640 respondents

B

Medicare Advantage

~560 respondents

C

Health Insurance Exchange

~410 respondents

D

The groups were then analyzed individually to

identify specific customer segments

4 segments 5 segments 4 segments 4 segments

1

2

4. Customer Segmentation

3

For each segment, we determined how they currently manage their health, what they value most in

healthcare, where they’re willing to take on more risk, and what customer experience features would most

resonate with them(See Segment Scorecards in Appendix section)

Example of Segment Scorecard

Demographic Profile

Key Statistics

Behavioral Tendencies

“How to reach them”“Willingness to Save”

12

13

Comparing the plan groups

5347

69

57

Median Age Likely Income

$25-$50K

$100K

$50-$75K

<$50K

While many of the groups had similar characteristics, subtle differences in demographic profiles and healthcare management approaches emerged when the groups were compared…


Chronic Illness Sufferers

46% 42% 61% 43%

Who are they?

How do they behave?

Likely Satisfaction w/ Current Care

Somewhat Satisfied

Ambivalent

Indifferent

Very Satisfied

Healthcare Approach

Cost Conscious

Quality Seeking

60%

52%

52%

63%

29%

44%

43%

33%

Private/Single

Private/Family

Medicare Advantage

Exchange

Own or Considering Wearable

31% 32%

21% 25%

13

Meet your plan Members

Private/Single

Fitness-focusedFey

Wary Walter

Trusting Terri Preoccupied Paulo

27% 25% 24% 23%

Fitness-focused Fay Wary Walter Trusting Terri Preoccupied Paulo

Who are they?

• Age: 18-34 (Mil)• Ethnicity: Black• Education: Grad

Degree• Makes: $50-$100K• Lives In: Major

Metro/South• Health: Healthy• Gender: Female

• Age: 55+ (Boomer)• Ethnicity: White• Education: HS

Diploma• Makes: $25-$50K• Lives In: Rural

town• Health: Chronic

Illness• Gender: Male

• Age: Neutral• Ethnicity: Asian• Education: Grad

Degree• Makes: $75-$150K• Lives In:

Suburbs/West Coast• Health: Healthy• Gender: Neutral

• Age: 45-54 (X)• Ethnicity: Hispanic• Education: College

Degree• Makes: $0-$50K• Lives In: Midwest• Health: Healthy• Gender: Male

How do they behave?

Healthy & cost-conscious• Diligently tracks

health stats• Digitally savvy &

uses wearable• Enjoys current

healthcare• Disappointed with

clinics• Sets ambitious

fitness goals• Wants cheapest care

possible• Prefers to self-treat

health issues

Focused on managing illness• Tracks his vitals

periodically• Uses web but not

mobile savvy• Satisfied with

current care• Clinics not suited for

his illness• Sets reasonable

fitness goals• Wants best care to

avoid issues • Trusts and consults

doc always

Healthiness = Happiness• Monitors health

carefully• Strongly considered

wearable• Highly pleased w/

healthcare• Not impressed w/

clinics• Highly motivated to

reach goals• Wants best care

insurance offers

Healthy but at risk• Doesn’t monitor

health• Doesn’t like current

healthcare• Dissatisfied w/

insurance• Uses clinics now for

most issues• Doesn’t set health

goals• Health/fitness not a

priority

How much less does their preferred plan cost than the base plan?

2.8%

4.4% 4.6%4.2%




Driven Darin Conventional Carl

Try-it-out Tori

Savvy Sam

24% 23% 22% 17% 14%

Driven DarinConventional

CarlTry-it-out Tori Savvy Sam Novice Natalie

Who are they?

• Age: 35-54 (X)• Ethnicity: Asian• Education:

Grad degree• Makes: $150K• Lives In:

Suburbs/South• Health: Healthy• Gender: Male

• Age: 55+ (Boomer)

• Ethnicity:White

• Education: Grad degree

• Makes: $25-$50K

• Lives In: Small town/Midwest

• Health: Chronic (Easy)

• Gender: Male

• Age: 45-64 (X,Boomer)

• Ethnicity: Black• Education: 2 yr

college degree• Makes: $25-

$75K• Lives In:

Suburbs/West Coast

• Health: Healthy• Gender: Neutral

• Age: 25-34 (Mil)• Ethnicity:

Asian, Black• Education:

Neutral• Makes: $25-

$50K• Lives In:

Moderate City• Health: Healthy• Gender: Neutral

• Age: 18-24 (Mil)• Ethnicity:

White• Education:

College Degree• Makes: <$25K• Lives In:

Town/Northeast• Health: Healthy• Gender: Female

How do they behave?

Willing to pay for quality• Tracks health

stats closely• Digitally savvy &

interested in wearables

• Generally happy with current care

• Finds alt care better than doc

• For goals, key is encouragement

• Wants best care possible

• Prefers to lookup issues online first

Tough & “Oldschool”• Doesn’t track his

vitals regularly• Not tech savvy• Extremely happy

with current care• Very dissatisfied

with alt care• Hardly ever sets

health goals• For major issues,

seeks out best care possible

• But for most issues, will just let them pass

Healthy but apathetic• Tracks health

sporadically• Somewhat

digitally savvy• Unimpressed

with current care• Very happy w/

alt care services• Not easily

motivated, sets easy andinfrequent goals

• Wants cheapest care possible

• Highly religious

Trend-setter• Tracks stats that

effect appearance• Uses wearable to

maintain fitness• Mildly satisfied

with current care• Ambivalent

about alt care• Values “social”

aspects of fitness – sharing, incentives, competition, etc.

• Isn’t sick often, so approach is unclear

Stressed student• Only tracks

calories closely• Digitally savvy,

uses wearable to track fitness

• Fairly satisfied w/ current care,

• Not thrilled w/ alt care services

• Sets easy goals, values “social” aspects of fitness

• Cost-conscious w/ care, will research illness online first


Novice Natalie 4.2%

5.2%5.8%

3.6%4.2%

Private/Family4. Customer Segmentation

15


Healthy Hogan Disengaged Dani

Chronic-care Cam

Spiritual Sai

41% 21% 20% 18%

Healthy Hogan Disengaged Dani Chronic-care Cam Spiritual Sai

Who are they?

• Ethnicity: White• Education: College

Degree• Makes: $50-$65K• Lives In: Moderate

city suburb/Midwest• Health: Healthy• Gender: Neutral

• Ethnicity: White• Education: Some

college (no degree)• Makes: <$50K• Lives In: Small

town/Northeast• Health: Chronic

Illness (easy)• Gender: Neutral

• Ethnicity: White• Education: Some

college (no degree)• Makes: $65-$95K• Lives In: Moderate

city/South• Health: Chronic

illness (difficult)• Gender: Neutral

• Ethnicity: White• Education: Neutral• Makes: $95K+• Lives In: Major

metro/West Coast• Health: Neutral• Gender: Neutral

How do they behave?

Low maintenance• Diligently tracks

many health stats • Digitally savvy• Ambivalent about

current care• Highly impressed by

alt care services• Sets some goals,

values analyzing data, encouragement

• Has simple health needs, prefers to self-treat issues and avoid costs

Apathetic chronic illness sufferer• Doesn’t monitor

health at all• Uses web, but not

mobile savvy• Ambivalent about

current care• Never used alt care• Low motivation to

pursue health goals, picks easy ones

• Wants cheapest care option available

Focused on disease• Track health stats to

manage condition• Digitally savvy, see

value in Wearables• Highly satisfied with

current care• Alt care not suited

for their illness• Health goals tied to

disease, value seeing data, sharing status

• Cost-conscious with healthcare, given complexity of needs

Value quality to ensure happiness• Not big on tracking

stats except steps• Love all aspects of

their current care• Have no use for alt

care, go straight to their doc for issues

• Highly religious, see health as path to happiness, set goals accordingly

• Want high quality care, will pay for it


Medicare Advantage

8.7%

10.9%

8.2% 8.1%




Premium Paul Struggling Sue

Restarting Rita

Aspirational Annie

31% 26% 24% 20%

Premium Paul Struggling Sue Restarting Rita Aspirational Annie

Who are they?

• Age: 55+ (Boomer)• Ethnicity: White• Education: Grad

Degree• Makes: $80K+• Lives In: Small

town/Northeast• Health: Healthy• Gender: Male

• Age: 18-34 (Mil)• Ethnicity: White• Education: College

Degree• Makes: $35-$50K• Lives In: Neutral• Health: Chronic

Illness• Gender: Female

• Age: 45-54 (X)• Ethnicity: White• Education:

Technical Degree• Makes: $0-$50K• Lives In:

Suburbs/Midwest• Health: Healthy• Gender: Female

• Age: 25-34 (Mil)• Ethnicity: White• Education: Grad

Degree• Makes: $50-$100K• Lives In: Near

moderate city/South• Health: Healthy• Gender: Female

How do they behave?

Successful in life, wants the best• Retired but not yet

eligible for Medicare• Actively tracks

health stats• Digitally savvy• Paid for premium

coverage, loves his current care

• No need for alt care• Fitness-focused,

self-motivated• Goes straight to his

doctor for any issues

Focused on managing illness• Tracks certain vitals

to manage condition• Mobile user, has

considered wearable• Satisfied with care

received, but dislikes insurance

• Disappointed by alt care services

• Sticks to easy health goals due to illness

• Values sharing, encouragement

Many competinglife priorities• No time/energy to

track health stats• No interest in

wearables• Unimpressed by

current care, dislikes insurance

• Never tried alt care• Cash-strapped, so

will deal w/ most health issues herself

• If care is needed, wants cost-effective option

Wants to improve• Actively tracks

health stats• Mobile power user,

very interested in wearables

• Ambivalent about current care

• Impressed w/ alt care services

• Struggles to meet health goals, values encouragement

• Wants cheapest care option, will researchsymptoms first


Exchange

5.9%

3.7%2.8%

3.9%



Appendix


For a discount, Fey would…

Fitness-focused Fay(27%)

Who she is…

Private/Single4. Customer Segmentation

1.4X likely to be healthy w/

no chronic issues✜20-50% more likely to be

somewhat satisfied w/ current care

50% more likely to be

cost-conscious with care$2.8% cost difference

between preferred plan and base★How she behaves…

Race African American

Gender Female

Age Millennial (18-34)

Education Grad Degree

Region Major southern city

Employment Newly employed

Salary $50-$100K

Digital Literacy High

Religious No

Health Tracking

• Passionate about maintaining a healthy lifestyle, good fitness

• Frequently tracks calories & steps taken, monthly sleep, BMI

Satisfaction w/ Current Care

• Generally happy with her doctor, specialists, pharmacists, and local drug store (very happy with her hospital)

Alterative care experience

• Tried a walk-in clinic on the recommendation of family, but was disappointed by it’s cost and aesthetics

Reaching Health Goals

• Sets challenging health goals and often reaches them• Uses a wearable to track her health, likes it’s social features

HealthcareApproach

• Very cost-conscious with care• Prefers researching symptoms online before seeking care

How to reach her…

• Make it easier for her to track her fitness and know if she’s on track with her goals – remote monitoring of her wearable data

• Empower her with self-diagnosis tools that help her determine if she needs to seek in-person care for her illness (vs. her making that decision on her own)

• Give her more self-service & telemedicine options to perform common health related tasks as simply/quickly as possible (Rx refills, follow-ups, etc.)

• Allow her to opt-in to more comprehensive/proactive disease testing in exchange for a discount on her premium

Use telemedicine tools for follow-up visits and Rx refills

Submit to more invasive, proactive disease testing & lab work

19

For a discount, Walter would…

Wary Walter (25%)

Who he is…


3.1X likely to have a difficult

to manage chronic condition✜40-90% more likely to be

very satisfied w/ current care

70% more likely to want

the highest quality care possible$4.4% cost difference

between preferred plan and base★How he behaves…

Race Caucasian

Gender Male

Age Baby Boomer (65+)

Education High School Degree

Region Rural Town

Employment Retired

Salary $25-$50K

Digital Literacy Low

Religious Yes

Health Tracking

• Tracks weight, blood pressure every day to manage illness

• Occasionally tracks calories when urged by doctor


• Extremely satisfied with doctors, specialists, pharmacists, drug efficacy, hospitals, health insurance, and advice received


• Has never used them since they aren’t equipped to handle a complex chronic condition like his


• Focused on illness, only periodically sets/reaches health goals• Values analyzing his vitals and encouragement from doctor

HealthcareApproach

• Goes straight to the doctor when he has an issue• Despite limited means, wants the best quality care possible

How to reach him…

• Make it easier for him to manage his chronic illness and know if his tracked vitals are within healthy limits – possibly with simplified wearable tech

• Offer him more frequent check-ins with a doctor via telemedicine to promote better adherence to treatment plans and provide positive encouragement

• Give him more self-service options to perform common health related tasks as simply/quickly as possible (i.e., Rx refills)

• Offer him more comprehensive/proactive disease testing in exchange for a discount on his premium in order to better prevent additional chronic issues



20

For a discount, Terri would…

Trusting Terri (24%)

Who they are…







between preferred plan and base★How they behave…

Race Asian

Gender Neutral

Age Neutral


Region West coast suburb

Employment Neutral

Salary $75-$150K


Religious Yes

Health Tracking

• Track weight & calories weekly, steps & BMI regularly

• Carefully manage health, very interested in wearables


• Love/trust their doctor - satisfied with advice received, treatments prescribed, specialists referred to


• Tried on advice of doctor, but saw no difference in cost &convenience and felt quality was worse than regular doc


• Often reach their health goals - value the encouragement of friends/family/doctor and being able to track their progress

HealthcareApproach

• Their health has major effect on their happiness, so they seek out best care available when faced with an issue

How to reach them…

• Subsidize wearables so that health tracking is integrated into their regular fitness/wellness routine and the data is made available to their doctors

• Provide proactive health warnings/alerts based on their activity data so they can prevent potentially damaging lifestyle choices

• Give them more telemedicine options so they can more conveniently/easily connect with their doctors when needed and complete simple tasks (i.e., Rx refills)

• Offer them more comprehensive/proactive disease testing so they can continue maintaining their healthy lifestyles



Accept proactive health warnings from doc based on activity data

21

For a discount, Paulo would…

Preoccupied Paulo (23%)

Who he is…



no chronic issues✜60-100% more likely to

feel ambivalent about current care

66% are cost-conscious

with care$4.2% cost difference


Race Hispanic

Gender Male

Age Gen X (45-54)

Education 4 Year College Degree

Region Midwest

Employment Employed

Salary $0-$50K


Religious Neutral

Health Tracking

• Doesn’t have the time/energy to track health (occasionally

checks weight) – focused on staying afloat financially


• Very ambivalent about people/institutions involved w/ care• Dissatisfied w/ insurance, so reluctant to engage in care


• Loves proximity & cost of urgent care clinics – uses them to handle most issues after being recommended by family


• Doesn’t have time or energy to set health goals, and doesn’tvalue motivating tactics like encouragement, incentives, etc.

HealthcareApproach

• Is healthy but generally avoids care b/c of costs involved• Low priority of personal health could lead to chronic issues

How to reach him…

• Offer him cost-effective and simple options for engaging in preventative care, possibly by offering coverage of his visits to walk-in clinics or remote support

• Give him low/no-cost self-service resources that improve his health intelligence and help him manage his lifestyle w/ minimal time commitments

• Sell him on the cost/speed benefits of telemedicine so that he becomes a more engaged customer and makes his a health a life priority

• Explain to him the long-term cost benefit of comprehensive/proactive disease testing and avoiding complex chronic conditions



22

For a discount, Darin would…

Driven Darin (24%)

Who he is…








Race Asian

Gender Male

Age Gen X (35-54)


Region Southern suburb

Employment Employed

Salary $150K+


Religious Ambivalent

Health Tracking

• Often tracks weight, blood pressure, steps, sleep, calories

• Very interested in a wearable for self-improvement


• Fairly satisfied w/ total health experience – likes the doctors he sees, the institutions he visits, and the advice he receives


• Fairly satisfied w/ alt care – feels cost, convenience, and customer service are better than typical doctor/hospital


• Desires encouragement and ability to analyze health data • Social incentives, progress sharing have little value

HealthcareApproach

• Will research nonthreatening issues online, but when care is needed he wants the highest quality available

How to reach him…

• Show him how to extract maximum value from a wearable as a tool to help monitor his health stats and achieve his health goals

• Allow him to automatically share his activity data with his doctor for more precise health coaching, feedback, & guidance and proactive/persistent alerts

• Give him robust self-service & telemedicine tools that make it quicker/easier for him to access his PCP when needed and perform common tasks

• Offer him more comprehensive/proactive disease testing so that he feels he is doing everything he can to maintain his health and avoid chronic issues

Private/Family




Allow his tracked activity data to be automatically shared w/ doc

23

For a discount, Carl would…

Conventional Carl (23%)

Who he is…


1.6X likely to have an easy-

to-manage chronic condition✜20-30% more likely to be





Race Caucasian

Gender Male



Region Midwestern town

Employment Retired

Salary $25-$75K


Religious Ambivalent

Health Tracking

• Not concerned with or interested in tracking health stats

• Occasionally tracks blood pressure to manage his condition


• Traditionalist – prefers using regular health care for issues• Very satisfied w/ all aspects of care (doctors, hospitals, etc.)


• Not surprisingly, finds alternate care to have worse quality and customer service than traditional care


• Doesn’t set many goals – if he does, it’s for his own personal satisfaction, nothing else

HealthcareApproach

• Old-school, prefers to let non-emergency issues pass• If he needs medical attention, he seeks out the highest quality

How to reach him…

• Give him simple self-service tools and easily accessible telemedicine support resources for managing his condition and reaching his doctor when needed

• Engage him in health education around the importance of maintaining his fitness to avoid further complications from his chronic condition

• Make it easier for him to check if his vitals are within healthy limits, possibly with simplified wearable tech

• Offer him more comprehensive/proactive disease testing in exchange for a discount on his premium in order to better prevent additional chronic issues

Private/Family



24

For a discount, Tori would…

Try-It-Out Tori (22%)

Who they are…



no chronic issues✜20% more likely to be

satisfied w/ current care




Race African American

Gender Neutral

Age X/Boomer (45-64)


Region Midwestern suburbs

Employment Employed

Salary $25-$75K

Digital Literacy Moderate

Religious Yes

Health Tracking

• Check blood pressure sporadically and occasionally monitor

their sleep patterns, but don’t focus on tracking their health


• Are fairly ambivalent w/ their current care, and in some cases, unsatisfied when compared to other segments


• Love the experience, find the quality, cost, proximity, aesthetics, and customer service all better than regular doctor


• Don’t set many health goals, if they do they’re easy to achieve and they don’t need any support to meet them

HealthcareApproach

• When facing a medical issue, they seek out the most cost effective treatment possible


• Give them simple, low-cost self-service that will empower & encourage them to more closely monitor their health – possibly w/ subsidized wearables

• Adopt the convenience and customer service features of retail clinics to improve provide a compelling experience that can win them back as customers

• Give them more telemedicine options so they can more conveniently/easily connect with their doctors when needed and complete simple tasks (i.e., Rx refills)

• Offer them more comprehensive/proactive disease testing in exchange for a discount on his premium to help prevent chronic issues from developing

Private/Family



25

For a discount, Sam would…

Saavy Sam (17%)

Who they are…








Race Asian

Gender Neutral



Region Moderate-sized city

Employment Neutral

Salary $25-$50K


Religious Neutral

Health Tracking

• Track stats that effect appearance (weight, steps, BMI, etc.)

• Uses wearable to be precise w/ monitoring and for “coolness”


• Somewhat satisfied to ambivalent with current healthcare experience – especially like their local pharmacy and hospital


• Tried on recommendation of doctor - liked aesthetics of facility, but otherwise indifferent about experience


• Value incentives, peer competition, encouragement, and the ability to analyze their wearable data when reaching goals

HealthcareApproach

• No chronic conditions and rarely get sick, so their approach to treating health issues is unclear


• Allow them to automatically share activity data with their doctor for more precise health coaching, feedback, & guidance and proactive/persistent alerts

• Provide simple tools for self-reporting key health metrics to their doctors for improved wellness tracking and proactive issue resolution

• Give them robust self-service & telemedicine tools that make it quicker/easier for them to access their PCP when needed and perform common tasks

• Offer them more comprehensive/proactive disease testing in exchange for a discount on their premium to better prevent future chronic conditions

Private/Family




Auto-share activity data w/ doc and self-report key health stats weekly

26

For a discount, Natalie would…

Novice Natalie (14%)

Who she is…








Race Caucasian

Gender Female


Education Some college

Region Northeast

Employment Student

Salary <$25K


Religious No

Health Tracking

• Focuses on regularly tracking calories, checking weight/BMI

monthly to ensure healthiness – interested in a wearable


• Somewhat satisfied with her doctor and pharmacy, but doesn’t have many comparison points given her age


• Has used urgent care clinics after recommendation of family/friends, but felt cost & aesthetics were worse than regular doc


• Sets easy fitness goals - values incentives, competition, encouragement, sharing her progress to keep her motivated

HealthcareApproach

• Researches her symptoms online before seeking care• If she needs treatment, wants the cheapest option possible

How to reach her…

• Subsidize wearables so she can better track her fitness and allow her to share that data with her doctor for better health coaching, proactive alerts

• Empower her with self-diagnosis tools that help her determine if she needs to seek in-person care for her illness (vs. making that decision w/ online research)

• Give her more self-service & telemedicine options to perform common health related tasks as simply/quickly as possible (Rx refills, follow-ups, etc.)

• Allow her to opt-in to more comprehensive/proactive disease testing in exchange for a discount on her premium

Private/Family




27

Medicare Advantage4. Customer Segmentation

For a discount, Hogan would…

Healthy Hogan (41%)

Who they are…


no chronic issues, but occasionally sick

✜20% more likely to be





Race Caucasian

Gender Neutral



Region Midwestern suburb

Employment Retired

Salary $50-$65K


Religious Neutral

Health Tracking

• Focus attention on tracking their BMI, steps taken, and

especially caloric intake (which they monitor daily)


• Are ambivalent w/ their current care, and only somewhat satisfied by their primary hospital and advice they receive


• Have used Urgent Care Clinics and found the experience to be the same or better than traditional doctors in all aspects


• Want to meet their health goals and consider access to their health data very important to confirm their goals

HealthcareApproach

• Rely on online research to resolve non life-threatening issues and avoid major medical costs


• Make it easier for them to track key fitness metrics by subsidizing and integrating wearables into their wellness program

• Give them low/no-cost self-service & telemedicine tools that make it easier for them to access health resources, diagnose issues, and contact their doctor

• Consider offering coverage for walk-in clinics to help reduce their bill and generate loyalty for covering a service they really enjoy

• Offer them more comprehensive/proactive disease testing in exchange for a discount on their premium to prevent the development of chronic issues



28


For a discount, Dani would…

Disengaged Dani(21%)

Who they are…


to-manage chronic condition✜60% are generally satisfied

w/ current care


cheapest care option possible$10.9% cost difference


Race Caucasian

Gender Neutral


Education Incomplete college

Region Northeast rural town

Employment Retired

Salary <$50k


Religious Yes

Health Tracking

• Don’t invest much effort into monitoring their health as they

never track BMI, steps taken, sleep patterns, or weight


• Are ambivalent w/ their current care, and only somewhat satisfied by their primary hospital and advice they receive


• Given the low priority they give health, they have never tried alternative health care services


• Occasionally set and reach easy health goals• Rely solely on personal satisfaction for motivation

HealthcareApproach

• Typically deal with a chronic condition that is easy to manage and look for the cheapest health care options available


• Give him low/no-cost self-service resources that improve his health intelligence and help him manage his condition w/ minimal time commitments

• Engage him in health education around the importance of maintaining his fitness to avoid further complications from his chronic condition

• Sell him on the cost/speed benefits of telemedicine so that he becomes a more engaged customer and makes his a health a life priority

• Explain to him the long-term cost benefit of comprehensive/proactive disease testing to avoid further complications from his chronic condition



29


For a discount, Cam would…

Chronic-careCam(20%)

Who they are…

1.2X likely to have a difficult

to manage chronic condition✜20-60% more likely to be





Race Caucasian

Gender Neutral


Education Incomplete college

Region Southern midsize city

Employment Retired

Salary $65-95K


Religious Neutral

Health Tracking

• Track their weight daily and make sure they stay active

• Use tech/mobile often and would be interested in wearables


• Happy with the care they receive to manage their illness• Satisfied with both doctors/pharmacists and their advice


• Do not use alternative care services since they need specialist care to manage their chronic condition


• Value being able to analyze their health stats to ensure treatments are successful and share them with loved ones

HealthcareApproach

• Given their expenses, they seek out the most cost-effectivetreatment options covered by their insurance


• Make it easier for them to manage their chronic illness and know if their tracked vitals are within healthy limits – possibly with subsidized wearable tech

• Offer them more frequent, lower cost check-ins with a doctor via telemedicine to check progress against health goals

• Give them more self-service options to perform common health related tasks as simply/quickly as possible (i.e., Rx refills), and to share their progress w/ family

• Offer them more comprehensive/proactive disease testing in exchange for a discount on their premium to prevent complications from their chronic issue



30


For a discount, Sai would…

Spiritual Sai(18%)

Who they are…

58% have a chronic condition✜20-30% more likely to be



highest quality care possible$8.1% cost difference


Race Caucasian

Gender Neutral


Education Neutral

Region Western metro region

Employment Retired

Salary $95K+


Religious Yes

Health Tracking

• Do not actively track much health data, but they do ensure

they maintain an active lifestyle by monitoring steps monthly


• Very satisfied with their care, especially the quality of theirspecialists, medical advice, and health insurance


• Given how happy they are with their care, they go straight to their doctors and do not use alternative care services


• Value encouragement from their doctors and the ability to analyze their health data to ensure they are on track

HealthcareApproach

• Usually seek out the highest quality health care from their doctors and don’t use alternative care services


• Educate them on the value of regularly tracking health stats as a means of better monitoring their chronic condition – possibly recommend wearables

• Offer them more frequent check-ins with their doctor via telemedicineto check progress against health goals and encourage healthy behavior

• Give them more self-service options to perform common health related tasks as simply/quickly as possible (i.e., Rx refills)

• Offer them more comprehensive/proactive disease testing in exchange for a discount on their premium to prevent complications from their chronic issue



31

Exchange4. Customer Segmentation

For a discount, Paul would…

Premium Paul (31%)

Who he is…





highest quality care possible$5.9% cost difference


Race Caucasian

Gender Male

Age X/Boomer (55+)


Region Northeastern town

Employment Retired

Salary $80K+


Religious No

Health Tracking

• Is comfortable with mobile technology and uses it to check

his weight and frequently monitor/log his steps taken


• Loves the hospital he visits, the doctors/specialists he sees, the advice he receives, and the treatments they prescribe


• Is content with the care he receives and sees no need to visit an alternative care facility


• Commits to his fitness and does not need much outside motivation

HealthcareApproach

• Goes straight to his doctor to determine the best treatment option when any issues arise

How to reach him…

• Show him how to extract maximum value from a wearable as a tool to help monitor his health stats and achieve his health goals

• Offer him more frequent check-ins with his doctor via telemedicine to check progress against health goals

• Give him more self-service options to perform common health related tasks as simply/quickly as possible (i.e., Rx refills)

• Offer him more comprehensive/proactive disease testing to help prevent any future chronic issues



32


For a discount, Sue would…

Struggling Sue(26%)

Who she is…


to-manage chronic condition✜20-40% more likely to be





Race Caucasian

Gender Female


Education 2 or 4 Year Degree

Region Neutral

Employment Neutral

Salary $35-50K


Religious Neutral

Health Tracking

• Monitors blood pressure and weight given her condition

• Does not have time to track fitness-oriented metrics


• Happy with level of care she receives from her physicians• Dissatisfied with her insurance plan due to limited coverage


• Uses various walk-in clinics to alleviate costs but is disappointed with the experience


• Given her condition, she has to set simple/easy fitness goals• Relies on family/friend encouragement for motivation

HealthcareApproach

• Has limited options when trying to deal with health issues due to small income and basic insurance means

How to reach her…

• Subsidize wearables so she can better and more easily track her fitnessand progress against health goals specific to managing her condition

• Offer her more frequent, lower cost check-ins with a doctor via telemedicine to check the status of her condition

• Give her low/no-cost self-service tools that make it easier for her to access health resources, diagnose issues, and determine if she needs to seek in-person care

• Offer her more comprehensive/proactive disease testing in exchange for a discount on her premium to help prevent complications from her chronic issue



33


For a discount, Rita would…

RestartingRita(24%)

Who she is…



✜20-40% more likely to be

ambivalent about current care




Race Caucasian

Gender Female

Age Gen X (45-54)


Region Midwestern suburbs

Employment Employed

Salary $0-50K


Religious No

Health Tracking

• Has little free time to actively track her health, so she tries to

at least track her weight monthly


• Very dissatisfied with her insurance coverage, the limited options it provides, and the doctors she is forced to see


• Never tries a walk-in clinic because it is not covered by her insurance and she must limit out-of-pocket expenses


• Given her economic condition, health and fitness goals are not a priority right now and therefore, non-existent

HealthcareApproach

• Wants to save money, so she either deals with the illness herself or reaches out to friends/family

How to reach her…

• Engage her in health education around the importance of tracking her fitness as she gets older and is at greater risk for chronic issues

• Give her low/no-cost self-service and telemedicine tools that make it easier/cheaper for her to access health resources and diagnose issues on her own

• Consider offering coverage for walk-in clinics to give her a low-cost option for seeking care for non-emergency issues (vs. avoiding care altogether)

• Offer her more comprehensive/proactive disease testing in exchange for a discount on her premium to help prevent any future chronic issues



34


For a discount, Annie would…

AspirationalAnnie(20%)

Who she is…



✜30-80% more likely to be

ambivalent about current care

14% more likely to be cost-

conscious with care$3.9% cost difference


Race Neutral

Gender Female



Region Southern city/suburb

Employment Neutral

Salary $50-100K


Religious No

Health Tracking

• Actively tracks weight, steps taken, and sleep pattern

• Estimates are imprecise so she is looking for a wearable


• Is unimpressed by the doctors and specialists she has seen and the hospitals and pharmacies she has visited


• Tried after seeing an ad and was impressed by the customer service and value as compared to her regular doctor


• Has historically struggled to meet her health goals• Values encouragement from friends/family/doctor

HealthcareApproach

• Extremely cost-conscious with managing her health• Will try to handle it herself or will go to local clinic

How to reach her…

• Subsidize wearables so she can better and more easily track her fitnessand progress against her personal health goals

• Offer her more comprehensive/proactive disease testing in exchange for a discount on her premium to help prevent any future chronic issues

• Give her low/no-cost self-service and telemedicine tools that make it easier/cheaper for her to access health resources and diagnose issues on her own

• Give her the option of seeing a Nurse or PA as her primary care giver for non-emergency issues in exchange for a discount on her premium



See a Nurse or Physician's Assistant first before seeing a doctor

35

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 insightsOur 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.

About our research

This publication has been prepared for general guidance on matters of interest only, and does

not constitute professional advice. You should not act upon the information contained in this

publication without obtaining specific professional advice. No representation or warranty

(express or implied) is given as to the accuracy or completeness of the information contained

in this publication, and, to the extent permitted by law, PricewaterhouseCoopers LLP, its

members, employees and agents do not accept or assume any liability, responsibility or duty of

care for any consequences of you or anyone else acting, or refraining to act, in reliance on the

information contained in this publication or for any decision based on it.

© 2015 PricewaterhouseCoopers LLP. All rights reserved. In this document, “PwC” refers to

PricewaterhouseCoopers LLP which is a member firm of PricewaterhouseCoopers

International Limited, each member firm of which is a separate legal entity.

PwC's Experience RadarA 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 [email protected]

Ceci ConnollyManaging Director, Health Research Institute+1 202 312 [email protected]

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 GiriManager

Nick BafaloukosManager

Anirban BhaumikSenior Associate

Apoorv SinghAssociate

mailto:[email protected]

mailto:[email protected]

http://www.pwc.com/us/en/advisory/customer/pwc-experience-radar.jhtml

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