OLIVER WYMAN CONSUMER HASSLE SURVEY FINDINGS 2015
Helen Leis Partner Health & Life Sciences helen.leis@oliverwyman.com
The average health consumer has experienced approximately nine frustrations, with “Staying on track with health-related goals” topping the list Frustrations per respondent
Most frequent frustrations 1) Staying on track with health-related goals 2) Understanding what medical care will be covered 3) Finding a solution that works for me to lose weight 4) Being able to afford healthy foods 5) Getting bills that I expected insurance to cover
0
1
2
3
4
5
6
7
8
9
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 >30
Frustrations selected
© Oliver Wyman
Source: Oliver Wyman analysis www.oliverwyman.com
1
Comparing frustrations across frequency and severity helps segment hassles into different tiers/categories 6.5
Niche Frustrations
Systemic Issues
Finding Coverage Living my Life
Getting access to Substance abuse treatment
Frustration severity (1-7)
6.0
Finding out a visit won’t be covered
Not knowing who to appeal to Getting conflicting info from doctor/insurance
Getting claims reimbursed & Claims resolved
Paying out of pocket
Getting Healthcare
Unexpected costs
Rx isn’t covered
Getting Specialty Care
Rx Authorization Bills for something I Paperwork issues Doctor no info on expected insurance to Finding the info I Enrolling in a previous visits cover need from insurance health plan Access to mental Higher co-pays Finding out the specialist health treatment doesn’t have info on previous Test costs Figuring how visits Understanding I have to pay Not needing Unwanted much for premiums Finding a solution to Getting care substitutions Figuring out how Doctor’s visit cost lose weight a referral much for a visit Getting enough time with a Getting time Understanding what Finding a solution specialist Comparing Figuring out w/doctorGetting an is covered to quit smoking Info to manage health plans Being able to prescription options appointment health conditions afford healthy Finding info on Solution to maintain a Getting access to Accessing health foods doctor/specialist other insurance healthy weight records & Accepts Too early Transportation Learning about quality Seeing a doctor insurance for refill Staying on track to hospital Getting enough the resources available when convenient with goals Getting timely time with a Finding tools to motivate results specialist me to exercise Finding healthy foods Running Scheduling tests Getting a follow up out of Preparing healthy meals Accessing refills Paying alternative electronic bills treatments
5.5
5.0
4.5
Managing Rx Paying the Bill
Keeping track of Rx
4.0
Occasional Bothers 0%
5%
Frequent Irritants 10%
15%
20%
25%
30%
35%
Frustration frequency © Oliver Wyman
Source: Oliver Wyman analysis www.oliverwyman.com
2
Systemic issues – those with both high frequency and high severity – are most likely to be related to paying the bill and out of pocket payments 6.5
Niche Frustrations
Systemic Issues
Finding Coverage Living my Life
Getting access to Substance abuse treatment
Frustration severity (1-7)
6.0
Getting claims reimbursed & Claims resolved
Niche hassles Access to mental health treatment
5.5
Finding out a visit won’t be covered
Not knowing who to appeal to Getting conflicting info from doctor/insurance
Paying out of pocket
Getting Healthcare
Unexpected costs
Rx isn’t covered
Getting Specialty Care
(Unexpected) Access to Rx Authorization for something I Paperwork issues Information Costs of careBills Doctor no info on expected insurance to Finding the info I Enrolling in a previous visits cover (health + needAdmin from insurance health plan Higher co-pays Finding out the specialist process) doesn’t have info on previous Test costs
Managing Rx Paying the Bill
Figuring how visits Understanding I have to pay Not needing Unwanted much for premiums Finding a solution to Getting care substitutions Figuring out how Doctor’s visit cost lose weight a referral much for a visit Getting enough time with a Getting time Understanding what Finding a solution specialist Comparing Figuring out w/doctorGetting an is covered to quit smoking Info to manage health plans Being able to prescription options appointment health conditions afford healthy Finding info on Solution to maintain a Getting access to Accessing health foods doctor/specialist other insurance healthy weight records & Accepts Too early Transportation Learning about quality Seeing a doctor insurance for refill Staying on track to hospital Getting enough the resources available when convenient with goals Getting timely time with a Finding tools to motivate results specialist me to exercise Finding healthy foods Running Scheduling tests Getting a follow up out of Preparing healthy meals Accessing refills Paying alternative electronic bills treatments
5.0
Managing Health & Wellness
4.5
Keeping track of Rx
4.0
Occasional Bothers 0%
5%
Frequent Irritants 10%
15%
20%
25%
30%
35%
Frustration frequency © Oliver Wyman
Source: Oliver Wyman analysis www.oliverwyman.com
3
Consumers believe that “my health insurance company” can best solve many frustrations, especially within finding coverage and paying the bill % of consumers who believed each group was most able to help Based on top 5 frustrations in each category
Insurance most able to solve?
Paying the bill
Finding coverage Managing prescriptions Getting specialty care Getting healthcare
Uninsured
Living my life 0%
10%
20%
Providers Hospital
© Oliver Wyman
Doctor
30%
40%
50%
60%
70%
Payers
Pharmacist Insurance Employer
80%
90%
100%
Least able to solve?
Other Gov't
Myself
Consumers
Other
None
Source: Oliver Wyman analysis www.oliverwyman.com
4
The key is developing a deep understanding of health consumers: The frustrations they express, and those they don’t
People’s conditions are far more complex than the symptoms we often see them through Consumers rely on Instagram and Pinterest for medical advice as much as they do docs and pharmacists Healthcare is often perceived as a series of adversarial relationships Searching for the right physician is frustrating and hard; consumers often ‘date’ multiple doctors before they find the right fit Consumers want to feel less lonely and isolated in their healthcare journey Cost, pricing, and billing confusion are major causes of frustration and inaction © Oliver Wyman
Source: Oliver Wyman analysis www.oliverwyman.com
5
Innovative health experiences are…
Human and empathetic
• Humanized brand voice • Simplified information • Owning up and over-delivering
Authentic and transparent
• Creating personal connections • Total transparency • Always with you
Simple and personalized
Holistic and integrated
• Celebrating the small things • Intelligent personalization • Giving consumers a voice
• Care teams • Seamless data • Experiential unification
In category
Out of category
© Oliver Wyman
Source: Oliver Wyman analysis www.oliverwyman.com
6
Successful consumer experience innovation doesn’t start with the solution, it starts with the consumer and works forward
“We love to travel, and need to make sure our healthcare travels with us.”
“I sometimes feel lonely and isolated.”
“I’m focused on staying active and healthy.” © Oliver Wyman
“My daughter makes all my healthcare decisions, can you talk with her?”
“I can’t always get to my doctor because I can’t drive.”
“Don’t treat me like a geriatric, I’m still in my prime!” Source: Oliver Wyman analysis www.oliverwyman.com
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