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American Healthcare Market Research BlogAs a market researcher who has studied the health insurance industry for over two decades, this year has shown a dramatic shift in consumer thinking; that is, consumers are being forced to think harder than ever before to determine which health insurance plan is best for their family.

While I have the benefit of working directly with health insurance companies on product development, numerous articles are published each week illustrating some of the challenges consumers are facing with their new plans. These experiences make it clear why conjoint (Discrete Choice) is such a strong tool to understand consumer preferences for different health insurance plan components.

As I digest all of this information, a number of themes continue to surface:

High deductibles – consumers need to know what is subject to the deductible and what isn’t (preventive, Rx etc.). It’s unlikely that insurers want consumers to avoid preventive care as a way to manage their costs, and yet that is exactly what some consumers are doing.

Limited Network – consumers are learning the hard way that you get what you pay for. There are many stories of consumers having to drive ridiculous distances to get treatment from an in-network provider, or those who validated that their physician accepts their carrier to later learn that they don’t accept all plans offered by the carrier. Many are also having difficulty getting an appointment within a reasonable period of time, and some have even visited an in-network hospital and received a bill from an out-of-network physician who treated them there.  

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I’m happy to work for a research company that embraces the philosophy that the respondent experience should be as close to the consumer experience as possible in order to elicit the most useful and actionable information. To that end, we employ different techniques that allow our survey participants to make choices – similar to what they would do in the real world. In so doing, we can provide results that are informative and actionable.

But enough of the sales pitch. I recently faced a problem that made me think of choice in an entirely new way: what if a consumer has a choice but doesn’t realize it? What are the potential consequences?

In my case, my physician ordered a treatment that required pre-certification by my insurance company. When I called for pre-certification, I inquired about the cost (my doc had warned me that the treatment can be very expensive). I was told it would be covered under a $250 co-pay.

I got the treatment and several months later the facility that administered my treatment sent me a bill for $1,500. After a lot of phone calls to my doctor, the facility and my insurance company, we finally determined what happened: my treatment can be performed either in a physician’s office (subject to the $250 co-pay) or at an outpatient facility (subject to a $1,500 outpatient deductible). Yet when I iniitally asked about the cost, the representative only told me about the in-office cost – without informing me that this cost only applied to in-office treatments. I was never told that where I received the treatment had a bearing on what I would pay. So I blindly made my appointment at the treatment facility recommended by my doctor.

We know that decisions should never be made in a vacuum. As researchers, we need to pay attention not only to the choices that we’re putting in front of our survey participants, but also to their awareness of whether or not these options even exist. For example, we’re about to launch a survey about an add-on to an existing technology. But we need to take into account whether the respondents even know that the existing technology is available to them – let alone the add-on. Defining and describing the existing product will help us put how interestested participants are in the add-on into context for our client. The more our participants know about their choices, the less likely they are to make a “mistake” in the choice task we put in front of them, and the better the data for our clients.  

Hits: 4111

Healthcare ReformsWith the recent Supreme Court ruling, it appears that HealthCare Reform is here.  Regardless of which side of the fence consumers fall on, there is important information that they should understand about HCR in order to make critical choices for their care and coverage.  We were interested in finding out how well informed they are now, to see how far we need to go in educating them about their healthcare choices in the coming years. Just under half consider themselves to be slightly knowledgeable, which is about where we’d expect consumers to be at this stage.  One quarter considers themselves knowledgeable and a third report that they are not knowledgeable.

You Think Researchers Have It Tough?

Posted by on in Healthcare

For the past few years MR blog posts have been dominated by posts questioning the future of Market Research or talking about just how tough it is to be a researcher in the new millennium. A recent discussion on Linkedin about the threat from DIY is a good example. If you read my blog frequently you know that I see the industry evolving, not going extinct. In any case, at TRC we do a great deal of research about Health Insurance and so I know that as challenging as research is, it is nothing compared to what the health insurance industry is going through.

First off, I'll ignore issues that have been with the industry for decades. More often than not they don't sell to the folks who use their products (most insurance comes through employers) and they often don't sell to the folks who pay the bills (a majority of insurance is sold through independent brokers). While some research clients don't expose us to their internal clients, we are nowhere near as separated from the folks who use our work as health insurance firms are.

Tagged in: Brand Market Research

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