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Pushing health care’s boundaries

The newly insured in the United States represent a different kind of health consumer. Who are they, and can they change the industry?

By Rich Birhanzel

Introduction

There is a new breed of health care consumer on the rise: the newly insured. In the United States, this group has been insured for two years or less, and includes people who have bought insurance through a public exchange, qualified for Medicaid through the Affordable Care Act, purchased individual coverage directly or have employer coverage. These consumers could be a harbinger of what’s to come for health care.

As Accenture research reveals, they are young (32 years old, on average), digitally savvy and motivated to stay healthy. At the same time, they’re largely unfamiliar with the health care system many older Americans have enjoyed for years. As millions of the newly insured enter the system, they hold the power to transform health care as we know it.

These emerging health care consumers have a new set of expectations: They want convenience and the right dose of digital when it comes to their health care experience. But do providers and insurers have the right tools to deliver it?

Care Without Complexity

Today’s connected health care consumers want frictionless care. And that’s not about avoiding needle pricks; it’s about having access to the right tools at the right time.

From checking symptoms to booking appointments online to virtual care, the newly insured want to control their health experience. These consumers are more immersed in the digital world than their insured predecessors, and using technology is second nature to them. According to our survey data (see the interactive graphic below for more comparative data):

  • 30 percent of the newly insured are inclined to use mobile health tools rather than reaching out to a doctor, compared with 20 percent of the already insured.

  • 36 percent are more likely to look for information online to avoid a doctor visit (vs. 26 percent).

  • 52 percent prefer virtual visits that save time (vs. 44 percent).

Newly insured vs. already insured: How do they compare?
Use of technology Technology is important to managing my health.
I’d rather use mobile health tools than reach out to my doctor.
Cost of care and incentives I would share data with my plan provider if I received an incentive.
I’d go to the gym 3-4 times a week if the membership were paid for.
Receiving Care I would prefer remote visits if they allowed me to interact more with my doctor.
I would prefer a virtual visit if it reduced the wait time.
Privacy and trust I’m concerned about the privacy of my electronic records.
I think that general practitioners are trustworthy.

Health plans are responding by offering apps and other tools to help consumers manage their health care. California-based managed care consortium Kaiser Permanente’s app allows patients to send messages to their doctor, see a list of medications they are taking, access their electronic medical records and even get directions to the closest in-network clinic.1

Doctors themselves have recognized the demand for connected care, and some are taking matters into their own hands. Two physicians created ZOOM+, a system of retail clinics in Oregon and Washington that offer mobile appointment booking, prescription medications, fitness coaching, transparent pricing and office appointments so fast they don’t even have magazines in the waiting room. ZOOM+ has grown to more than 30 locations and now offers dental care, mental health services, chronic disease management and access to specialists.2

As new options for frictionless care appeal to the wishes of the newly insured, they also need to respond to their concerns.

They Don’t Trust What They Don’t Know

Lack of experience with the health care system might have engendered a lack of trust of providers and insurers. Interestingly, only 31 percent of the newly insured regard general practitioners as trustworthy, compared with 44 percent of those already insured, and just 36 percent of newly insured trust nurses, compared with 53 percent of the longtime insured. This distrust might lead to data privacy concerns, as well.

The newly insured are more likely than the longtime insured to be “somewhat concerned” or “very concerned” about the privacy of their electronic health records (78 percent vs. 69 percent). However, they will share information for a price. More than three-quarters of the newly insured surveyed (77 percent) would be willing to share data with their health plan if doing so would make them eligible for a discount or incentive. And, as indicated in Accenture research, financial rewards are also an impetus to keep their health on track.

Get Healthy. Get Rewarded.

Newly insured health care consumers are more likely to respond to incentive programs, such as monetary rewards or paid gym memberships. Such perks motivate this group in significant numbers. According to our research:

  • 82 percent are likely to track weekly diet and exercise information for monetary incentives.

  • 78 percent would go to the gym three to four times a week if their membership were paid for.

  • 75 percent would take annual biometrics tests to earn discounts or rewards for achieving health outcomes.

Some health plans are responding by investing in online portals and offering new incentive programs. For instance, New York-based Oscar offers members a free step tracker and will pay as much as $1 a day to members who reach their personalized daily step goals.3

As the examples so far illustrate, more providers recognize the importance of creating a consumer-driven experience. So how should they develop their long-term strategy?

Defining a consumer-centric approach

The newly insured’s attitudes toward health care could be indicative of broader trends.4 Although these consumers’ habits and preferences present challenges (e.g., overcoming less trust in the health care establishment), their digitally engaged, health-conscious and active nature offers new potential for innovation in health care services. Providers and insurers alike can explore—and strive to close—the gap between the expectations of the newly insured and the health system’s capabilities. Here’s how.

  1. Check your toolbox
    Priorities will vary among health care organizations and insurers, but answering the following types of questions can provide a lens into what an organization needs to do: How do you stack up against your competitors? What are the organization’s digital strengths and weaknesses? (For instance, is your website optimized for mobile, or is it an antiquated portal?) What other capabilities does the organization have to improve the omnichannel customer experience? Is your organization equipped to address the security concerns of the newly insured?

  2. Embrace the change
    The dynamics of health care are changing—from how care is delivered to what consumers expect of the system. Moving to a consumer-driven model can produce meaningful financial benefits. For instance, research indicates that hospitals offering a superior patient experience can achieve up to 50 percent higher margins.5 Rethink your strategy, assess how you are spending marketing dollars and consider how omnichannel tools (e.g., websites, patient portals, apps, virtual clinics and customer help centers) can improve the experience you deliver to the newly insured—and to all patients.

  3. Power up
    Once the organization has identified opportunities for omnichannel improvement, it’s time to take action. Look across channels of engagement to see how technology can be used to appeal to consumers’ digital desires.6 Consider on-demand services, remote monitoring, virtual therapies and more. Think about the data you gather and how it can be integrated to deliver insight-driven health care for today’s (and tomorrow’s) health care consumers. See how your people can be there for patients and close gaps in the consumer experience.

RISING TO THE OCCASION

The newly insured audience is raising the bar for insurers and providers, serving as a potential leading indicator for the health care consumer at large. Health care organizations in the United States and abroad must figure out how to meet these rising expectations now to achieve success for years to come.

About the research

Accenture commissioned a seven-country survey of 7,840 consumers ages 18 and up to assess their attitudes toward health, the health care system, electronic health records, health care technology and their health care providers’ electronic capabilities. The online survey included consumers in seven countries (Australia, Brazil, England, Norway, Saudi Arabia, Singapore and the United States). In the United States, 211 newly insured respondents participated in the research. The survey was conducted between November 2015 and January 2016. The analysis provided comparisons by country, sector, age and use. Where relevant, the survey uses select findings from the Accenture Doctors Survey 2015 to compare the doctor and consumer responses.


1. https://healthy.kaiserpermanente.org

2. TIME Money, “How a New Breed of Health Insurer is Luring Millennials;” May 9, 2016, online at http://time.com/money/4320098/zoom-health-insurance-millennials/

3. Oscar Health, online at https://www.hioscar.com/experience/

4. https://www.accenture.com/us-en/insight-research-shows-patients-united-states-want-heavy

5. https://www.accenture.com/us-en/insights-happy-patients-healthy-margins

6. Ibid.

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AUTHORS

 

 


Richard Birhanzel

Richard Birhanzel

is the managing director for the Accenture Health Administration Services. He is based in Minneapolis.



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