Trends From The Trenches - Consumer Data, Insights and Innovation


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Healthcare Innovation: Trends From The Trenches
Consumer Data, Insights and Innovation

Featured Speakers:
Andrea (Andi) Simon, PhD and President of Simon Associates Management Consultants
Linda MacCracken, VP, Truven Health Analytics and Adjunct Lecturer, Harvard School of Public Health
In the 3rd webinar, Linda MacCracken will review data analytics needed for Fee For Service and Fee for Value consumer engagement in today’s rapidly changing healthcare industry. Linda will review pressing business questions which focus on data analytics as effective, innovative ways to improve customer intimacy and enhance margin. She will share a case study and give practical tools to help you and your teams find better ways to serve your customers.
Andrea Simon PhD, webinar host, will introduce and conclude Linda's presentation with ways to tie data and information into valuable insights to help you better “see, feel and think” in new ways so you can “do” better in changing times.

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Trends From The Trenches - Consumer Data, Insights and Innovation

  1. 1. CONSUMER INSIGHTS, DATA AND INSIGHTS INNOVATION Webinar #3 Healthcare Innovation: Trends from the Trenches
  2. 2. Our Presenters Andrea J. Simon, PhD Corporate Anthropologist President Simon Associates Management Consultants Linda MacCracken, MBA Vice President, Advisory Services Truven Health Analytics
  3. 3. What We Are All About “We don’t see things as they are. We see things as we g y g are.” ~Anais Nin The “The real voyage of discovery consists not in seeking new landscapes but in having new eyes.” ~Marcel Proust Our Job is to help you “See, Feel and Think” in New Ways—before you “do.” y y
  4. 4. Today, Our Guest Will…    Share new research insights about consumer g behavior, and key innovation needed in healthcare marketing. Review how Big Data analytics can shine new light on innovation. Return to the question about why consumer data matters.
  5. 5. What Consumers Are Feeling Confused Cynical Angry
  6. 6. What To Do?    Can you imagine and engage consumers that still, or y g g g , finally, make your service “the place to get care” and “the place to innovate” in healthcare? Can you inspire your associates and physicians to “look at analytics” to benchmark and drive new types of healthcare? Can you bring in evidence to launch “innovative ways” that add “real value” — not just engage around storylines?
  7. 7. Trends from the Trenches
  8. 8. Observations From The Field      Changing times make data really, really, important. How can we see leading indicators, not lagging ones? What are the emerging trends? Can we see real life behavior in the data itself? Shall we trust it and let it help us change?
  9. 9. What Are We Looking For?  In Healthcare Today, to thrive you must look for:  Patterns emerging.  Opportunities to leap frog over the rest to offer leap-frog innovative solutions before they become ordinary. N Non-users with unmet needs that might open a new way ith t d th t i ht to deliver care ‘their way,’ not the old way.
  10. 10. If Times Are Changing    Hospitals, Physicians, Healthcare Services must “create” new value in innovative ways. Explore opportunities that could open new market space. Include consumers, aka “patients,” in the evolutionary process.
  11. 11. From “Fix Me To “Keep Me Well Fix Me” Keep Well”   Data is critically important to show us how to better engage, communicate and tell our stories if we are going to shift lifestyles and consumer habits in new directions. Consumers also have to “see feel and think in new see, think” ways.
  12. 12. Leading To Communication Challenge    How do you engage consumers and patients? How do you match the message and the storytelling to their demographics and psychographics? How do you measure impact?
  13. 13. Consumer Insights, Data & Innovation May I Introduce You To Linda MacCracken
  14. 14. Key Questions     What Can We Know About Consumers to Shape Datap Driven Innovation? What Data Shows Us That Is Likely to Change in FFS to FFV? What Innovation is Possible from Data-Identified Opportunities? O ? Steps to Drive Value in the Trenches
  15. 15. Consumer Insight & Data Focus Is Trying Amidst a Perfect Storm  Perfect Storm of Consumer/Data Driven Innovation     Consumer decision-driven healthcare is more crucial that PCPs and Payers: PPOs allow more choices among “Same Day” or “When You Want It” appointments. Unknown provider competition is already in play: Private office-based care; “retail health” at Walgreens, CVS, Wal-Mart; Telehealth via Cisco American retail health Walgreens CVS Cisco, Well and your mobile applications (iPhone). Change commitment requires team engaged priorities, focal business questions and agreement on key indicators. Need teams with clinicians, administrators, pre/post care services, marketing, finance and payment professionals to concur and align about challenges, directions and initiatives.
  16. 16. Clearly Storm Survival Calls for An Aligned Team Clearly, I’ sure glad the hole isn’t in our l d th h l i ’t i I’m end…
  17. 17. Consumer Insights, Data-Driven Insights, and Innovation is a Team Sport 1. Create Urgency 2. Pull Together a Guiding Team 3. Develop Change Vision & Strategy 4. Communicate for Understanding & Buy-In 5. Empower Others to Act 6. Produce Short-Term Wins 7. Don’t Let Up 8. Create N C lt C t New Culture
  18. 18. Organize Team Position on Change Drivers to Deliver Innovation Change Process Key Factors Create Urgency -Impact of newly insured -Targeting a new type of patient or new care site T ti t f ti t it Pull Together Guiding Team -Action-biased champions in each discipline -Engage clinical delivery providers p g gy Develop Change Vision & Strategy -Use facts to show change drivers: data-competitors g p -Develop vision for best future Communicate to Educate & Get Buy-In -Use generations among team/to target patients -Hook team members and share stage Empower Others to Act -Remove barriers to allow delivery agents to make vision real -Identify roles throughout team Produce Short Term Wins/Don’t Let Up -Create platform for successes and celebrate -Press harder and f t after fi t success P h d d faster ft first Create New Culture -How will this impact the Budget and Innovation celebrations? -Hold on to new ways of behaving and make sure they succeed
  19. 19. From All Consumers To Unique Consumers W What Can We Know About Consumers to S p DataC W C Shape Driven Innovation?   Approach Consumers By Segment to Engage Uniquely pp y g g g q y  Identify Key Consumer Drivers & Choice Options  Have Consumer Segment Focus on the Back of Your Hand
  20. 20. Consumer Views Make It Harder To Engage In Either “Fix Me” Or “Keep Me Well” Fix Me Keep Source: Truven Health Pulse Survey
  21. 21. Shift In Consumer Focus for Strategic Plan      Barrier: “Have” the Seniors–seek to engage non-Medicare patients for Fee for Value/Loyalty St t f V l /L lt Strategy Better: Focus services to younger segments Even Better: Identify segments tied to specific services with margin and service use by household Heroic Results: Outreach programs & ROI portfolio for each Service Line and program to identify what programs bring in higher loyalty and revenue Subsequently: Marketing budget is offered more resources for targeted programs
  22. 22. Using/Teaching Unique Consumer Terms Greatest/Silent G /S Baby Boomers “I will do as you say, doctor.” “Baby I was born to question you!” Baby, you! Gen X “I’m glad to see you if I can see you Tuesday at 5:00.” Millennials “OMG, I’m so Sunday!! S d !! . I’ll be, like, free on Adapted from: Truven Health Pulse Survey/ Matching the Market paper
  23. 23. RETHINKING TRADITIONAL PATIENT BASE # of People In US AVERAGE: 80 (millions) 122 Dschgs g FROM INPATIENT TO OUTPATIENT FROM ACUTE / 1000 pop (SLOW) CONTACT OR TO OUTPATIENT22K Visits /1000 pop (FASTER) CONTACT 111 Dschgs / 1000 pop 86 Dschgs / 1000 pop 70 60 85 Dschgs / 1000 pop 50 40 30 12K Visits / 1000 pop 17.5K Visits / 1000 pop 344 Dschgs / 1000 pop 28K Visits / 1000 pop 46.6K Visits / 1000 pop 20 10 0 Millennial Generation X Baby Boomers Greatest/Silent Source: Adapted from Matching the Market: Using Generational Segments to Attract and Retain Consumers, Truven Health
  24. 24. 9 out of 10 f Older Adults have a PCP v. 4 out of 5 GenXers and 2 out of 3 Millennials Mill i l TAKING STOCK OF PRIMARY CARE PROVIDER CONNECTION ~90% have had PCPs for 12+ months 2013 Pulse Consumer Research
  25. 25. PRIMARY CARE PHYSICIAN SELECTION FACTORS How Do Consumers Make Decisions? Greatest/Silent Baby Boomers ~30% each for Quality & Communication & “Cares about me’” 33% Communication, ~28% Quality & “Cares about me,” ~7% Cost/Convenience each Gen X 28% at Quality & Communication, 20% “Cares t Q lit C i ti “C about me,” 12% Convenience & 9% Cost Millennials 32% Quality, with ~21% Communication/ Cares,’ Quality 21% Communication/’Cares 14% Cost & 9% Convenience 2013 Pulse Consumer Research
  26. 26. Seniors know more about Physician Sites than use Internet I TAKING STOCK OF INTERNET CONNECTION 2013 Pulse Consumer Research
  28. 28. CONSUMERS SEEK MULTIPLE CHANNELS FOR HEALTH REMINDERS/ALERTS S/ S    Regular mail matters as key part of 35+-year-old engagement Match reminders with targeted services to have a better life: orthopedics & heart Media channels matter; too risky to pick one 2013 Pulse Consumer Research Truven Health Pulse, 28
  29. 29. VIRTUAL FRONT DOOR IMPACT AVERAGE ENCOUNTERS FOR CALL / CONTACT CENTER CUSTOMERS 14 Encounters 14 Encounters 97% Insured 9 Encounters 84% Insured 78% I Insured d 6 Encounters 75% Insured -Encounters from Truven Health CRM Database, 2013 -Insurance status from Truven Health Consumer Research, 7/13
  30. 30. Move From All Consumers To Unique Consumers: Teach the Teams     Leverage ‘generations in the workforce’ frameworks to shape ‘generations i the patient b ’ f ‘ i in h i base’ focus with your teams ih Identify in each service which generation and types of patients are served. Add to generation: married/coupled, with/without children, age group, gender focus, and income/payer mix / Target generations/patient types for each currently related and p potential service Identify target consumer connection venues: 1-1 messaging via email, direct mail, newsletter enrollment, affinity group or enrollment in Electronic Health Record (e.g., EPIC’s MyChart) ( g, My )
  31. 31. What Data Can Show From FFS To FFV W What Data S Shows U That Is Likely to C g in Us y Change FFS to FFV?   Service Selection & Choices  Service Scope & Site of Care Delivery  Key Business Questions of the Entire Team
  32. 32. What to Expect from the Data, Consumer to Drive Innovation 32
  33. 33. Changes In Coverage Will Drive Changes In Utilization 33 CHANGE IN MILLIONS I S 30 20 10 Medicaid ESI Individual Exchanges Uninsured 0 -10 -20 -30 -40 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Exchanges drive the largest change BUT Medicaid’s number of people are g g g g p p generally sicker y Source: Truven Health Insurance Coverage Estimates
  34. 34. The Impact from Expanded Coverage 261M 220M 246M 62M 53M Medicaid 47M 177M 173M 172M Private Group/ Non-Group 22M 49M 2012 21M 27M 2016 Partial Opt In Opt-In Private, Exchanges 21M Unsinsured 2022 Full Opt-In Opt In Source:  Truven Health Analytics Insurance Coverage Estimates 
  35. 35. Effects Will be Localized Medicaid Opt-In Enrollment, 2016 Exchange Enrollment, 2016 % Medicaid Growth, 2012 – 2016 Assumes States Opt-In 100%+ 60% - 100% 40% - 60% 20% - 40% < 20% 35
  36. 36. Prioritize The Newly Insured Needs For Demand Impact And Intervention Focus 36 Profile Factor Insurance History   Key Findings: Comparison of Future Exchange Likely Adults to Current Privately Insured (Group + Non-Group) 50% likely to have been uninsured for more than 3 years or have never had insurance Cost is dominant factor for uninsurance Health Status  Higher levels of health deterioration, disability (aliased by income) and ADL problems Health Risks   Use tobacco at m ch higher rates and exercise less much e ercise Health risk levels not favorable Chronic Conditions   Report mental health issues at a similar rate, but are much less likely to have seen a mental health professional Report similar levels for many chronic conditions, but lower rates for arthritis and heart disease      Fewer women, more in 18-44 age group More likely to be of Hispanic origin Less likely to be U.S. born or citizens Less likely to be employed Slightly lower BMI   Report lower rates of visits with medical and dental professionals p p Have slightly higher rates of ER use and lower rates of surgeries Demographics Biometrics Use of Healthcare Services
  37. 37. When Our Teams Say “We Need More Patients/ Volume Volume”…      Barrier: Getting the right patient, right volume‒not just any will do (think margin, t i target payer mix, t t i target procedures and repeat users) t d d t ) Better: Getting the right prospect to the right service with the right care compliance for the right next service use Even Better: Ensuring capacity in primary care practices f appointments in for next 3 working days for net new high(er) income/insured Boomers/GenXers via the web connect contact center Heroic Results: To identify incremental $1 2M revenue f th t H i R lt T id tif i t l $1.2M for the target t physician practices. Subsequently: Focus on Specific Consumers (to start)
  38. 38. When Our Teams Say: “We Need to Be Different”… We Different     Develop a program for Service Line Innovation: have leaders present f fact-driven/consumer-based innovation to each other di / b di i h h Provide a forum to showcase cost-effective innovation to Finance, Clinical Redirection to Population Health Team, Patient Engagement to the Satisfaction Team Establish Before/After Profiles to Demonstrate Success – or at least outcomes and Lessons Learned Engage Senior Leadership to champion innovation & again, get their key data questions – for Round Two!
  39. 39. Coordination of Care Alone Presents a Huge Opportunity In A Fee-for-Value World 39 Care Coordination represents a $50B opportunity
  40. 40. Prioritize Local Chronic Disease Risk And Intervene With Highest-Risk Consumers 40 Zip codes with highest Population segments with high combined IOC for selected IOCs for selected chronic chronic conditions. How are we conditions. serving this population? What are the unique needs/attitudes of these segments?
  41. 41. Consumer Choices Invite & Compel New Innovations: Imagine Their Questions To Launch Your Possibilities Today’s Choices  Am I going to a doctor in my health plan?  How will I get there?  Do I need a referral?  Where will I get my prescriptions from: Internet, hospital, drug store? Tomorrow’s Choices  Do I want to work for an employer that doesn’t have insurance? doesn t  Should I buy my insurance on the exchange or pay the penalty?  Do I need to go to doctor, retail clinic, call or can I stay home and Skype?  How much does it cost from my pocket and is it worth it?  How do I respond to wellness incentives?  Do I need a coach, or nutritionist?  What bonuses/credits do I get for my health activities?  What health reminder system do I need to manage my health and y g y risk?
  42. 42. Focus In-Network Care Navigation In Top Services With Leakage Hotspots 42 16.00% 14.00% 14 00% 12.00% 10.00% 8.00% 6.00% 4.00% 2.00% 0.00% Goal: R t i treatment AFTER diagnosis G l Retain t t t di i BREAST SURGERY MASTECTOMY, PARTIAL BREAST ASPIRATION & BIOPSY ULTRASOUND, BREAST X-RAY - BREAST
  43. 43. Redirect From The Emergency Department 43 National ED Highlights:  ~62% ED Visits are Urgent; Why not redirect to cheaper care sites?  Opportunities: Redirect 20% ED visits saves $4B/ year Broward County, FLA Highlights:  28% of Seniors ED visits are Urgent  61% of Adults (45-64 yrs) are Urgent  76% of Young Adults (19-44 yrs) are Urgent  82% of Children (<19 yrs) are Urgent Redirect Super–Users to Community Health Centers: Care directed texts for 5+ visits/ year =$1.5M savings  Offer expanded office/urgent care capacity for children: Request urgent care from ED source  Set up Preventive Screenings: Send prompts to chronic care patients for preventive care 62% of Total ED visits are Urgent; BUT  
  44. 44. From Data Insights To Consumer Engaged Innovations Consumer-Engaged W What Innovation is Possible from Data-Identified v Opportunities?   Segment, Segment, Segment to Identify Actionable Customer g , g , g y Groups to Engage in a Focused Way  Find Small Victories and Don’t Let Up  Build a Culture Favoring Many Marketing Innovation
  45. 45. Trends From The Trenches 45 1. Four unique customer segments using healthcare today: q g g y    Digital Natives with Low Use Rates who are PCP driven (Millennials/Gen Xers) vs. Digital Immigrants with High Use Rates who are Care Loyal (Boomers/Greatest) Sustainability-Driven (Millennials/Greatest) to Cost Sensitive Pragmatics (GenXers/Boomers) Personal Friend/Professional Sales/Direct Mail-Driven ( oo e s/G ea es ) vs e d/Web/Soc a Med a ve (Boomers/Greatest) vs. Friend/Web/Social Media-Driven GenXers/Boomers)
  46. 46. Trends From The Trenches 46 1. 2. 3. 3 4. 5. In 2014, 14 million Americans will gain insurance from the insurance exchanges and Medicaid expansion In 2017, 34 million Americans will have gained insurance Think local. Using national numbers will ultimately leave hospitals local underprepared for what will happen in their local market. Rethink Sites of Care: The traditional Emergency Department should no longer be the first primary care stop for Medicaid enrollees Think All Points of Patient Contact for 1-1 Engagement: Leverage targeted communication via email, direct mail, affinity groups, patient discharge and the Electronic Health R h El H l h Record portal d l
  47. 47. Trends From The Trenches, cont’d. cont d. 4. 5. 6. 7. Prepare to take on risk. Providers will be expected to share in the responsibility of population health management. ibili f l i h lh Gain insight into the health of the population. Understand underlying health issues, such as the prevalence of diabetes or heart disease, in the population of newly insured patients. Prepare sufficient capacity. Demand is still a function of coverage, so provide risk assessments & offer appropriate g , p pp p care, such as medical homes, navigators and patient messaging. Engage the newly insured personally. Providers should be connect virtually to improve compliance with attention to their priorities. y p p p
  48. 48. Steps to Drive Value (and survive) the Perfect Storm  Perfect Storm of Consumer/Data-Driven Innovation     Data Profile Local Consumers & Their Preferences: Think Segments, Prioritize Personas & Focus on Service Line Portfolio. Responsively Position to Locally & Virtually Available Competitors: Research preference, preference adoption rate non-user characteristics. Think Partnerships/Speed to rate, characteristics Market to Build or Buy by each Service Line Prioritize & Rebuild Service Lines: Re-array service lines based on data-driven criteria, target consumer and performance criteria. Prioritize consumer-engaged data-driven growth based on target goals. d d hb d l Need innovation platform for consumer-engaged business successes. Relentless revisiting of the market data can align and cost effectively steer agreement about market focus resources resources.
  49. 49. From Big Data To People Data Storytelling Insights
  50. 50. Cannot Just Assume Services Continue as Usual    People don’t want to focus on your Emergency p y g y Department. They want to engage to convenient care – urgent y g g g care, evening/weekend hours, primary care, retail care They ask, “Can you: Help Me Get the Right Care at the Right Time  Connect with Me Via Email, Text, Alerts, Phones, In Person  Gi Give Me S lf S M Self-Serve When I Want It? Wh W I? 
  51. 51. To Thrive in Changing Times  Remember that… Consumer Insights Drive Creative Service Ideas  Unique Consumers, Unique Markets and Service Venues WILL Dilute The Ones You Had Had.      New services need new stories. Staff need to embrace and live the new consumer engagement. Review analytics benchmarks and local market indicators to retain your authentic market needs. The New Healthcare is not a place or a thing but an experience.
  52. 52. Big Data And Observational Research   To add power to the data, perhaps we need to add data a bit of anthropology. We f d W found recurring themes worth sharing here. h h h h
  53. 53. Newly Involved Men In Healthcare Decisions  Men were becoming more involved in the healthcare decisions as they had to pay more out-of-pocket expenses. expenses
  54. 54. Internet Is Changing The Decision Process  People of all ages showed us how they were searching for data to help in their decisions, and then were not sure how to interpret the information they were finding.
  55. 55. Searching For Simple And Easy   Nothing was simple or easy, anymore. Across demographic segments. t
  56. 56. “Paradox Of Choice” Paradox Choice   Abundant Options leading to the “Paradox of Paradox Choice” Not making decisions for fear that whatever they did decide would be the wrong decision.
  57. 57. Have Lost Ability To See The Difference  Common statement: “Aren’t all doctors and hospitals Aren t the same?” Shouldn’t they be?
  58. 58. Increasing Challenge Of Retailers  Recurring theme: The ease and comfort of going to a Walgreens or CVS to get care.
  59. 59. How Can You Apply This? We Can Adapt To Changing Times
  60. 60. What Does This Suggest    Consumers are driving and can drive the changes. Data is shedding compelling information and insights. insights Put “flesh on the numbers.”
  61. 61. Engage And Communicate To Innovate 1. 2. 3. 3 4. 5. 5 Consumers are facing the “paradox of choice.” g p Help them choose wisely. Engage them earlier in the change process. Tailor your messages and messaging to who they are. Let them help create better solutions for themselves and for healthcare delivery organizations and p y physicians.
  62. 62. End Where We Began “We don’t see things as they are. We see things as we We don t are.” ~Anais Nin The o age discovery “The real voyage of disco er consists not in seeking new landscapes but in having new eyes.” ~Marcel Proust P t
  63. 63. We Hope Our Journey Has Helped Our job was to help you “See Feel and Think” in See, Think New Ways — before you “do.”  Perhaps we can be of help to you as you begin this journey. 
  64. 64. Next Webinar: Andrea Simon PhD Friday February 14 At Noon EST. “Healthcare Innovation: Mastering the Front and Back-End of Innovation” I will be conducting our next webinar and will be talking about: b t 1. How to take data and ideas and envision new ways to solve old problems‒simpler and better. problems simpler 2. Take these ideas and turn them into testable innovations. 3. Build this into a culture of innovation for your institution. y
  65. 65. For More Conversation And Information Andrea J. Simon, PhD Corporate Anthropologist President, Simon Associates Management Consultants Office 914-245-1641 ff 9 6 @simonandi and @andisamc Linda MacCracken Vice President, Advisory Services Truven Health Analytics @