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![Page 1: ▪ research for your brand’s health klein & partners Another Kitchen Sink Survey from Klein & Partners: What consumers think about a plethora of healthcare.](https://reader030.fdocuments.net/reader030/viewer/2022032600/56649dcf5503460f94ac39ed/html5/thumbnails/1.jpg)
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Another Kitchen Sink Survey from Klein & Partners:What consumers think about a plethora of healthcare topics…
Presented by:
Rob Klein, Founder & CEO
Klein & Partners
4th Quarter, 2014
Disclaimer: Please feel free to use these charts in any of your presentations; just cite Klein & Partners as the source of the information.
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INTRODUCTION
Page 2
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Background The purpose of this nationwide quantitative survey was to understand consumers’ current thinking on a wide
range of healthcare-related topics, including:
Methodology A national online survey was conducted among 407 heads of household, 18 or older who are most responsible for
healthcare decisions for themselves and/or the household. Interviewing was conducted from September 9 – 13, 2014. The sample frame used was Research Now’s online consumer panel. The final data set was weighted by geography, age, education, income, and ethnicity.
The total sample size of 407 yields a sample error of +/-4.1% at the 90% Confidence Level (CL). For example, if this study were repeated 100 times, in 90 times out of that 100 (i.e., 90% confidence level) we would find a total sample statistic of 50% to fall within approximately 46% and 54%.
Significant differences are called out in the charts using letters or arrows. Colors and bolding are used to highlight interesting patterns and/or findings.
Introduction
• Reactions to health reform• Perceptions of health providers• Tax exempt perceptions• Perceptions of healthcare costs and profits• Primary care physician• Electronic medical record• Medical home awareness and perceptions• Concierge medicine• Smart phone use
• Interest in new information sources• Communication methods used• Choosing a hospital• Websites visited• Retail clinics used• Online healthcare shopping behavior• Transparency/price shopping• Health insurance and getting care• Rural healthcare perceptions
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SO WHAT DID WE LEARN?
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This year’s theme?
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1) Patients are becoming customers in their expectations. Health reform is a major cause of this shift in attitude because most folks feel they are paying more now under reform.
2) Catch-22 regarding tax-exempt status most Americans don’t support you but they know they will pay the price if you lose your tax-exempt status.
3) Americans think hospitals make very large profits like health insurers. You are losing your ‘good guy’ status.
4) Fewer Americans are price shopping for healthcare services (hypothesis: they are not getting good answers so they are giving up).
5) Concierge medicine could create access problems and may create a moral challenge.
6) Why can’t I schedule a doctor’s appointment online when I can make a restaurant reservation with Open Table?
7) Trying to pick the best doctor remains a daunting task with little useful information available.
8) Medical Homes… What?
9) EMR gaining traction
10) Like us on Facebook? Not likely
11) What people say – I will seek out lots of sources of information before deciding which hospital to choose. What people actually do – What ever you say doctor.
12) Very few people actually look to HealthGrades or US News & World Report or any other online quality ranking sites when choosing a hospital.
13) Most hospital website visitors find the experience ‘adequate’ but not ‘exceptional.’ We need to think of our website as a ‘digital brand dialogue’ that impacts our overall brand relationship.
14) The new competitors Walgreens, CVS, Walmart, Target, etc. and they want primary care!Page 6
Top-10 (ok 14) key disruptive takeaways
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TOP CONCERNS
Page 7
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Economy/jobs
Health care
Taxes/spending
Education
Terrorism/Homeland Security
Energy
Immigration
Wars in Afghanistan and Iraq
Other
28%
22%
13%
11%
11%
4%
3%
2%
4%
39%
23%
12%
12%
4%
3%
3%
3%
1%
42%
27%
11%
7%
1%
2%
1%
2%
2%
40%
24%
11%
9%
3%
2%
3%
1%
3%
49%
23%
8%
3%
5%
1%
6%
3%
2%
Issues of most concern to Americans
2009
2010
2011
2012
2014
Page 8
Significantly higher among women, seniors, and those with HHI <$45K
Q1: Which one of the following issues is MOST important to you?
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REACTIONS TO HEALTH REFORM
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Medical coverage
Network of available doctors
Network of available hospitals
Being seen by my doctor in a timely manner
Cost of insurance benefits
12%
10%
9%
8%
7%
39%
54%
61%
59%
30%
43%
27%
19%
24%
57%
6%
9%
11%
9%
6%
What’s getting better or worse for you under healthcare reform?
Getting better Remaining unchanged Getting worse Not sure
Q2: What do you feel is getting better or worse for you personally under healthcare reform? Page 10
And this is giving rise to the healthcare ‘customer.’
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Completely comfortable
Mostly comfortable
Mixed
Mostly uncomfortable
Completely uncomfortable
Not sure
2%
16%
38%
13%
22%
9%
How comfortable are you with an ACO managing your health and
wellness?
Significantly higher among college educated
Q3: Next we have a question about how health care eventually will be delivered under reform called an Accountable Care Organization or ‘ACO’.
Currently healthcare providers get paid when you, as a patient, receive care. Under reform, providers will be paid to manage the entire health of a population of people so they don’t get specifically paid when you need care, but they are paid a fixed sum to manage your health whether you ever get sick or injured or not. So their incentive is to keep you healthy and be cost effective in how they deliver care. And providers could include your local health care system of hospitals and doctors, a single hospital, even a large physician group, and they would be responsible for managing a large population of people in the community. Based on this basic description of healthcare under reform, how comfortable are you in having this ACO manage all aspects of your health and wellness?
2012
4%
15%
37%
17%
19%
8%
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PERCEPTIONS OF HEALTH PROVIDERS
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Page 13Q4: Next is a list of people or organizations that have been in the news lately. Please tell us how favorable you are towards each using a scale of 1 to 10 where 1 means very unfavorable and 10 means very favorable. Of course, you may use any number from 1 to 10.
1
2
3
4
5
6
7
8
9
10
7.00 6.98 6.89
5.90
5.094.68
Favorability rating for people/organizations in the news
Don’t know enough to rate it
17% 14% 7% 23% 12% 9%
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TAX EXEMPT STATUS
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Support or oppose hospitals be-ing exempt from paying state
and local taxes?
-100% -75% -50% -25% 0% 25% 50% 75% 100%
-26%
-16%
-18% 33%
8%
Somewhat oppose Strongly oppose Not sure Somewhat Support Strongly support
Support hospitals being tax-exempt
Page 15Q5: Do you support or oppose hospitals being exempt from paying state and local taxes?
42% 41%Support for tax-exempt status is not very strong
among Americans.
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2014: Hospitals charged property and sales tax to increase revenue
2013: Hospitals charged property and sales tax to increase revenue
-100% -75% -50% -25% 0% 25% 50% 75% 100%
-34%
-29%
-40%
-39%
26%
32%
Q6: As you may or may not know, many local communities and states are looking for ways to increase revenue to meet rising demands for services. One way that has been proposed is to treat local hospitals just like any other business in the community and charge them property tax and sales tax. Do you think this is a good idea or a bad idea?
Charging hospitals property and sales tax
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Bad idea Not sure Good idea
But taxing hospitals isn’t necessarily a
good idea either.
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Hospitals earning tax-exempt status
Hospitals give away enough free services and health education to
justify tax-exempt status
-100% -75% -50% -25% 0% 25% 50% 75% 100%
-28%-14%
-24%
24% 11%
Probably not Definitely not Not sure Probably Definitely
Q7: Would you say that hospitals in your area do or do not provide enough free medical care and health education services in your community to justify their tax-exempt status? Would you say they…?
42% 35%Most Americans don’t think so.
How much money do you spend
each year trying to convince your
communities?
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While hospitals may have once been charitable organizations that were run by churches or community organizations, they now are really just profitable enterprises and should be treated like any other business.
If we start taxing hospitals, it will just raise the cost of healthcare and hospitals will have to charge us more at a time when healthcare costs are already rising.
Hospitals are an important part of the community because of the vital services they provide and therefore, they should not be subject to any local taxes.
-100% -75% -50% -25% 0% 25% 50% 75% 100%
-11%
-8%
-15%
-20%
-6%
-23%
-4%
-2%
-5%
47%
31%
34%
19%
53%
23%
Views on hospitals
Q8: Do you agree or disagree with the following statements?
Strongly disagree Somewhat disagree Not sure Somewhat agree Strongly agree
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7% 20% 9% 40% 24%
4% 10% 6% 33% 47%
12% 21% 11% 35% 22%
2013
2013
2013
Classic Catch-22
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PERCEPTIONS OF HEALTHCARE COSTS AND PROFITS
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Insurance company profits
The uninsured
Overuse and misuse of health care services
Poor health and wellness
Hospital profits
Cost of medical malpractice
Physician profits
The government
New technology
Other
Not sure
25%
19%
14%
12%
8%
6%
3%
2%
2%
2%
8%
Largest impact on health insurance costs
Page 20Q9: Which one of the following do you think has the largest impact on health insurance costs?
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Making a large profit; 40%
Making a small profit; 32%
Losing money; 6%
Not sure; 22%
Do you believe local hospitals are…
Q10: In the current healthcare environment, do you believe your local hospitals are…?
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Health insurers Hospitals Doctors-100%
-75%
-50%
-25%
0%
25%
50%
75%
100%
-21%-35%
-53%
65%45%
29%
-2%
-5%
-10%
-13%
-16%
-8%
Paid too much
Paid appropriate amount
Paid too little
Not sure
Amount paid for services
Q11: For each of the following organizations, please check if you think they are paid too much, too little, or an appropriate amount for the services they provide in today’s healthcare environment? Page 22
Klein & Partners is seeing a shift in attitude towards hospitals. What were once viewed as altruistic organizations
in line with the virtues of doctors, hospitals are now more in line with the ‘profit-driven’ health insurers.
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PRIMARY CARE PHYSICIAN
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Q12: Do you have a primary care or personal physician?Q15: Have you ever gone online to a social networking site and shared your experiences about a doctor or a hospital you recently visited? Page 24
Primary care physician
Primary Care Doctor
82%
Just 60% among
Millennials.Going online to rate a doctor or
hospital has doubled in the past few years:
6% in 20099% in 2011
14% in 201212% in 2013
12% in 2014
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Don't feel the need (young, healthy)
Can't afford it
Don't have health insurance
Too hard to get an appt.
Easier to go to urgent care or ER
Can't find one close enough
Looking for one
Employer doesn't offer health benefits
Lost my job and health insurance
New to the area
Other
Not sure
33%
23%
13%
9%
9%
7%
6%
4%
2%
1%
3%
9%
Why no PCP?(among the 18% with no PCP)
Page 25Q13: Why do you currently NOT have a primary care physician? Q14: If you needed to see a primary care doctor where would you most likely go (or where have you gone) for care?
Walk-in to doctor's office
Urgent care center
Hospital ER
Virtual appointment
Free-standing ER
Other
Wouldn't go
Not sure
29%
26%
7%
7%
1%
5%
3%
23%
Where go for primary care?(among the 18% with no PCP)
Purple = No needGreen = Financial
Red = Access
Impacts access
Impacts costs
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Page 26
Yes and I've used it; 2%
Yes but I have not used it; 5%
No I am not aware of this app; 93%
Aware of ZocDoc
Q16: Are you aware of an online physician office scheduling App called ZocDoc?
Recent focus group participant: “Why can I use Open Table to make a restaurant reservation but I have
to call and argue with my physician’s office to schedule an
appointment when I’m sick?”
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Family/friend recommendation
Health insurer physician directory
Recommendation from another physician
Health insurer website
Google search
Online patient reviews (Angie's List, Yelp, etc.)
HeathGrades
Phone book/Yellow Pages
Hospital website
Someone from hospital
Interviewed doctor
Local publication
US News & World Report
Newsletter (healthcare org)
Social media site
CMS quality ratings
Direct mail
Advertising
Other
None
Not sure
39%
37%
22%
19%
10%
7%
7%
7%
6%
4%
4%
3%
2%
2%
2%
1%
1%
1%
2%
9%
8%
29%
18%
14%
6%
4%
3%
3%
1%
1%
1%
3%
1%
9%
8%
Most useful information sources for physician choice
Most usefulAll mentions
Page 27
Q17: Thinking back to when you were first looking for a new primary care physician, which of the following sources of information, if any, did you seek out to help you choose that physician?Q17a: Now, which one of these sources of information, if any, was most useful to you in choosing this physician?
*Word-of-mouth!
** *Significantly higher among Millennials
*
*
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In health insurance networkConvenience of office location
Personal attention of physicianEasy to get in quickly
Reputation of physicianFocused on health and wellness
Doctor speaks English clearlyTime doctor spends with patients
Hospital affiliationTruly understands and responds to needs
Years as a physicianService level of office staff
Short/no wait timesGender of physician
Hours and days doctor's office openAcademic credentials
Nice officeExperience w/my condition
CostAccess to EMR
Can communicate via email/textOnline scheduling abilities
OtherNot sure
57%
55%
44%
37%
36%
33%
26%
26%
26%
23%
22%
22%
20%
19%
19%
16%
15%
15%
10%
8%
8%
3%
5%
4%
29%
5%
13%
3%
10%
4%
1%
3%
2%
4%
2%
1%
1%
5%
2%
1%
3%
2%
2%
1%
4%
4%
Most influential factors considered in physician choice
Most influentialAll mentions
Page 28
Q18: Think back to when you chose your current primary care doctor which of the following factors did you take into consideration when you were deciding on which doctor you chose?Q18a: And which one of these factors would you say had the biggest influence on which primary care physician you chose?
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Personal attention of physicianIn health insurance network
Convenience of office locationTime doctor spends with patients
Truly understands and responds to needsFocused on health and wellness
Easy to get in quicklyExperience w/my conditionService level of office staff
Reputation of physicianDoctor speaks English clearly
Short/no wait timesHospital affiliation
CostHours and days doctor's office open
Gender of physicianYears as a physician
Nice officeCan communicate via email/text
Access to EMRAcademic credentials
Online scheduling abilitiesNot sure
60%
45%
42%
38%
37%
34%
29%
26%
26%
22%
22%
22%
21%
16%
16%
16%
15%
14%
12%
12%
8%
4%
7%
25%
19%
5%
3%
12%
6%
1%
7%
1%
3%
2%
1%
2%
1%
2%
1%
1%
1%
7%
Factors that influence staying with physician
Most influentialAll mentions
Page 29Q19: Now, which of the following factors influence whether or not you want to stay with this physician? Q19a: And which one of these factors would you say has the biggest influence on whether or not you want to stay with this physician?
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Personal attention of physicianIn health insurance network
Convenience of office locationTime doctor spends with patients
Truly understands and responds to needsFocused on health and wellness
Easy to get in quicklyExperience w/my conditionService level of office staff
Reputation of physicianDoctor speaks English clearly
Short/no wait timesHospital affiliation
CostHours and days doctor's office open
Gender of physicianYears as a physician
Nice officeCan communicate via email/text
Access to EMRAcademic credentials
Online scheduling abilitiesNot sure
13%
29%
5%
3%
4%
4%
3%
3%
1%
10%
1%
1%
2%
2%
2%
5%
2%
1%
2%
1%
4%
25%
19%
5%
3%
12%
6%
1%
7%
1%
3%
2%
1%
2%
1%
2%
1%
1%
1%
7%
Factors that influence choosing vs.staying with physician
StayingChoosing
Q18a: And which one of these factors would you say had the biggest influence on which primary care physician you chose?Q19a: And which one of these factors would you say has the biggest influence on whether or not you want to stay with this physician?
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Q20: Next, for each of the following statements please check if you…Note: * = Asked of all; ** = Asked only of those with a PCP Page 31
*
*
*
*
*
**
**
**
I am most responsible for my own health and wellness
You cannot really be sure you picked the right doctor until after you see them for an actual visit
My doctor respects my time as being as valuable as his/hers
I want my experience at the doctor’s office to be more like customers are treated at a favorite store
If I’m not in optimal health it is mostly my own fault
There isn’t a lot of good objective information out there to help you decide which physician to choose
Service at my doctor’s office has gotten so bad that I am considering changing physicians
My doctor doesn’t seem to know what is going on with staff and how they treat patients
-100 -75 -50 -25 0 25 50 75 100
-15
-15
-28
-33
-30
-35
-16
-19
-2
-2
-6
-7
-12
-14
-11
-16
-1
-3
-4
-3
-5
-11
-62
-55
32
35
36
33
37
32
10
5
50
46
26
25
17
8
2
5
Views on physicians
Strongly disagree Somewhat disagree Neutral Somewhat agree Strongly agree
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ELECTRONIC MEDICAL RECORDS
Page 32
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Page 33
Very interested
Somewhat interested
Not interested
Not sure what this is
Already have access to EMR
34%
36%
12%
4%
15%
48%
35%
11%
1%
5%
48%
35%
13%
1%
3%
47%
35%
14%
2%
2%
Interest in having online access to your electronic medical record
2010
2011
2012
2014
Receipt of test results
View health information
Renew prescriptions
Review info after seeing doctor
Look up info on medical condition
Manage appointments online
Message physician
Review preventive health screenings
Track and graph information
Request an eVisit
85%
79%
72%
71%
65%
61%
59%
57%
43%
32%
84%
71%
82%
67%
56%
76%
64%
50%
37%
41%
Very interested in accessing via electronic medical record
Especially 21-44
Q21: How interested would you be in having online access to your own personal health record – called an Electronic Medical Record (or Patient Portal) – to track your own health through a secure website that only you and your doctor and hospital can access? Q22: Which of the following features, if any, would you definitely be very interested in accessing or have accessed through your electronic medical record? [Among those very interested or already have access]
Use EMR – 12%Haven’t used yet – 3%
Men
Women
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MEDICAL HOME AWARENESS AND PERCEPTIONS
Page 34
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Very familiar
Somewhat familiar
Just heard the term
Not at all familiar
5%
8%
19%
68%
2%
8%
28%
62%
Medical Home familiarity
20122014
Page 35
5% believe they are part of a Medical Home with their physician (3% in 2012) which equals <1% of the adult population.
Consistent with other Klein & Partners research, half (55%)
learned about a ‘Medical Home’ after they chose that physician.
(53% in 2012).
And when asked if they see any difference in their relationship with
their physician because of the Medical Home program, 60% said
yes. (new Q in 2014)
Q23: Prior to this survey, were you familiar with the term ‘Medical Home’ or what also is called a ‘patient-centered medical home’ which is a team-based healthcare delivery model led by the physician?Q24: Are you part of a Medical Home through your primary care doctor?Q25: Did you choose your doctor because he/she was part of a Medical Home or did you learn about that after you choose your doctor?Q26: Do you notice any difference in your relationship with your physician because of the Medical Home program?
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Comfortable for every situation
Comfortable for most situations
Comfortable with some situations
Comfortable for very few situations
Not comfortable at all
Not sure
14%
22%
26%
15% 14%
9%9%
30% 29%
14%11%
7%
Comfort seeing care givers other than your PCP
20142012
Page 36
Q27: As part of a Medical Home with your primary care physician, there may be times when you come in for an appointment and you will see one of the doctor’s team members who could be a Nurse Practitioner, Physician’s Assistant, or some other care giver. How comfortable are you or would you be in being seen by one of the care givers instead of your primary care physician? [Among those with a PCP]
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CONCIERGE MEDICINE
Page 37
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Page 38
Q28: Next, have you heard of a ‘concierge medical practice?’ Q29: If your primary care doctor told you that he/she was converting their practice to a concierge practice and offered you to stay for an additional annual fee like what was outlined above, what additional amount above and beyond what your insurance covers now would you be willing to pay annually to stay with your current doctor in this new concierge practice format?
Yes I have definitely heard of this but I am not in one; 24%
Yes I have definitely heard of this and I am currently in a concierge medical practice;
3%
No I have never heard of this; 62%
Not sure; 11%
Heard of ‘concierge medical practice’ Additional amount willing to pay to stay with doctor in new
concierge format:Less than $100: 2%
$100-$199: 3%$200-$499: 3%$500-$999: 1%
$1000+: 3%Would not pay extra: 58%
Not sure: 29%2013Yes, but not in one: 32%
Yes, and in one: 2%No: 62%
Not sure: 4%
Mean = $495
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Creates inequality in healthcare system so rich get better care and those who
can't afford it have less access to quality primary care; 33%
Don't really see any value in paying more for a level of service I should be receiving already;
32%
This has real patient benefit for those who can afford it; 16%
Not sure; 19%
Reaction to concierge medical practice
Q30: Whether or not you have heard of concierge medicine prior to this survey, which statement best describes your reaction to it?
Women more likely to feel this way
Seniors more likely to feel this way
Millennials more likely to feel this way
Those with no PCP more likely to feel this way
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SMART PHONES‘Can you hear me now?’
Page 40
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Look up information on health symptoms
Research a health topic
Visit health insurer's website
Visit hospital's website
Look up information on a particular doctor
Make an online donation to a charity
Participate in health and wellness program
Check lab results
Look at your electronic medical records
Watch a healthcare video
Read a health magazine
Schedule a doctor's appointment
Schedule a test or procedure
Text question to doctor
Check how busy an ER is
Have a smart phone but have not used it
Do not have a smart phone
22%
18%
12%
13%
13%
8%
6%
6%
6%
6%
5%
3%
2%
2%
2%
31%
22%
22%
22%
12%
13%
17%
7%
8%
6%
3%
5%
7%
9%
6%
4%
1%
26%
28%
26%
21%
11%
15%
17%
8%
8%
6%
3%
6%
7%
6%
5%
2%
1%
22%
38%
23%
20%
10%
10%
11%
5%
2%
2%
5%
3%
3%
2%
17%
49%
9%
9%
6%
5%
5%
2%
1%
1%
2%
2%
2%
1%
16%
65%
Current health-related smart phone uses
2010
2011
2012
2013
2014
Q31: Next, have you used a smart phone (e.g., Droid, iPhone, Blackberry, or any phone that can access the Internet) to go online and do any of the following…? Page 41
Any of these uses is significantly higher among
Millennials.
Americans are using their smart phones to
search for lots of information… just not
healthcare… yet
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Make, change or cancel an appt
Check lab results
Renew prescription
Clinic appt check-in
Email doctor
Check medical records
Emergency room wait times
Where do I park
Doctor lookup (find-a-physician)
Pay medical bills
Wayfinding - directions within hospital
Wouldn't use any of these
58%
52%
51%
44%
39%
39%
35%
34%
31%
28%
25%
19%
68%
58%
66%
49%
44%
37%
38%
21%
39%
36%
25%
12%
Hospital Apps most likely to use(Among the 72% with a smart phone)
20122014
From a market segmentation standpoint, potential use for most of these Apps is higher
among Millennials.
Q32: If a hospital you used offered a mobile app for your smart phone, which of the following features would you MOST LIKELY USE? Page 42
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INTEREST IN INFORMATION SOURCES
Page 43
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WebMD
Friend/Family
Health plan website
Called health plan directly
Books, magazines, newspapers
Hospital website
Called hospital directly
Consumer's Report
Health plan newsletter
Social media
Hospital newsletter
Newsletter at doctor's office
TV or radio programs
Online support group
A health resources center or library
YouTube
HealthGrades website
Yelp
CMS Hospital Compare website
Blog or microblog
Other healthcare website
JD Power
Angie's List
46%
36%
20%
19%
17%
12%
11%
8%
7%
6%
6%
5%
5%
5%
5%
5%
5%
5%
3%
2%
2%
1%
1%
1%
Sources of health-related information sought in past year
Page 44
Green = OfflineBlue = Digital
Q33: Besides your physician, which of the following have you sought health-related information from in the past year?
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Learned about a specific medical conditionResearched symptoms experiencing
General health informationResearched medical procedures
Disease wellness informationRefilled a prescription
Directions to hospital/facilityChecked on a patient bill/paid bill
Read physician reviews/ratingsResearched/compared treatment options
Info to find a new doctorCompared health plans
Health and wellness programChecked lab or test results
Scheduled an appointmentChose a health plan
Disease management programsInstructions on how to prep for a test/exam/surgery
Sought consumer reviews onlinePre-registration for procedures or admissions
Read hospital reviews onlineSubscribed to an e-health newsletter
Price shopped costs of a test/procedure/visitRegistration for health/wellness classes
Asked a doctor/nurse for medical adviceVisited state exchange website
Had an email consultation with my doctorWeb nursery/birth announcements
Chose a hospitalCompared services offered at different hospitals
Checked ER wait timesHave NOT searched any health-related info on the Internet
37%33%
32%21%21%
19%19%
18%17%17%
16%16%
15%15%
14%11%11%
8%7%7%7%
6%6%
5%5%5%
3%2%2%2%2%
22%
Health related information sought on the Internet
Page 45Q34: And which of the following information, if any, have you done online?
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Search symptoms when sick
Visited health insurer's website for health-related info
Participated in employer's wellness program
Completed an online health assessment
Accessed online personal health record to track own health information
Downloaded healthcare-related articles
Watched a video online on a healthcare topic or procedure/surgery
Participated in health plan's wellness program
Visited a hospital's website for health-related info
Viewed online animation of a medical procedure/surgery
Viewed hospital's health and wellness class schedule
Visited an independent healthcare rating organization's website
Listened to a Podcast on a healthcare topic
Followed a hospital's Facebook page
Watched a live healthcare webcast
Followed/Participated in a healthcare dialogue on someone's BLOG
Participated in an online patient support group
Followed a health plan's Facebook page
Participated in an online chat with a healthcare provider
Used cell phone to search healthcare-related info
Followed a hospital's BLOG or Twitter activity
Followed/Participated in a healthcare dialogue on Twitter
None of these
42%
20%
16%
16%
12%
11%
11%
10%
9%
6%
5%
4%
3%
3%
2%
2%
2%
1%
1%
0%
0%
0%
33%
Recent participation in online health-related activities
Page 46Q35: Which of the following online health-related activities have you participated in over the past few years?
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COMMUNICATON METHODS
Page 47
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Q36a: Which of the following communication methods have you used to communicate with your primary care physician?Note: Not sure/no PCP scores re-percentaged out
Phone call
In person
Going to a website
Through the mail
Through EMR
Using a smart phone online
Using an 'App' on a smart phone
Texting
Using online social media
Video chat (Skype)
71%
69%
10%
8%
2%
8%
3%
2%
2%
2%
1%
78%
66%
20%
14%
9%
7%
4%
2%
3%
2%
1%
80%
66%
15%
10%
11%
7%
3%
2%
1%
1%
1%
79%
68%
12%
4%
12%
1%
0%
2%
0%
Which methods do you use to communicate with your PCP?
2011201220132014
Page 48
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Phone call
In person
Going to a website
Through the mail
Through EMR
Using a smart phone online
Texting
Using an 'App' on a smart phone
Using online social media
Video chat (Skype)
50%
38%
10%
5%
6%
5%
3%
1%
2%
1%
1%
57%
46%
12%
10%
8%
3%
2%
1%
1%
1%
1%
51%
41%
12%
13%
9%
4%
2%
1%
1%
1%
1%
54%
40%
11%
14%
6%
1%
1%
1%
0%
Which methods do you use to communicate with your hospital?
2011201220132014
Q36b: Which of the following communication methods have you used to communicate with your hospital? Page 49
Significantly higher level of ‘none of these/don’t have a hospital this year compared to last year (33% vs. 21%).
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Visited but haven't "Liked"
Visited and "Liked"
Have not visited
Not sure
3%
4%
90%
3%
3%
4%
90%
3%
Visiting/Liking health plan or hospital Facebook pages
Hospital Facebook page
Health Plan Facebook page
Q37: In the past year, have you visited and/or ‘Liked’ a health plan or hospital Facebook page?
2013
4%
3%
2%
3%
91%
91%
3%
3%
Facebook visitors are
almost entirely Millennials.
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Yes I have used a virtual doctor service; 2%
No I have not used a virtual doc-tor service, but am familiar with
them; 22%
No I have not used a virtual doctor service, and am not familiar with
them; 71%
Not sure; 5%
Ever had a virtual doctor visit?
Q38: Have you ever had a ‘virtual doctor visit’ where you talk with a physician face-to-face using a PC, tablet, or smart phone?
Opportunity or threat?
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CHOOSING A HOSPITAL
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Physician
Health insurance website
Family/friend
Online search
Hospital's website
HealthGrades
Online patient support group
WebMD
Patient satisfaction ratings
Hospital advertising
Joint Commission
Consumer Reports
Social media sites
Consumer review sites (like Angie's List)
US News & World Report
Employer
Blogs about hospitals
CMS website
ANA Magnet Status
Hospital publications
Thomson Reuters Top 100
None of these
43%
14%
12%
6%
5%
4%
4%
4%
2%
1%
1%
1%
1%
1%
1%
0%
0%
0%
0%
0%
0%
38%
45%
24%
33%
15%
15%
9%
5%
10%
8%
2%
2%
9%
4%
4%
3%
11%
1%
5%
2%
6%
3%
23%
Hospital choice factors by hospital experience
Have not been to hospital (59%)
Been to hospital (41%)
Page 53
Q39: Have you personally been to a hospital for inpatient, outpatient, or ER care in the past 2 years?Q40: (Q39 Yes) Next, think back to when you were hospitalized and had to decide which hospital you should choose. Which of the following sources of information, if any, did you seek out to help you make that choice? (Q39 No) Next, if you had to be hospitalized and you wanted to gather information about which hospital you should choose, which of the following sources of information would you definitely use to help you make that choice?
Those who have not been to a hospital ‘think’ they would
investigate their hospital choice a great deal more than what actually
happens in a hospital choice scenario. The only real constant is
‘physician recommendation.’
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Quality ranking organizations such as HealthGrades, US News
& World Report, Hospital Compare from the government
Consumer-driven quality rating organizations such as Angie’s
List, Yelp, Vitals, and other social media sites
Neither
Not sure
34%
16%
26%
24%
35%
15%
27%
23%
Most useful information for hospital decision
20132014
Q41: Now, if you were looking for information on hospital quality to compare different hospitals before you made a decision on which hospital to choose, which of the following sources of quality information, if either, would you more likely find useful in your decision-making? Page 54
Other Klein & Partners research has shown that consumers aren’t finding these sources useful yet because there are so few reviews for a particular
doctor or hospital. We are conducting further research
to find out how many reviews are needed for
source credibility.
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WEBSITES VISITED
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Q42: Have you been to a hospital website in the past 3 months?Q43: Think about the most recent hospital website that you visited. What were your main reasons for visiting this website?Q44: Overall, how well did this website meet your needs? Was this website visit…?
Excep-tional; 23%
Accept-able; 68%
Disap-pointing;
5%Not sure; 4%
Website met my needs
Schedule/cancel appt.
Get directions/contact info
Find info about particular health service
Find info on physician
View my test results
Pay/review bill
Apply for job/review job listings
Access hospital's patient portal
Look up info on specific condition
Learn more about the hospital
Look up info/sign up for class or event
Request medical records
Look up info on health and wellness
Connect to a service that provides patient updates
Pre-register for a test or procedure
Check ER wait times
31%
31%
24%
23%
20%
18%
14%
14%
13%
12%
10%
10%
9%
7%
6%
3%
Reasons for visiting websiteVisited a hospital website in the past 3 months: 11%
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RETAIL CLINICS
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OTC medications
Shopping for food, beverages, cosmetics, etc.
Drop-off/pick up prescription
Medical products
Flu shot/other vaccinations
Urgent care visit
Primary care visit
Blood test
Other
Never shopped at this retailer
Retailer not in my area
Not sure
49%
41%
35%
23%
12%
4%
1%
1%
1%
15%
7%
9%
45%
56%
19%
22%
3%
1%
1%
1%
3%
16%
3%
8%
Retail healthcare services utilized
WalmartWalgreens
Page 58Q45: Next, we have a couple questions about getting healthcare services or products at a retail store. Have you been to a {RESTORE RETAILER} for any of the following?
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Walgreens
Walmart
22%
12%
33%
23%
20%
20%
18%
35%
7%
10%
Comfortable going to retail clinic(among those who have shopped at that store before)
Very comfortable Fairly comfortable Not very comfortable Not comfortable at all Not sure
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Q46: If your doctor wasn’t available and you had a minor illness (e.g., cold, flu, stomach or ear ache, etc.) and you decided to find an urgent care center because you didn’t want to wait to see your doctor for care – how comfortable would you be in going to {RESTORE Q45 RETAILER} for this type of care compared to another type of urgent care facility?
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ONLINE HEALTHCARE SHOPPING
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Q47: In the past year have you purchased any healthcare-related products online? Q48: Why did you purchase these healthcare-related products online? Q49: What online site(s) did you purchase these healthcare-related products from?
Cheaper prices
Easy to purchase
Free shipping
Don't have to leave the house
Automated refills easier online
More selection
Lots of positive online reviews
My doctor recommended
Family/friend recommended
Faster than mail order
HCP (not doctor) recommended
Insurer requires it
56%
51%
47%
36%
25%
25%
10%
6%
4%
3%
3%
3%
Why purchased healthcare products online?
Amazon
CVS
Walgreens
Drugstore.com
Express Scripts
Walmart
Target
Other
Not sure
31%
20%
12%
12%
9%
7%
4%
25%
10%
Online sites purchased from
Purchased healthcare-related products online in
past year:
23%
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PRICE SHOPPING
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Dental services
Lab services
Physician services
Outpatient surgery
Radiology
ER/Urgent care
GI procedure
Physical therapy
Inpatient surgery
Cardiac procedure
Other
30%
21%
37%
15%
15%
7%
2%
3%
4%
1%
18%
29%
20%
25%
15%
18%
5%
6%
9%
8%
2%
16%
26%
27%
36%
10%
31%
14%
7%
7%
7%
1%
20%
24%
31%
31%
15%
27%
10%
6%
10%
4%
0%
19%
35%
27%
35%
20%
21%
14%
9%
12%
9%
4%
8%
46%
43%
29%
25%
32%
12%
8%
10%
11%
3%
4%
48%
40%
33%
21%
18%
16%
10%
9%
5%
4%
3%
Health service price shopped
2008
2009
2010
2011
2012
2013
2014
2008 2009 2010 2011 2012 2013 2014
Households that have contacted a healthcare organization to ask the price for a specific visit, test, treatment, or surgery
33% 32% 32% 22% 28% 24% 16%
Chose the least expensive provider for one of these healthcare cases
36% 41% 31% 31% 33% 24% 44%
% of the total patient market 12% 13% 10% 7% 9% 6% 7%
Price check in aisle five!
Q50: Within the past year, did you or did a member of your immediate household contact any healthcare organization, hospitals, or physician offices to ask about the price for a specific visit, test, treatment, or surgery? IF YES…Q51: How did you check on pricing?Q52: What type of health service did you ask about pricing for?Q53: Did you end up choosing the least expensive provider?
Went online10%
Stopped in and spoke to someone
4%
Called86%
How did you check on pricing?
Called:2010/2011 71%
2012 72%2013 73%
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HEALTH INSURANCE AND GETTING CARE
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Provided through work or union
Individual coverage from insurance company
Insurance through a state insurance exchange
Insurance through a federal insurance exchange
Insurance through a private exchange
Medicare (Part A or Parts A/B only)
Medicare (with a supplemental plan)
Medicaid
VA/CHAMPUS
No health insurance
Not sure
51%
5%
0%
2%
0%
6%
12%
6%
1%
10%
6%
48%
7%
2%
1%
1%
7%
13%
3%
2%
10%
6%
Current health insurance
20132014
Q54: What type of health insurance, if any, do you have currently?
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1st Qtr 2009
4th Qtr 2009
4th Qtr 2011
4th Qtr 2012
4th Qtr 2013
4th Qtr 2014
20% 23%17% 17% 17% 15%
Had recent financial hardship due to medical bills
Q55: Have you experienced a significant financial hardship in the past year due to medical bills? Page 66
Especially among those <$45K HHI
(25%).
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RURAL HEALTHCARE
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Primary physician care
Hospital care Outpatient care Urgent care-100%
-75%
-50%
-25%
0%
25%
50%
75%
100%
80% 80% 78%64%
-18% -18% -16%-31%-2% -2% -6%
-5%
Yes
No
Not sure
Adequate healthcare access in rural areas
Q56: Would you describe where you live as…?Q57:You checked that you live in a rural area. Do you feel there is adequate access to each of the following types of healthcare services close by where you live or not (i.e., without having to drive a far distance to another town or city)?
17% consider themselves to live in a rural community
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Primary physician care
Hospital care Outpatient care Urgent care-100%
-75%
-50%
-25%
0%
25%
50%
75%
100%
27% 25% 30% 21%
37%25% 20%
17%
-17%-27% -27% -35%
-12%-14% -15%
-19%-8%
-9% -7%
-9%
Excellent
Very good
Good
Fair
Poor
Adequate healthcare access in rural areas
Q56: Would you describe where you live as…?Q58: And how would you rate the quality of medical care provided by each of these healthcare services?
17% consider themselves to live in a rural community
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APPENDIX
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Demographic profile TotalFemale 54%
Children in HH 23%
EthnicityCaucasian
HispanicAfrican American
AsianOther/refused
62%171272
Age18-4445-64
65+Median age
46%3618
47
Median household income $54,600
Education LevelUp to high school
Some collegeCollege grad (undergrad)
Graduate degree
15%561811
Generally think of yourself as…Strongly Republican
Moderately RepublicanIndependent, lean Republican
IndependentIndependent, lean Democrat
Moderately DemocratStrongly Democrat
OtherNot sure
9%1310181413130
10
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32%
40%
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k l e i n & p a r t n e r sAdditional information
If you would like additional information regarding this study, please contact:
Rob Klein
President
Klein & Partners
[630] 455-1773
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