8 Myths About the Orthopedic Consumer

Orthopedics is a consumer products industry. That’s a fact.

But how well do we understand consumer thinking and how clearly do we see the influence consumers are exerting on orthopedic products and services?

McKinsey & Company, the global research and consulting powerhouse with more than 9, 000 consultants, nearly 2, 000 research and information professionals and a $400 million annual research budget released an interesting analysis of the healthcare consumer in December 2015.

Their analysis uncovered eight common myths about the healthcare consumer.

Myth #1: Healthcare is different from other industries. Consumers don’t bring the same expectations about customer experience to healthcare that they bring to retail or technology companies.

McKinsey’s researchers found, however, that consumers bring the same expectations to doctors and clinics as they do to other service and product companies like, for example, Apple or Amazon.

More than half the consumers polled by McKinsey said that customer service is as important for healthcare companies as it is for non-healthcare companies. Getting specific, consumers said that they want healthcare providers who deliver on expectations, make their lives easier, and offer great value.

But don’t be lulled into thinking these comments are bromides. McKinsey made the point of saying that healthcare providers are NOT meeting the standards of their non-healthcare consumer brethren.

Said the report’s authors: “Customer expectations are being set by non-healthcare industries, and meeting those expectations is likely to be critical to ensure satisfaction and loyalty.”

Myth #2: Consumers know what they want from healthcare companies and what drives their decisions. Most consumers have strong opinions about what matters to them when they make healthcare decisions or receive healthcare services.

McKinsey’s researchers found a big disconnect here. What consumers think matters most to them is not what influences their opinions most strongly.

As part of McKinsey’s 2014 CHI (Consumer Health Insights) survey of healthcare consumers, researchers posed two questions about “satisfaction” to patients who’d been hospitalized within the previous three years.

First, McKinsey researchers asked how satisfied these former patients were with their hospital experience. More than 90% said they were at least somewhat satisfied with the care they received.

Second, they asked patients to rank the importance of various factors that might have influenced their satisfaction levels. Most of the responding patients said that outcome of their treatment was the factor most bearing on their satisfaction level.

When McKinsey’s analysts dug into the factors that drove their satisfaction, they found that the empathy and support provided by health professionals (especially nurses) had a stronger impact than outcomes did. And coming right behind empathy was the quality and consistency and quantity of information given during and after treatment.

Bottom line: patients tend to tend to overstate tangible factors (e.g., parking, pain management) and understate emotional or abstract factors (e.g., empathy or ‘value’).

Myth #3: Most consumers research their healthcare choices before making important decisions and then make fact-based choices based on their research.

Five different surveys conducted by McKinsey over the years show that patients do not make research-based decisions.

The findings are clear. According to McKinsey’s research, only a few consumers exert the effort to research provider costs or the number of providers available to them. A minority of consumers is starting to research their health plan choices but even among this group, many are not aware of key factors they should consider before selecting coverage.

McKinsey’s 2015 CHI survey found that only 22% of patients responding to the survey asked about cost before going to a doctor or other healthcare provider. Regardless of whether the patient was seeking orthopedic care or some other treatment, patients reported that they had “talked to someone” (e.g., a provider or insurance representative) to investigate costs instead of cruising the Internet and studying websites.

Even of those patients who did research costs before undergoing an expensive, invasive procedure (e.g., joint surgery), half said that their doctor’s recommendation was the key factor that influenced their decision about where to seek care.

Cost is not the only factor consumers don’t research. When asked, the patients in the McKinsey survey said there was only one local hospital when, in fact, there were a median of three hospitals within a 10-mile radius of their home and ten hospitals within a 20-mile radius.

Myth #4: Now that consumers are paying more for their healthcare, premium price is the only truly important factor in purchase decisions.

In both the McKinsey 2014 and 2015 surveys, patients reported that premium pricing was an important factor in their decisions but a large percentage of those same patients did not buy the cheapest health insurance plan available to them.

Quality matters.

In McKinsey’s 2015 post-OEP (open enrollment period) survey, 49% of the responding patients remembered their insurance plans’ pricing but said that they picked insurance with premiums that were average or above average as compared to other plans.

To drill down further into consumer attitudes about healthcare pricing, McKinsey asked patients to design their own plan and presented them with tradeoffs between premium prices and various cost-sharing and benefit options (e.g., premiums went up as deductibles went down).

Only 15% of the participants selected a $0 premium plan. Two-thirds said they would be willing to pay a $50 premium per month if it would reduce their medical deductible to $0.

Fully 30% said they would pay more than they were currently paying if it lowered their deductible or give them ancillary products. What did these patients want most? A $0 deductible for prescription drugs.

Even more interesting, one-third said they were willing or very willing to pay up to 20% more for health insurance if it gave them more choices about where to seek care.

A recent Department of Health and Human Services report also found that pricing is not the only factor patients consider when buying healthcare coverage. That survey found that 66% of the 8.84 million people who bought health insurance through the federally facilitated marketplace during the 2015 OEP could have purchased a health plan with a monthly premium of $50 or less (after the advanced premium tax credit was applied). However, only about half of these people bought the very-low-cost plans.

Myth #5: Almost all consumers have a primary care provider (PCP) and are highly reluctant to change doctors.

Not exactly.

In McKinsey’s 2015 CHI survey, 82% of the responding patients said that they had a regular PCP but said that they would change providers under the right set of circumstances.

Patients that were over 65 years old were the most likely to have a PCP (96%). Patients that were between the ages of 18 to 34 years were the least likely to have a PCP (65%)

Income was the other big factor. Patients with incomes above $100, 000 and patients with one or more chronic conditions were 89-90% likely to have a PCP.

Two-thirds of the patients who have a regular PCP would change providers if they or their doctor moved. A little more than half (57%) said they would switch doctors if their health plan no longer covered their PCP. The most likely patients to leave their PCP were those who were the newest with that PCP. So 72% of the patients who’d been using a doctor for a year or two would switch while only 53% of those who had been with their doctor for five or more years would switch.

Other evidence from this year’s CHI suggests that many consumers are willing to consult providers other than a regular PCP.

For example, 71% of the surveyed patients agreed with the statement: “There are many good primary care physicians that I would be satisfied seeing.” Forty-five percent of the participants said that they had made an appointment at least once with any available doctor within the same practice or facility as their regular PCP. Of those who had not done so, only 18% indicated that they were unwilling to consult any doctor but their PCP.

Furthermore, 16% of the patients surveyed received care from a multi-doctor primary care clinic rather than an individual PCP.

Why? Convenient locations, shorter waiting times, easier scheduling.

Myth #6: Retail clinics will remain a niche health solution.

More than 80% of McKinsey’s respondents know about drug and retail store healthcare services. About half were unsure of the specific services being offered. But two-thirds said they are willing to use healthcare services offered by a pharmacy or retail store and 20% have already received treatment in these settings—which is double the 10% reported in McKinsey’s 2013 CHI survey.

Convenient locations, not needing an appointment, convenient hours—these were the reasons patients went to these strip mall providers. And more than three-quarters of the 2015 participants who used these providers said they would do so again.

What services are patients purchasing at retail or pharmacy locations? Immunizations, minor illnesses and nutritional/weight loss support.

According to McKinsey, alternative care options like these are growing substantially. The number of retail clinic locations across the United States rose from 1, 183 in 2010 to 1, 866 in 2015. CVS, which operates about half of the retail clinics, has announced that it plans to have 1, 500 clinics by 2017. Growth among other the major players is likely to accelerate now that Walmart is putting primary care practices within its stores, and Walgreens is partnering with Theranos to offer convenient, affordable blood testing.

How long will it be before basic orthopedic services like bone density scans or pain management services are also on the menu at the local strip mall? In many respects, the growth opportunity is to create simple orthopedic treatment kits or systems which open up these retail markets.

Myth #7: Only young people are using technology to manage their health and healthcare needs.

Nope.

The top two healthcare activities which were managed by patients using electronic technologies were doctor communications and scheduling appointments. Patients 65 years of age or older said that websites and apps were more effective (65% and 78%, respectively) than phone or in-person communications.

However, in terms of using social media, millennials (those between the ages of 18 and 34) were much more likely than older participants to share wellness ideas and participate in online wellness groups.

Myth #8: Most people are willing to trust insurers to store their Fitbit or other health monitoring records.

When McKinsey’s researchers asked patients to imagine having some sort of health monitoring device and then to say where they’d want to store the health data from that device, the overwhelming answer was their PCP.

Not their health insurer, Google, or Apple. And even fewer respondents wanted their employer to store it. Patients also said that they were most comfortable sharing their personal health data with their PCP generally.

Conclusions

McKinsey’s analysts ended their report (available in full here) by saying that doctors, clinics and health insurance providers should think about the evolving role of new healthcare technologies in shaping consumer behaviors.

So, orthopedic technologies designed for the hospital setting can become victims to changing consumer expectations. McKinsey argues that companies have the opportunity at this early stage to take advantage of the evolution in consumer attitudes.

Finally, everyone who serves the orthopedic patient—directly or indirectly—should, in McKinsey’s words, “realize that consumers’ expectations are no different in healthcare than in any other industry. In fact, other industries will continue to shape these expectations—healthcare companies need to catch up, or they risk being disrupted.”