Consumer-driven health plans, and their sky-high deductibles, present millions of consumers each year with a difficult question: “Is my health worth the price?” How people decide whether to receive care is likely influenced by pre-existing attitudes toward health, according to a growing body of patient segmentation research. Health-conscious enrollees might prioritize visiting a doctor when they become sick while health is less of a priority for other consumers in the face of day-to-day life’s competing pressures.

Understanding how different types of patients react when faced with high-deductibles is important to consider because CDHPs can end up doing more harm than good if consumers are discouraged from receiving care. Patient segmentation tools, which use shared personalities and traits to define distinct groups of patients, can help us think about how healthcare consumers vary with regard to their attitudes toward health and how they might confront the wallet-or-well-being conundrum.

One such patient segmentation tool is the Consumer Classifier survey, developed by Cincinnati-based c2b, which sorts participants into one of five groups: Direction Takers, Balance Seekers, Priority Jugglers, Willful Endurers, and Self-Achievers. These groups span an entire spectrum of consumers, from those that hang on a doctor’s every word to those that couldn’t care less about their health.

Here’s the breakdown, according to the Consumer Classifier, with some added information on how each of these consumers could deal with high deductibles:

  • Willful Endurers are the most short-sighted of the five consumer types. They visit a doctor only as a last resort and are generally noncompliant with physician orders. High deductibles associated with CDHPs likely reinforce this behavior, since there is a potent financial deterrent to visiting the doctor, and may put these consumers at risk for developing complications when they inevitably do get sick. Also, these patients probably neglect saving money in a Health Savings Account, a vehicle commonly paired with CDHPs to help patients offset out-of-pocket expenses, if they even have an HSA established in the first place.
  • Priority Jugglers place the health of others above their own. These consumers put off their own care until absolutely necessary and often spend much of their time and money taking care of others. This behavior is probably exacerbated by high deductibles, as seeking medical care or contributing to an HSA requires resources these patients would rather devote to a loved one.
  • Balance Seekers are the middle ground among the five consumer types. They are health conscious but do not heavily weigh physician recommendations. High deductibles could push this population to avoid physician visits at the first sign of an illness. Balance Seekers may also contribute to an HSA, but not to as large of an extent as more proactive consumers like Direction Takers.
  • Direction Takers will seek treatment as soon as they become sick but, while generally committed to living a healthy life, may not make regular use of preventive services like check-ups or screenings if they are inconvenient. High deductibles could discourage some of these patients from receiving care if the out-of-pocket expense is high enough. However, their concern with long-term health likely means these patients make regular contributions to HSAs.
  • Self-Achievers are very proactive and heavily weigh instructions from their doctor. They also tend to stay up-to-date with check-ups and screenings. Out of all five types, Self-Achievers are probably best suited for CDHPs. Since they are proactive, they likely utilize more preventive services in order to avoid major illnesses and maintain healthy balances in their HSAs to cover the inevitable costly illness.

Patient personalities are important to consider as CDHPs, which account for over 17 percent of the national commercial market, become more  prevalent. Insurers must be mindful of how personalities and attitudes play a role in the way people make healthcare decisions, and consider using tools similar to the Consumer Classifier to help them tweak CDHPs and make them manageable for a wider range of consumer segments. As they stand now, CDHPs are certainly not for everyone and stand to reinforce, rather than discourage, risky decision making among most consumers.

Follow Tyler Dinwiddie on Twitter @TylerDinwiddDRG

 

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