Consumer Driven Healthcare

• Are all consumers the same?

• Deloitte/ Four Consumer Classifications

• Trailblazers

o Younger, higher income, excellent health, more men, use report cards of doctors, hospitals, will change doctors if dissatisfied

• Prospectors

o 2nd youngest group, high income, men=women, open to wearable tech & virtual office visits, use quality ratings
• Homesteaders

o 2nd oldest, low income, women>men, not open to tech, avg. wellness, convenience > OOP, don’t change providers

• Bystanders

o Oldest, poorest, women > men, not open to tech, avg. wellness, don’t share info with doctor, least likely to follow healthy diet, choose doctor on OOP and convenience

• Why are we talking about this?

o If consumer can pick their health care option, then who are the consumers, i.e., what types do they fit?

o What do they want?

o With Congress and the States trying to model health care as ACA or an alternative, then what patient types should they consider?

• In actuality, the US already has a multi-tiered health care system –

o Healthy, young people can buy commercial insurance or not

o Poor people and children have Medicaid or County hospitals/clinics for caring for the poor and uninsured

o General Public has the ACA

o Older people have Medicare

o Injuries have Workers Comp

• If we use the Deloitte Consumer Classifications, then we have one method of classifying different patient types.

• For other than Medicaid/Medicare, Workers Comp, and Commercial Insurance, the law of large numbers prevails. To provide insurance for people with pre-existing conditions, healthy and sick people must participate. Options include:

o Modifying the ACA – produced low ER, low hospital, downward drug spend – needs alternative options for healthy individuals

o Aggregating populations with sick and poor to contribute to insurance

o Various per-capita formulae for different segments of the population

o State or Federal government re-insurance programs

o National health care

o Other options

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