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Why you should Segment Your Healthcare 
Customers and How to Do it 
AHIP 2014 Consumer Series 
Webinar Program 
October 2014
Our Host 
Principal at Kevin Riley & Associates | modelH 
• Former chief innovation officer of Florida Blue (BCBS of Florida) 
• Founder and former president/CEO of GuideWell 
• Founder of AssureClick 
• Founder of HealthTHREADS 
Kevin Riley & Associates formed to help companies 
with the convergence of health care and the 
consumer. He founded and was CEO of a national 
health care retail company, played leadership roles 
for several national retail health start-ups, and served 
as the first Chief Innovation Officer of a major 
insurance plan. 
Follow me on @kevineriley, linkedin, slideshare
Our Speakers 
Jennifer Haid 
Vice 
President, 
Consumer 
Strategy, 
Iconoculture, 
Inc. 
Debra Richman 
Senior 
Vice 
President, 
Nielsen 
Paul Janowitz 
CEO 
and 
Founder, 
icanmakeitbe>er
How do you create and 
execute an effective 
segmentation strategy for 
health insurance shoppers?
1. Why Segment? 
2. What Models? 
3. What Methods? 
4. What Results? 
5. What Next?
Easy Ways to Segment Your Customers and Create Actions 
A QUICK RECAP
At our AHIP summer forum we 
talked a lot about various ways 
consumers approach 
healthcare. Can we briefly 
review?
Consumers are increasingly 
making healthcare decisions as 
they make other consumer 
decisions. It is critically 
important to know your 
Members as “Consumers”
Cost will continue to drive the 
Market. Consumers care about: 
• Price, Price, Price 
• Lower costs, regardless of 
health status
Understand Preferences & Trade Offs 
• Age matters in likeliness to accept 
benefit restrictions 
• There is increased receptivity to 
narrow networks among all consumer 
segments including Medicare 
• All segments want access to primary 
care, and are willing to trade off 
broader access to specialty care for 
lower costs
Change the Consumer Health Conversation 
Best self 
Balance 
Path
Easy Ways to Segment Your Customers and Create Actions 
WHY SEGMENT HEALTHCARE MARKETS?
Why do health plans need to 
consider segmentation in the 
new consumer markets? What 
are its practical implications 
and purposes. Can you provide 
some good examples?
Understand Preferences 
& Decision Making 
Consumers have unique sensibilities that directly affect behaviors; from 
healthcare to how they shop; integrating and balancing healthcare needs 
across their entire lives. 
THEN 
Women 18-49 
Member 
NOW 
( 
Women 18-49 
(children = 2) + 
(self employed - family insurance coverage) + 
(uses smartphone 1.2 hours/day)+ 
(Cycles 3X/ weekly) + 
(Has Asthma- takes Rx )+ 
(HH income < $75K) + 
( Light TV/ heavy online) 
Member
Syncing Behaviors with Consumers 
What we know about James’ 
media preferences: 
• Prefers the Fox News Channel, Golf 
Channel and AMC 
• Listens to news/talk radio 
• Reads National Geographic 
• Visits dLife.com for Diabetes info 
“James” What we know about James’ 
ailment(s): 
• Type 2 Diabetes sufferer 
• Diagnosed 2 years ago 
• Prescription drug coverage 
• Brand of meter/medications used 
most often 
What we know about James’ 
shopping behaviors: 
• Total value to the front/back of the 
store by key retailers 
• Target shopper but fills prescriptions 
at CVS 
• Purchases dietetic candy and first aid 
gauze products more than the 
average household 
Attitudes on James’ ailment(s) 
and other aspects of life: 
• Considers adding exercise to his 
routine the most challenging part of 
managing his diabetes 
• Part of the “Magic Bullet” segment for 
H&W attitudes 
• Very concerned with the ongoing 
economic crisis 
Illustrative 
…Ailments, Choices, Actions
Key Findings: Subgroups of Consumers 
STRATEGIC 
HEALTH 
PERSPECTIVES℠ 
Overall Regardless of narrow network tradeoffs, low monthly premiums is consistently the most 
important element across all chronic disease groups. 
Age 
Older consumers are much more likely to want access to leading hospitals in their area, while 
younger consumers are more interested in cash incentives or rewards for healthy behavior. 
Older consumers are also more likely to be interested in an extensive network of hospitals and 
doctors. 
Commercial 
Insurance Type 
No differences between those with employer-based & those who buy their own. 
• Findings do indicate individual plan members find an extensive network of doctors more 
important, as well as cash incentives for healthy behavior. 
• Those who have employer based plans are more concerned with lower costs associated with 
hospitalization and coverage for dependents. 
Uninsured 
The uninsured are primarily concerned with cost, such as low deductibles and low co-pays for 
doctor visits and generics. The uninsured are also more concerned with coverage at alternate 
sites of care. 
Medicaid 
Medicaid recipients find all out of pocket cost items to be much more important. They are 
primarily concerned with a low deductible followed by access to imaging at low cost sharing 
levels. 
Chronic Illness 
Those with Cancer & Diabetes rate benefit importance on a similar scale. However, some 
differences exist: 
• Those with cancer place more emphasis on direct access to imaging and specialists and an 
extensive network of doctors 
• Those with diabetes are generally more price sensitive. They place more emphasis on lower 
premiums and copays for doctor visits.
Cost Important, Network/Brand Less So 
Consumers concerned with cost elements, including deductibles and copays for 
doctors & hospitals… Brand is least important to decision 
Relative Importance of Benefit, Under Age 65 SHP CONSUMER 2014 
Low monthly premiums 214 
Has a low deductible 
Average* 
186 
Below Average 
Above 
Average 
40 
36 
52 
49 
59 
75 
70 
69 
91 
108 
103 
100 
125 
125 
115 
182 
Low copay for doctor visits 
Access to all medical imaging (e.g. MRIs or CT scans) at reasonable 
cost-sharing, or co-pay, levels 
Reasonable cost sharing, or copay levels for hospitalization 
Direct access to all specialists (no referral needed) 
Low copay for generic drugs 
Coverage for dependents 
Includes an extensive network of doctors 
Access to leading hospitals in my area 
Access to cutting edge medical devices and medications 
Access to brand name drugs at reasonable cost-sharing, or co-pay, 
levels 
Coverage for medical care at retail clinics or urgent care centers 
Provides me with cash incentives or rewards for healthy behavior 
Coverage for a wide selection of brand name drugs 
Includes an extensive network of hospitals 
Coverage for over-the-counter medications 
The insurance brand is a name I know and trust 
Base: All US Adults Under Age 65 (2014 n=1015 in half sample) 
Respondents were given a maximum difference trade off exercise in which they were forced to choose the most preferred 
and least preferred plan feature. *Average is 100, and the scores represent importance relative to that average.
Acceptance of Responsibility
Resistance to Accountability 
An unfolding era of self-subsidy in health 
IconoCommunities Participants: 
“Reasonable health” penalties 
are not fair 
Yes 
24% 
No 
76% 
N = 336 Q: Do you think it would be fair if 
there were a nationally agreed upon standard 
for “reasonable health” from which penalties 
and rewards were determined? 
Source: IconoCommunities, November 2013 
IconoCommunities Participants: 
Monetary rewards and/or penalties 
based on the quality of one’s health are 
not rational 
No 
Yes 
78% 81% 84% 87% 
22% 19% 16% 13% 
Employment Government or 
taxes 
Public or 
commercial 
transportation 
Consumer goods 
N = 336 Q: Do you think it is rational for people to be 
rewarded and/or penalized monetarily? 
Source: IconoCommunities, November 2013
Instincts 
Don’t 
Change 
Action, not 
Analysis 
Choices 
Do 
CPG World
When do segments not 
matter?
No $ 
Can’t Target 
No Time 
Monopoly
SEGMENTATION 
CRITICAL STEPS 
UNDERSTAND 
FIND 
ENGAGE 
• Consumer 
behaviors 
and 
aRtudes 
• Plan 
benefits 
that 
are 
most 
appealing 
to 
prospects 
• Inherent 
risk 
(chronic 
condiVons) 
and 
healthy 
behaviors 
• CompeVVve 
threats 
• Understand 
consumers 
as 
they 
make 
informed, 
personalized 
decisions 
• Help 
members 
improve 
their 
health 
and 
manage 
their 
chronic 
condiVons 
• Consumers 
-­‐-­‐ 
where 
and 
how 
they 
live, 
work 
and 
shop 
• PrioriVzed 
hot 
spots 
in 
market 
area 
• Media 
channels 
members 
are 
likely 
to 
uVlize 
and 
prefer
Only segment when you have 
money to create more than one 
“message” and when you can 
externally identify that 
segment to market to.
Easy Ways to Segment Your Customers and Create Actions 
WHAT MODELS & METHODS?
What are some of the new 
segmentation models & 
methods healthcare companies 
can use? Why are these useful 
and how do they fall short?
Health Sophistication
The Total Consumer 
WHAT 
THEY 
WATCH 
WHO 
THEY 
ARE 
WHAT 
THEY 
BUY 
ONLINE 
TV 
• 
Below 
Average 
TV 
Viewers 
• 
Watch 
College 
and 
Pro 
Sports 
• 
Watch 
ESPN, 
TBS, 
History, 
FX 
MOBILE 
• 
Heavy 
Internet 
Users 
• 
Visit 
EducaVon, 
Travel, 
Entertainment 
websites 
• 
Most 
Trusted 
Medium: 
Internet 
• 
Own 
a 
Smartphone 
• 
Use 
mobile 
apps 
• 
Use 
Mobile 
email 
and 
LocaVon-­‐Based 
Services 
DEMOGRAPHICS 
HH 
Income: 
$100K+ 
• 
Married 
with 
Kids 
• 
Suburban 
Homeowners 
• 
College/Post 
Grad 
EducaVon 
• 
Work 
Full 
Time 
• 
Caucasian 
& 
Asian 
LIFESTYLE 
• 
Age 
45-­‐64 
• 
• 
Belong 
to 
Country 
Club 
• 
Foreign, 
DomesVc 
Travel 
• 
A>end 
Theater, 
SporVng 
Events, 
Art 
Galleries/Shows 
HEALTH 
& 
WELLNESS 
• 
Exercise 
at 
Health 
Club, 
Play 
RecreaVon 
Sports 
• 
Go 
to 
Doctor 
for 
Regular 
Check-­‐Ups 
• 
Eat 
Healthy 
& 
Pay 
A>enVon 
to 
NutriVon 
RETAIL 
• 
Order 
Any 
Items 
by 
Internet-­‐ 
$200+ 
• 
Shop 
at 
Nordstrom, 
Kohl’s, 
Po>ery 
Barn 
• 
Prefer 
Products 
With 
the 
Latest 
Technology 
FINANCIAL 
AUTOMOTIVE 
• 
Income 
Producing 
Assets 
(IPA): 
$100K-­‐ 
$500K 
• 
Use 
Licensed 
Financial 
Advisor 
• 
Do 
Online 
Banking 
• 
Have 
Mutual 
Funds, 
CDs 
& 
IRAs 
• 
Drive 
Luxury, 
Sport 
UVlity 
Vehicles 
• 
Belong 
to 
AAA 
Auto 
Club 
• 
Buy 
Auto 
Service 
at 
Dealer 
• 
Drive 
15K+ 
Miles-­‐ 
1yr 
SOCIAL 
MEDIA 
• 
One+ 
Social 
Networking 
Profiles 
• 
Made 
a 
Comment/Post 
on 
Social 
Networking 
Page
Health Insurance Track Attributes 
CURRENT 
DEMOGRAPHICS 
COVERAGE 
PURCHASE 
PROCESS 
HEALTH 
BEHAVIORS 
& 
RISK 
• Current 
Plan 
Channel/ 
Source 
• Previous 
Insurance 
Status 
• Companies 
in 
Decision 
Set 
• Decision 
Making 
Criteria 
• Ideal 
Purchasing 
Environment 
• Exchange 
Plan 
Tiers 
and 
Subsidies 
• Reason 
for 
Uninsured 
• Source 
of 
Coverage 
• Provider 
• Medicare 
• Medicaid 
• Carrier 
• Plan 
type 
• Monthly 
Payment 
• DeducVble 
• Out-­‐of-­‐pocket 
Limit 
• SaVsfacVon 
• Current 
Health 
Status/ 
CondiVons 
• Treatment 
OpVons 
through 
Provider 
or 
Rx 
by 
Ailment 
• Exercise 
• Height/Weight 
• Dietary 
Habits 
• Use 
of 
Tobacco 
• Willingness 
to 
Spend 
on 
Wellness 
Products 
• Age/Gender/Race 
• Income/EducaVon 
• Sexual 
OrientaVon 
• OccupaVon 
• Business 
Owner 
• Nielsen 
SegmentaVon 
• Wealth 
Scores 
• Geography
What is the role of personas vs. 
segmentation? How can we 
use “agile” market research in 
conjunction with our big data 
and segmentation methods?
Nova 
Conversations, 
Not Questions 
1% 
Law of averages 
vs. fast, real 
insights
Health Ailment Panels 
Information captured for ~57,000 households and 98,000 individuals 
Nielsen Health Ailment Panels 
Basic Patient Facts 
Acid Reflux/GERD/Heartburn Enlarged prostate (BPH) 
Acne Gum Disease (Gingivitis, Inflammation etc) 
Allergies – food related only Headache - Chronic/Tension/Migraine 
Allergies (outdoor, hay fever, indoor, 
Heart Disease/Heart Attack/Angina/Heart 
seasonal etc…) 
Failure 
Anxiety/Depression High Blood Pressure/Hypertension 
Arthritis – Osteo Imperfect vision (Near or Far-sightedness, 
Astigmatism, etc…) 
Arthritis – Rheumatoid Insomnia/Sleepless 
Asthma Irritable Bowel Syndrome (IBS) 
Attention Deficit Disorder/Hyperactivity Joint/Neck/Back Pain (not Arthritis) 
Bronchitis/Pulmonary 
Disease/COPD/Emphysema Lactose Intolerance 
Cholesterol Problems (i.e. High Cholesterol, 
Triglycerides) Menopause/Perimenopause 
Constipation (chronic) Muscle Pain/Spasms 
Pre-Diabetes Obesity/Over weight 
Diabetes - Type I Osteoporosis/Bone loss 
Diabetes – Type II Restless Leg Syndrome (RLS) 
Dry Eye (loss or reduction of ability to 
produce tears) 
Skin Condition (not Acne - Rash, Irritation, 
Psoriasis, Eczema, Dermatitis etc…) 
Eye Disease (Glaucoma, Cataracts etc) Urinary Incontinence/Overactive Bladder 
Basic Patient Facts 
Aliment Length 
HCP Interaction 
Ailment Treatments 
Influencers of 
Treatment Regimen 
Severity 
Insurance Type 
Caregiver Status 
Retail Clinic Utilization 
Cigarette/Tobacco Use 
Prevention/Promotion Concerns 
Heart Health 
Women’s Health 
Digestive Health 
Mental Alertness 
Energy Level 
Stress Reduction 
Smoking Cessation 
Weight Management 
Dental Health 
Vision Health 
Immunity System 
Osteoporosis 
Arthritis 
Pain Management
Using Health Ailment Panels 
TOP 5 PREVAILING AILMENTS FOR MEMBERS INSURED WITH… 
PRIVATE INSURANCE 
WITH RX COVERAGE MEDICARE MEDICAID PAY CASH / NO 
INSURANCE 
SUBSIDIZED/ 
FEDERALLY 
ASSISTED 
Menopause / 
Perimenopause Enlarged Prostrate Attention Deficit Gum Disease Attention Deficit 
Acne Eye Disease Asthma Headache- 
Chronic Gum Disease 
Allergies- 
Nonfood 
Heart Disease / 
Heart Attack 
Bronchitis / 
Pulmonary Acne Anxiety / 
Depression 
Imperfect Vision Osteoporosis / 
Bone Loss 
Constipation- 
Chronic 
Insomnia / 
Sleeplessness 
Constipation- 
Chronic 
Pre-Diabetes Arthritis-Osteo Anxiety/Depression Menopause/ 
Perimenopause 
Insomnia / 
Sleeplessness 
Individuals without insurance have the highest incidence of Gum Disease, Headaches, and Insomnia. 
Individuals with Medicaid and Federally Subsidized insurance have high rates of ADD/ADHD 
Source: Nielsen Homescan – Ailment Panel – Annual Survey 2014
What can be measured is, 
move from research to 
conversations that matter, 
speed and innovation trump 
all.
Easy Ways to Segment Your Customers and Create Actions 
WHAT ARE THE RESULTS?
What results should healthcare 
companies expect from their 
segmentation work? How do 
they turn their models into 
action?
Stories 
Sell 
Executives 
Matter 
Engage, 
Don’t Preach 
Agencies & 
Creatives 
Matter
Knowing Members as Consumers 
WHO THEY ARE WHAT THEY WATCH WHAT THEY BUY 
TV 
• Primetime TV Viewers 
• Watch Golf, Baseball, College 
Football & HBO 
ONLINE 
• Heavy Internet Users 
• Track Investments, make Travel 
Plans Online, Visit Facebook 
MOBILE 
• Own Smartphone 
• Surf Internet on Mobile 
• Annoyed by Phone Ads 
DEMOS 
• Age 35-54 
• HH Income: $150K+ 
• Married, Kids 
• Homeowners 
LIFESTYLE 
• Do Scuba/Skin Diving/ 
Snorkeling, Mountain Biking 
• Go to Professional Football & 
Hockey games 
HEALTH & WELLNESS 
• Follow Regular exercise Routine 
• Buy Organic Foods 
• Take Vitamins 
RETAIL 
• Shop at Lord & Taylor, 
Crate & Barrel 
• Dine at Ruth’s Chris 
Steakhouse and 
Bertucci’s 
FINANCIAL 
• IPA: $500K-$1M 
• Use Licensed Financial 
Advisor 
• Annuity through credit 
union 
AUTOMOTIVE 
• Own Luxury Car 
• Belong to Auto Club 
• Recommend Vehicles 
they like to others 
• Drive 15K+ miles/year 
PRINT 
• Heavy Magazine & Newspaper 
Readers 
• Read Coastal Living, Food & Wine 
and Golf Digest
Consumers are increasingly 
making healthcare decisions as 
they make other consumer 
decisions. It is critically 
important to know your 
Members as “Consumers”
Understanding consumers as 
the unique groups they are is 
critical to creating efficiencies 
in marketing; attracting new 
customers and retaining 
members.
In a commoditized 
marketplace, go beyond basic 
demographics to obtain a 
complete view of what 
consumers are like, where they 
live & work & how they 
engage.
Create a story – who are you 
talking to, where did they eat 
today, how was their morning 
and why would they give a s*#! 
about what you have to say?
Easy Ways to Segment Your Customers and Create Actions 
WHAT LIES AHEAD?
What are your own predictions 
about the changing shopping 
habits of healthcare 
consumers? What makes you 
think this?
The “Healthcare Shopper” has 
emerged - consumers are 
making healthcare decisions 
like they are making other 
decisions and the same factors 
will apply: Convenience, 
Quality, Experience, Access, 
Cost
No One 
Knows 
Confusing 
Disruptive 
Opportunity
Final Thoughts

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Easy Ways to Segment Your Customers and Create Actions

  • 1. Why you should Segment Your Healthcare Customers and How to Do it AHIP 2014 Consumer Series Webinar Program October 2014
  • 2. Our Host Principal at Kevin Riley & Associates | modelH • Former chief innovation officer of Florida Blue (BCBS of Florida) • Founder and former president/CEO of GuideWell • Founder of AssureClick • Founder of HealthTHREADS Kevin Riley & Associates formed to help companies with the convergence of health care and the consumer. He founded and was CEO of a national health care retail company, played leadership roles for several national retail health start-ups, and served as the first Chief Innovation Officer of a major insurance plan. Follow me on @kevineriley, linkedin, slideshare
  • 3. Our Speakers Jennifer Haid Vice President, Consumer Strategy, Iconoculture, Inc. Debra Richman Senior Vice President, Nielsen Paul Janowitz CEO and Founder, icanmakeitbe>er
  • 4. How do you create and execute an effective segmentation strategy for health insurance shoppers?
  • 5. 1. Why Segment? 2. What Models? 3. What Methods? 4. What Results? 5. What Next?
  • 6. Easy Ways to Segment Your Customers and Create Actions A QUICK RECAP
  • 7. At our AHIP summer forum we talked a lot about various ways consumers approach healthcare. Can we briefly review?
  • 8. Consumers are increasingly making healthcare decisions as they make other consumer decisions. It is critically important to know your Members as “Consumers”
  • 9. Cost will continue to drive the Market. Consumers care about: • Price, Price, Price • Lower costs, regardless of health status
  • 10. Understand Preferences & Trade Offs • Age matters in likeliness to accept benefit restrictions • There is increased receptivity to narrow networks among all consumer segments including Medicare • All segments want access to primary care, and are willing to trade off broader access to specialty care for lower costs
  • 11. Change the Consumer Health Conversation Best self Balance Path
  • 12. Easy Ways to Segment Your Customers and Create Actions WHY SEGMENT HEALTHCARE MARKETS?
  • 13. Why do health plans need to consider segmentation in the new consumer markets? What are its practical implications and purposes. Can you provide some good examples?
  • 14. Understand Preferences & Decision Making Consumers have unique sensibilities that directly affect behaviors; from healthcare to how they shop; integrating and balancing healthcare needs across their entire lives. THEN Women 18-49 Member NOW ( Women 18-49 (children = 2) + (self employed - family insurance coverage) + (uses smartphone 1.2 hours/day)+ (Cycles 3X/ weekly) + (Has Asthma- takes Rx )+ (HH income < $75K) + ( Light TV/ heavy online) Member
  • 15. Syncing Behaviors with Consumers What we know about James’ media preferences: • Prefers the Fox News Channel, Golf Channel and AMC • Listens to news/talk radio • Reads National Geographic • Visits dLife.com for Diabetes info “James” What we know about James’ ailment(s): • Type 2 Diabetes sufferer • Diagnosed 2 years ago • Prescription drug coverage • Brand of meter/medications used most often What we know about James’ shopping behaviors: • Total value to the front/back of the store by key retailers • Target shopper but fills prescriptions at CVS • Purchases dietetic candy and first aid gauze products more than the average household Attitudes on James’ ailment(s) and other aspects of life: • Considers adding exercise to his routine the most challenging part of managing his diabetes • Part of the “Magic Bullet” segment for H&W attitudes • Very concerned with the ongoing economic crisis Illustrative …Ailments, Choices, Actions
  • 16. Key Findings: Subgroups of Consumers STRATEGIC HEALTH PERSPECTIVES℠ Overall Regardless of narrow network tradeoffs, low monthly premiums is consistently the most important element across all chronic disease groups. Age Older consumers are much more likely to want access to leading hospitals in their area, while younger consumers are more interested in cash incentives or rewards for healthy behavior. Older consumers are also more likely to be interested in an extensive network of hospitals and doctors. Commercial Insurance Type No differences between those with employer-based & those who buy their own. • Findings do indicate individual plan members find an extensive network of doctors more important, as well as cash incentives for healthy behavior. • Those who have employer based plans are more concerned with lower costs associated with hospitalization and coverage for dependents. Uninsured The uninsured are primarily concerned with cost, such as low deductibles and low co-pays for doctor visits and generics. The uninsured are also more concerned with coverage at alternate sites of care. Medicaid Medicaid recipients find all out of pocket cost items to be much more important. They are primarily concerned with a low deductible followed by access to imaging at low cost sharing levels. Chronic Illness Those with Cancer & Diabetes rate benefit importance on a similar scale. However, some differences exist: • Those with cancer place more emphasis on direct access to imaging and specialists and an extensive network of doctors • Those with diabetes are generally more price sensitive. They place more emphasis on lower premiums and copays for doctor visits.
  • 17. Cost Important, Network/Brand Less So Consumers concerned with cost elements, including deductibles and copays for doctors & hospitals… Brand is least important to decision Relative Importance of Benefit, Under Age 65 SHP CONSUMER 2014 Low monthly premiums 214 Has a low deductible Average* 186 Below Average Above Average 40 36 52 49 59 75 70 69 91 108 103 100 125 125 115 182 Low copay for doctor visits Access to all medical imaging (e.g. MRIs or CT scans) at reasonable cost-sharing, or co-pay, levels Reasonable cost sharing, or copay levels for hospitalization Direct access to all specialists (no referral needed) Low copay for generic drugs Coverage for dependents Includes an extensive network of doctors Access to leading hospitals in my area Access to cutting edge medical devices and medications Access to brand name drugs at reasonable cost-sharing, or co-pay, levels Coverage for medical care at retail clinics or urgent care centers Provides me with cash incentives or rewards for healthy behavior Coverage for a wide selection of brand name drugs Includes an extensive network of hospitals Coverage for over-the-counter medications The insurance brand is a name I know and trust Base: All US Adults Under Age 65 (2014 n=1015 in half sample) Respondents were given a maximum difference trade off exercise in which they were forced to choose the most preferred and least preferred plan feature. *Average is 100, and the scores represent importance relative to that average.
  • 19. Resistance to Accountability An unfolding era of self-subsidy in health IconoCommunities Participants: “Reasonable health” penalties are not fair Yes 24% No 76% N = 336 Q: Do you think it would be fair if there were a nationally agreed upon standard for “reasonable health” from which penalties and rewards were determined? Source: IconoCommunities, November 2013 IconoCommunities Participants: Monetary rewards and/or penalties based on the quality of one’s health are not rational No Yes 78% 81% 84% 87% 22% 19% 16% 13% Employment Government or taxes Public or commercial transportation Consumer goods N = 336 Q: Do you think it is rational for people to be rewarded and/or penalized monetarily? Source: IconoCommunities, November 2013
  • 20. Instincts Don’t Change Action, not Analysis Choices Do CPG World
  • 21. When do segments not matter?
  • 22. No $ Can’t Target No Time Monopoly
  • 23. SEGMENTATION CRITICAL STEPS UNDERSTAND FIND ENGAGE • Consumer behaviors and aRtudes • Plan benefits that are most appealing to prospects • Inherent risk (chronic condiVons) and healthy behaviors • CompeVVve threats • Understand consumers as they make informed, personalized decisions • Help members improve their health and manage their chronic condiVons • Consumers -­‐-­‐ where and how they live, work and shop • PrioriVzed hot spots in market area • Media channels members are likely to uVlize and prefer
  • 24. Only segment when you have money to create more than one “message” and when you can externally identify that segment to market to.
  • 25. Easy Ways to Segment Your Customers and Create Actions WHAT MODELS & METHODS?
  • 26. What are some of the new segmentation models & methods healthcare companies can use? Why are these useful and how do they fall short?
  • 27.
  • 29. The Total Consumer WHAT THEY WATCH WHO THEY ARE WHAT THEY BUY ONLINE TV • Below Average TV Viewers • Watch College and Pro Sports • Watch ESPN, TBS, History, FX MOBILE • Heavy Internet Users • Visit EducaVon, Travel, Entertainment websites • Most Trusted Medium: Internet • Own a Smartphone • Use mobile apps • Use Mobile email and LocaVon-­‐Based Services DEMOGRAPHICS HH Income: $100K+ • Married with Kids • Suburban Homeowners • College/Post Grad EducaVon • Work Full Time • Caucasian & Asian LIFESTYLE • Age 45-­‐64 • • Belong to Country Club • Foreign, DomesVc Travel • A>end Theater, SporVng Events, Art Galleries/Shows HEALTH & WELLNESS • Exercise at Health Club, Play RecreaVon Sports • Go to Doctor for Regular Check-­‐Ups • Eat Healthy & Pay A>enVon to NutriVon RETAIL • Order Any Items by Internet-­‐ $200+ • Shop at Nordstrom, Kohl’s, Po>ery Barn • Prefer Products With the Latest Technology FINANCIAL AUTOMOTIVE • Income Producing Assets (IPA): $100K-­‐ $500K • Use Licensed Financial Advisor • Do Online Banking • Have Mutual Funds, CDs & IRAs • Drive Luxury, Sport UVlity Vehicles • Belong to AAA Auto Club • Buy Auto Service at Dealer • Drive 15K+ Miles-­‐ 1yr SOCIAL MEDIA • One+ Social Networking Profiles • Made a Comment/Post on Social Networking Page
  • 30. Health Insurance Track Attributes CURRENT DEMOGRAPHICS COVERAGE PURCHASE PROCESS HEALTH BEHAVIORS & RISK • Current Plan Channel/ Source • Previous Insurance Status • Companies in Decision Set • Decision Making Criteria • Ideal Purchasing Environment • Exchange Plan Tiers and Subsidies • Reason for Uninsured • Source of Coverage • Provider • Medicare • Medicaid • Carrier • Plan type • Monthly Payment • DeducVble • Out-­‐of-­‐pocket Limit • SaVsfacVon • Current Health Status/ CondiVons • Treatment OpVons through Provider or Rx by Ailment • Exercise • Height/Weight • Dietary Habits • Use of Tobacco • Willingness to Spend on Wellness Products • Age/Gender/Race • Income/EducaVon • Sexual OrientaVon • OccupaVon • Business Owner • Nielsen SegmentaVon • Wealth Scores • Geography
  • 31. What is the role of personas vs. segmentation? How can we use “agile” market research in conjunction with our big data and segmentation methods?
  • 32. Nova Conversations, Not Questions 1% Law of averages vs. fast, real insights
  • 33. Health Ailment Panels Information captured for ~57,000 households and 98,000 individuals Nielsen Health Ailment Panels Basic Patient Facts Acid Reflux/GERD/Heartburn Enlarged prostate (BPH) Acne Gum Disease (Gingivitis, Inflammation etc) Allergies – food related only Headache - Chronic/Tension/Migraine Allergies (outdoor, hay fever, indoor, Heart Disease/Heart Attack/Angina/Heart seasonal etc…) Failure Anxiety/Depression High Blood Pressure/Hypertension Arthritis – Osteo Imperfect vision (Near or Far-sightedness, Astigmatism, etc…) Arthritis – Rheumatoid Insomnia/Sleepless Asthma Irritable Bowel Syndrome (IBS) Attention Deficit Disorder/Hyperactivity Joint/Neck/Back Pain (not Arthritis) Bronchitis/Pulmonary Disease/COPD/Emphysema Lactose Intolerance Cholesterol Problems (i.e. High Cholesterol, Triglycerides) Menopause/Perimenopause Constipation (chronic) Muscle Pain/Spasms Pre-Diabetes Obesity/Over weight Diabetes - Type I Osteoporosis/Bone loss Diabetes – Type II Restless Leg Syndrome (RLS) Dry Eye (loss or reduction of ability to produce tears) Skin Condition (not Acne - Rash, Irritation, Psoriasis, Eczema, Dermatitis etc…) Eye Disease (Glaucoma, Cataracts etc) Urinary Incontinence/Overactive Bladder Basic Patient Facts Aliment Length HCP Interaction Ailment Treatments Influencers of Treatment Regimen Severity Insurance Type Caregiver Status Retail Clinic Utilization Cigarette/Tobacco Use Prevention/Promotion Concerns Heart Health Women’s Health Digestive Health Mental Alertness Energy Level Stress Reduction Smoking Cessation Weight Management Dental Health Vision Health Immunity System Osteoporosis Arthritis Pain Management
  • 34. Using Health Ailment Panels TOP 5 PREVAILING AILMENTS FOR MEMBERS INSURED WITH… PRIVATE INSURANCE WITH RX COVERAGE MEDICARE MEDICAID PAY CASH / NO INSURANCE SUBSIDIZED/ FEDERALLY ASSISTED Menopause / Perimenopause Enlarged Prostrate Attention Deficit Gum Disease Attention Deficit Acne Eye Disease Asthma Headache- Chronic Gum Disease Allergies- Nonfood Heart Disease / Heart Attack Bronchitis / Pulmonary Acne Anxiety / Depression Imperfect Vision Osteoporosis / Bone Loss Constipation- Chronic Insomnia / Sleeplessness Constipation- Chronic Pre-Diabetes Arthritis-Osteo Anxiety/Depression Menopause/ Perimenopause Insomnia / Sleeplessness Individuals without insurance have the highest incidence of Gum Disease, Headaches, and Insomnia. Individuals with Medicaid and Federally Subsidized insurance have high rates of ADD/ADHD Source: Nielsen Homescan – Ailment Panel – Annual Survey 2014
  • 35.
  • 36. What can be measured is, move from research to conversations that matter, speed and innovation trump all.
  • 37. Easy Ways to Segment Your Customers and Create Actions WHAT ARE THE RESULTS?
  • 38. What results should healthcare companies expect from their segmentation work? How do they turn their models into action?
  • 39. Stories Sell Executives Matter Engage, Don’t Preach Agencies & Creatives Matter
  • 40. Knowing Members as Consumers WHO THEY ARE WHAT THEY WATCH WHAT THEY BUY TV • Primetime TV Viewers • Watch Golf, Baseball, College Football & HBO ONLINE • Heavy Internet Users • Track Investments, make Travel Plans Online, Visit Facebook MOBILE • Own Smartphone • Surf Internet on Mobile • Annoyed by Phone Ads DEMOS • Age 35-54 • HH Income: $150K+ • Married, Kids • Homeowners LIFESTYLE • Do Scuba/Skin Diving/ Snorkeling, Mountain Biking • Go to Professional Football & Hockey games HEALTH & WELLNESS • Follow Regular exercise Routine • Buy Organic Foods • Take Vitamins RETAIL • Shop at Lord & Taylor, Crate & Barrel • Dine at Ruth’s Chris Steakhouse and Bertucci’s FINANCIAL • IPA: $500K-$1M • Use Licensed Financial Advisor • Annuity through credit union AUTOMOTIVE • Own Luxury Car • Belong to Auto Club • Recommend Vehicles they like to others • Drive 15K+ miles/year PRINT • Heavy Magazine & Newspaper Readers • Read Coastal Living, Food & Wine and Golf Digest
  • 41. Consumers are increasingly making healthcare decisions as they make other consumer decisions. It is critically important to know your Members as “Consumers”
  • 42. Understanding consumers as the unique groups they are is critical to creating efficiencies in marketing; attracting new customers and retaining members.
  • 43. In a commoditized marketplace, go beyond basic demographics to obtain a complete view of what consumers are like, where they live & work & how they engage.
  • 44. Create a story – who are you talking to, where did they eat today, how was their morning and why would they give a s*#! about what you have to say?
  • 45. Easy Ways to Segment Your Customers and Create Actions WHAT LIES AHEAD?
  • 46. What are your own predictions about the changing shopping habits of healthcare consumers? What makes you think this?
  • 47. The “Healthcare Shopper” has emerged - consumers are making healthcare decisions like they are making other decisions and the same factors will apply: Convenience, Quality, Experience, Access, Cost
  • 48. No One Knows Confusing Disruptive Opportunity

Notas del editor

  1. With health insurance becoming direct-to-consumer, the necessity to understand the segmentation of customers and prospects has never been higher.  Do you know whom you want   to target? Which prospects look most like your best customers?  Which prospects are most likely to respond to a targeted offer? Who needs to leave, who should be retained, and who should be targeted for “win back”? 
The science of segmentation is the art of knowing your customers through the engineering of your product, message, channels and services to attract and keep them. And like all business functions, segmentation follows a maturity curve. Where are you today along the segmentation spectrum? Are you applying segmentation across the customer life cycle (awareness, acquisition, activation, and retention) as well as across functional areas (e.g., communications, medical, wellness, service)? 
As these questions imply, segmentation is also bridging the gap between data (IT), segmentation (analytics), insight (marketing), and action (line of business). Join us as we ask the experts simple ways to get started and keep moving along this spectrum. Discover techniques to produce quick wins and also collaborate to achieve a company-wise segmentation mindset. Learn how you can move segmentation out of strategy and into tactics.
  2. Create high quality content (videos, infographics, educational blog posts, etc.) that people will want to share through social networks.
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  4. Create high quality content (videos, infographics, educational blog posts, etc.) that people will want to share through social networks.
  5. Create high quality content (videos, infographics, educational blog posts, etc.) that people will want to share through social networks.
  6. Create high quality content (videos, infographics, educational blog posts, etc.) that people will want to share through social networks.
  7. Create high quality content (videos, infographics, educational blog posts, etc.) that people will want to share through social networks.