Presentation on Chronic Illness and how Americans\' Value Health Care products, programs and services www.healthvaluestudy.com

1. The Spectrum Health Value Study™
Presentation to the Chronic Care & Prevention Congress
May 19, 2009

2. Introductory Remarks
“To address both the costs and performance of the health care
system, greater consensus will be required on what constitutes
value in health care, and how to measure and increase that
value.”
Institute of Medicine
Roundtable on Evidence Based Medicine, March 2009

3. Purpose and Objectives
The purpose of this study is to identify the relative level of
importance of health programs, product and services.
Specifically, the research objectives were designed to:
1. Gain a better understanding of consumer use of and relationship to
health programs, products and services
2. Evaluate the relative value consumers place on different attributes
of health programs, products and services
3. Identify key segments of health care consumers such as those with
chronic illness
3

4. Methodology
A total of 1,013 respondents in January and 1,012 respondents in
April were interviewed for this study for a total of 2,025
respondents to date.
1235 Respondents indicated that they suffered from a chronic
illness in the past year
790 Respondents did not suffer from any chronic illness in the
past year
Respondents were matched to the US population by:
Age
Gender
Census Region
Ethnicity
4

5. Health Care Benefits,
Attitudes And Usage

6. The Chronically Ill by Age; between ages 35 and 54 there are no
statistically significant differences in the numbers; however at younger
ages, people are more well and at older ages people are chronically ill.
The Chronically Ill and Non-Sufferers by Age
18
16
16 15
14 13
12 12
12
12 11
11
10
10 9
9 9
8 8
8 8
8 7
6
6 5
4
4 3
2 2
2 1
-
18-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75 or older
Sufferers Non-Sufferers

7. The majority of all respondents currently have health insurance. The percentage of
all respondents covered dropped significantly from January to April, there was also
change in coverage for persons who reported suffering from chronic illness from 82%
in the first quarter to 77 in the second quarter
100
90 82
78 77
80
70
60
50
40
30
20
10
0
Total (n=2025) Q. 1 Sufferers (n=1235) Q. 2 Sufferers (n=790)
Base = Total Respondents
Q7. Do you currently have health insurance?
7

8. The number of covered person who believe that insurance coverage is
„Absolutely essential‟ is about 68%. Among those who suffer from
chronic illness, the number is much higher and is contrasted here with
those persons who do not have chronic illness. (Data are for both
quarters)
100
90
80 72
68
70 61
60
50
40
30
20
10
0
Total (n=2025) Total Sufferer (n=1235) Total Non Sufferer (n=790)
Base = Total Respondents
Q7. How important do you think it is to have health insurance?
8

9. Sufferers seem to have lost some ground, in terms of their coverage over the
past three months in terms of what they say is covered by their plans. It should
be noted that because this groups uses their coverage more frequently, they are
more sensitive to changes in their coverage, than for example, the total
respondent group.
Q1 Sufferers(n=520) Q2 Sufferers (n=483)
Q2
100 92 93 92
88 88 88 88 86 88 Q2 88 Q2
85 84 83 84 82
Q2
80 76
60 55 52 55 54 52
51
37 39
40
20
1 2
-
Doctor visits Hospital Emergency Prescriptions Annual Lab tests Outpatient Major Dental Vision Mental Hearing All other
stays room visits exams/ procedures Medical health and/ mentions
Preventive or substance
care abuse
Base = Total Have Health Insurance
Q11. Which of the following are covered by your current health insurance plan?
9

10. Overall Ratings of
Health Care Services
And Programs

11. Generally, when asking respondents how satisfied they are with service, programs and
products they have actually used, non-sufferers tend to give higher satisfaction scores than do
sufferers. However, on a few items—which may be considered specialty concerns—the
opposite is true with sufferers having greater satisfaction with surgical services, medical and
scientific research and emergency care.
Physician Services 69 74
Dentist Services 7072
Diagnostic Laboratory Services 68
70
Over The Counter Drugs 61 72
Prescription Drugs 60 69
Health/Personal Care Goods 58 65
41
Non-Sufferers
Surgical Services 63
Sufferers
Outpatient Services 58
Medical Services At A Hospital 54 57
Pharmaceutical Research 36 55
Medical Research 39 55
Scientific Research 46 51
Emergency Care Services 45 49
n
0 10 20 30 40 50 60 s 70 80 90 100
Base = Total Respondents Q1. In general, how would you rate health care services that are available in the U.S.? For each of the following
services please use a scale of 1 to 10, where a 10 means that in general that service is EXCELLENT and a 1 means that in
general that service is POOR.
11

12. Services Used On A Regular Basis

13. Chronically ill people use statistically significantly more drugs, both prescription and OTC,
than their uninsured counterparts on a regular basis. They also use more of other health care
services and programs on a regular basis. There is no program, product or service that is more
used on a regular basis by non-sufferers than by those with chronic illness.
Sufferers Non-Sufferers
Prescription Drugs 35 71
Over The Counter Drugs 41 61
Physician Services 30 55
Dentist Services 39 46
Health/Personal Care Goods 14 23
Outpatient Services 6 18
Diagnostic Laboratory Services 8 20
Preventive Health Services 8 14
Wellness Services 9 12
Medical Services At A Hospital 5 11
Family Social/Health Services 6
6
Nutrition Services 4 6
Emergency Care Services 3 5
Surgical Services 1 3
0 10 20 30 40 50 60 70 80
Base = Total Respondents Q3. Which, if any, of the following health care services
and programs do you use on a regular basis?
13

14. When we look at all respondents, the percent of people using
products and services on a regular basis has generally fallen
between January 2009 and April 2009.
Total Q2 (n=1012) Total Q1 (n=1013)
Q2
Prescription drugs 61
53 Q2
Over the counter drugs 58
49
48 Q2
Physician services 43
47 Q2
Dentist services 40
Q2
Health/personal care goods 23
16
Diagnostic laboratory services 17
14
Outpatient services 13
14
Preventive Health Services 12
11
Wellness services 11
10
Medical services at a hospital 9
8
Family social/health services 4
8 Q1
Mental health services 4
7 Q1
Psychiatric services 4
7 Q1
Individual social/health services 5
5
- 10 20 30 40 50 60 70 80
Base = Total Respondents
14 Q3. Which, if any, of the following health care services and programs do you use on a regular basis?

15. When we look at just respondents who reported having a chronic illness
(n=1235), the use of some products have increased and others have
decreased between January 2009 and April 2009. Question: Are the
services in the red circle more, economically, elastic than the other
services?
100
90
80 76
70 67 66
60
60 56
50 51
50 42
40
27
30
18
20
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10 4 4 4 6
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January April 09
Base = Total Respondents
15 Q3. Which, if any, of the following health care services and programs do you use on a regular basis?

16. Max-Diff

17. Max-Diff
Max-Diff was chosen over other techniques because:
1. It is easy to administer to respondents
2. 2. It is easy to implement and to analyze
3. 3. And, it provides extremely discriminating data
17

18. The three most important health care services have to do with “access”:
physician services, medical services at a hospital and emergency care services,
prescription drugs are not far behind.
Total Apr Total Jan
Physician Services 91
95
Medical Services At A Hospital 89
91
Emergency Care Services 89 Q2
90
Prescription Drugs 83
87
Dentist Services 72
81
Outpatient Services 71 Q2
75
Diagnostic Laboratory Services 66
75 Q2
68
Surgical Services 71 Q2
Preventive Health Services 64 Q2
69
Over The Counter Drugs 53 Q2
60
F
Medical Research 57 Q2
60
Wellness Services 49
52 Q2
Health/personal Care Goods 54
51
F
0 20 40 60
Q1 80 100
M
F
Base = Total Respondents Q5. Recognizing that health care costs vary, depending on your level of insurance coverage and other health benefits that you either purchase
or receive through an employer or other source, and thinking about the actual dollars that are spent, listed below are four health care services
18 with costs that you and other individuals ultimately pay for either directly or indirectly. Of these four, which is the most important and which is
the least important for you and your family as you spend your health care dollars.

19. Between January and April, some products and services seemed to gain ground such as family
social/health services.
The least valued services did not change.
Total Apr Total Jan
Individual Social/health Services 51
50
Care For The Elderly 47
45
Pharmaceutical Research 43
44 Any ratings
Scientific Research 40 lower than 50
44 mean those
Family Social/health Services 50
43 features lost
39 out to another
Nursing Care Services
36 feature more
Home Health Services 33 Q1 than half the
29
time
Nutrition Services 29
27
Health Relief Services (such As … 32
26
Mental Health Services 25
19
Psychiatric Services 21 Q1
15
Vocational Rehabilitation 15 Q1
12
Mental Retardation Services 9 Q1
6
Substance Abuse Services 6 11
0 20 40 60
Q1
Base = Total Respondents Q5. Recognizing that health care costs vary, depending on your level of insurance coverage and other health benefits that you either purchase
or receive through an employer or other source, and thinking about the actual dollars that are spent, listed below are four health care services
19 with costs that you and other individuals ultimately pay for either directly or indirectly. Of these four, which is the most important and which is
the least important for you and your family as you spend your health care dollars.

20. For the top five „access‟ services, only emergency care services did not differ significantly
between the chronically ill and non-sufferers. Interestingly, non-sufferers value medical
research significantly more than do the chronically ill.
Sufferers Non-Sufferers
Physician Services 91
94
Medical Services At A Hospital 89
90
Emergency Care Services 89 Q2
90
Prescription Drugs 79
87
79
Dentist Services 73 Q2
Outpatient Services 69
75 Q2
Diagnostic Laboratory Services 67
72 Q2
67
Surgical Services 71 Q2
Preventive Health Services 66 Q2
66 F
58 Q2
Over The Counter Drugs 56
60 Q2
Medical Research 57
Wellness Services 52
49
F
Health/personal Care Goods 57 Q1
50
M
0 20 40 F 60 80 100
Base = Total Respondents Q5. Recognizing that health care costs vary, depending on your level of insurance coverage and other health benefits that you either purchase
or receive through an employer or other source, and thinking about the actual dollars that are spent, listed below are four health care services
20 with costs that you and other individuals ultimately pay for either directly or indirectly. Of these four, which is the most important and which is
the least important for you and your family as you spend your health care dollars.

21. Non-sufferers value both individual social/health services and family social/health services
more than do persons with chronic illness. They also value health relief services more. The
chronically ill value Care for the Elderly much more than do person who do not suffer from a
chronic illness.
Sufferers Non-sufferers
Individual Social/health Services 53
50
Care For The Elderly 42
49
Pharmaceutical Research 44
43
Scientific Research 44
40
Family Social/health Services 50
46
39
Nursing Care Services 36
Home Health Services 33
32
Nutrition Services 32
27
Any ratings
Health Relief Services 32 lower than 50
29
21 mean those
Mental Health Services 23 features lost
Psychiatric Services 18 out to another
19 Q1 feature more
Vocational Rehabilitation 15 than half the
14
time
Mental Retardation Services 8
8
Substance Abuse Services 89
0 20 40 60
Base = Total Respondents Q5. Recognizing that health care costs vary, depending on your level of insurance coverage and other health benefits that you either purchase
or receive through an employer or other source, and thinking about the actual dollars that are spent, listed below are four health care services
21 with costs that you and other individuals ultimately pay for either directly or indirectly. Of these four, which is the most important and which is
the least important for you and your family as you spend your health care dollars.

22. Thank You.
• To view our complete information on the Spectrum Health
Value Study, including methodology and additional findings
go to: www.healthvaluestudy.com
• We are continuing quarterly data collection, with the next collection in
July 2009 and the next release of data and reports in August.
• For more information contact Audrey Spolarich at 202-587-2532 or
aspolarich@spectrumscience.com
22