Rebecca Madsen, Chief Consumer Officer for UnitedHealthcare, breaks down the 2021 Consumer Health Care Engagement Trends survey.
COVID-19 has had an outsized influence on the health plan Americans intend to select during open enrollment, according to the new UHC Consumer Sentiment Survey. Meanwhile, the majority of Americans surveyed say they are interested in using a smartphone or laptop to access medical services.
The fifth-annual UnitedHealthcare Consumer Sentiment Survey examines Americans’ attitudes and opinions about multiple areas of health care, including open enrollment preparedness, technology trends and health plan preferences.
By the numbers:
Consumer Engagement Trends
Evan Sweeney 00:00
Hello, and welcome to UnitedHealth Group's Weekly Dose Podcast, where we’ll get you up to speed on the latest trends shaping the future of healthcare. I’m your host, Evan Sweeney. This week we’re taking a closer look at how consumers engage with the healthcare system, including how that changed in 2020. And how that could shape those interactions in 2021. Recent surveys offer a window into how the COVID-19 pandemic has prompted that recalibration. 44% of Americans say COVID-19 has influenced their preferred health plan choice, including 68% of Gen Z respondents according to UnitedHealthcare’s annual survey, Americans are seeking plans with lower out of pocket costs and more comprehensive benefits. Many Americans are also looking for ways to interact with the health system virtually either through digital pharmacy solutions, telehealth, or mobile apps. The pandemic is also directing more focus on wellness. Half of respondents surveyed over the summer say they have been more motivated to pay attention to their health, and many have made health related New Year’s resolutions. Joining us to talk about these ongoing shifts and how they could influence healthcare in 2021 is UnitedHealthcare Chief Consumer Officer Rebecca Madsen. Rebecca, welcome to the podcast.
Rebecca Madsen 01:11
Thanks so much for having me here.
Evan Sweeney 01:13
Absolutely. Well, excited to talk to you. To start, can you just give us a brief synopsis of your role as Chief, Chief consumer officer?
Rebecca Madsen 01:23
Sure, I’d be happy to. I’ve been at UnitedHealthcare for almost 24 years, all in consumer capacity, primarily. And my role is the simplest way I can explain it is my role is to understand consumers, to advocate for them, and to really champion their experiences as they go through the healthcare system. And as we interact with them. So, I always say it’s the voice in the conscience of the consumer, but also making sure we use things such as data and analytics to understand the consumer experience, identify gaps and figure out how to fill those gaps.
Evan Sweeney 02:02
And I mean, I think people get a sort of general sense of what you know, consumerism is when they think about like retail or, you know, buying a TV or something like that, but what is healthcare consumerism?
Rebecca Madsen 02:13
Well, healthcare consumerism is if you think of the journey people take in their health care experiences. In the commercial population, for example, we have about 70% of people that we call kind of cough, cold, flu type people, they go to the doctor and frequently when they’re sick, for their annual physical, but otherwise, we don’t interact with them as much historically. So, consumerism to them is, how do I get what I need? When I want it? How do I see the claim that I just had easily How do I interact with you 24, seven, digitally, then you have the percent of the population that has acute or chronic illnesses, and all the way up to the top one to 2% of the population. And interaction with them is very different. It means help me with my care, helped me manage my medications, helped me Look at my experience and make it seamless, because I’ve so many different touch points, both with you, and with my providers. So, consumerism, if you think about it broadly, is really about how people engage with the healthcare system. And our role in that is really to advocate for them and to help them and to make sure they make smart choices and maintain their health and wellness.
Evan Sweeney 03:27
Mm hmm. So, 2020, obviously a very dynamic year, to say the least. But what changes have you seen in the last year just in terms of what consumers are prioritizing how their behaviors are changing, both around, you know, care coverage and sort of the needs they’re looking for?
Rebecca Madsen 03:45
Well, you mentioned one of the things obviously, this has been the year of COVID-19, and the pandemic. And that’s really, I think, changed a lot of the ways that people look at their health, their engagement with the health care system, you mentioned that almost half of people said COVID-19 influenced the health plan that they chose, but 35% of their spent more time researching health plan options. This is an area where we’d seen kind of very minimal engagement historically, people are now paying attention. We also saw things such as telehealth 91% of people said them now interested in it compared to 39% last year, and 47% or almost half of people said that they would use telehealth for their behavioral health needs. And what we’ve seen, obviously during the pandemic is it’s not only about people’s health, but there’s a huge rise in behavioral health needs people’s anxiety, people’s fear people losing their jobs and what that means for themselves and their family and their mental health. So we’ve seen that people are more open to engaging and using different types of technologies to make sure that they have access, even if they can get to a provider’s office or if they Don’t want to get to a provider’s office due to health concerns.
Evan Sweeney 05:03
Mm hmm. Well, that brings me to my next question, which is, you know, how do you think some of these shifts will carry over into 2021? What changes are here to stay? I mean, you mentioned telehealth, and a lot of people have brought that up is, you know, something that seems like it could actually stick this time after many years of trying, but what do you think will sort of, you know, carry over long term?
Rebecca Madsen 05:27
I think what you said is exactly correct, which is, I think the way people access their care, through technology through digital health, I think that’s something that people saw the convenience, the access, frankly, the lower costs, and as a way to connect with their provider, and I expect that that will continue and accelerate 2021 and beyond even once we hopefully get move beyond the pandemic, I also think the social determinants of health will be an important thing that people are focused on that 90% of your health is determined and based on the actions you take outside of the doctor’s office, and people really focusing on their health more broadly, walking, exercising, getting their flu vaccine, getting a physical, and people with chronic and acute illness, their desire for connectivity. So connecting with their provider, you know, not just virtual visits, but also remote medical monitoring things such as I char, I see those really accelerating going forward, because of people’s desire to have that connection that maybe they weren’t as focused on before.
Evan Sweeney 06:40
And what’s I guess the overall impact on the patient or the consumer that is interacting with that system? I mean, you know, how does that trickle down? When we think about sort of improving the health system or lowering costs or improving outcomes? How do these sorts of tools, or that engagement actually do that?
Rebecca Madsen 07:01
Well, what’s important is not, I think, historically, if we look at health care, a lot of the onus was on the individual to engage with us. Now we have a responsibility. And we have the data, we have the analytics, we have all these different tools, such as artificial intelligence, to understand that individual. So, if I think of our role as UnitedHealthcare, it’s not only tell people what to do, and tell them when they’ve made a bad decision, but help back that up in the process, and know them. So we know when they’re about to make a sub optimal decision, you know, directing them to the right side of care, helping them not go out of network, giving them information they need to manage their health, how they want to consume, it is incredibly exciting. And I think a real transformation in healthcare, as we look forward is that consumerism is not just about what the individual does, but how we as a, you know, provider community, and we as an insurance community, how we really help that individual smarter choices leads to better outcomes, better health and lower cost.
Evan Sweeney 08:12
So, it sounds like, you know, 2020 has sort of set this foundation or increased engagement among consumers. But what are some of the biggest challenges in terms of, you know, sustaining that engagement, making those things stick?
Rebecca Madsen 08:29
So, one thing is health literacy. And we still see that there’s a huge gap in people’s understanding of basic health care terminology, of how their benefits work, of decisions they have to make. And so really continuing to understand that just because there’s been a pandemic and people are paying attention doesn’t mean that they’re more informed. And how do we really make sure that we’re communicating with them in ways that they can understand? I think another challenge is just really sustaining that engagement in terms of not only the knowledge and accessing care but changing behaviors. We know, you know, third of the country is overweight, another third is obese, how people change their diet, how they exercise, how they get proactive care if they have things such as diabetes, or heart disease, or any type of illness, and how they’re compliant with their medications. You know, often people sort of go in and they don’t feel well, they take their medications or they’re have a chronic illness, and how we sustain that engagement, I think is going to be one of the biggest challenges we’ve had historically. And we’ll continue to have,
Evan Sweeney 09:38
we’ve talked a little bit about kind of your thoughts on 2021 some of the long-term trends that you see, but what are your predictions for consumer expectations in the coming year? Where do you see some of those shifts either intensifying or fading away?
Rebecca Madsen 09:55
So, I think what people expect is they expect to be Connected when they want to be connected. And there’s lots of different ways of having connectivity, there’s the digital conductivity, where people want to access the information they want 24 seven, and have it be personalized and relevant to them. I think also the connection between the consumer and their provider, and how, you know, our role in facilitating that. But people want access, they don’t want to have to wait. You know, I live in Manhattan, and I’ve seen it, some of the urgent care centers, for example, people are waiting for three hours to get a COVID test. People want access, and they want access quickly. You know, we’ve also seen, you know, some of the increase of things such as urgent care, and people really using that as a as a new opportunity to engage in addition to virtual care, and what kind of care they can get when they want and, and how they want it. And then lastly, we can’t underestimate the importance of cost and coverage 60% of people’s experience is driven by cost and coverage, they expect to get the best care at the lowest price and not have any surprises. But I call kind of the gotchas that we’re telling them, they don’t want to get caught in a gotcha. They want us to do what they think our role is, which is prevent them from making decisions that are going to lead to higher out of pocket costs.
Evan Sweeney 11:20
Mm hmm. And it seems like there’s very little room for error there, right? I mean, you wait three hours in line for a COVID test, and you walk away and say, Boy, this, you know, this is, you know, totally is a terrible experience, or, you know, you get a surprise bill, and you go on, you know, unbelievable, this is, this is a bad experience again. So, it does seem like there’s just the margin for error is very small there,
Rebecca Madsen 11:42
in the expectations are high. If you think of everything else has you started at the, you know, kind of beginning around consumerism, if you think of people’s expectation, you know, they buy something on Amazon, they get an email instantly, it shows up at their door, the next day, if not, the next hour, they get constant tracking and updates. And people have become accustomed to sort of the now, economy, I want what I want, I want it now I want you to deliver to me, it must be perfect. And if it’s not perfect, I’m going to tell you. So, the burden of responsibility on us is to really understand not only what their expectations are, but our role in that. And to really think about how we pivot to being sort of an end to end consumer company, you know, outside of the fact of being just an insurance company, how do we really pivot to look at the entire journey that somebody has, and you said, low margin for error. It’s very true. You know, even if we say, okay, we educated you on something, and somebody makes it a mistake. What we’ve seen in our real time data and our verbatims, is, they think that’s our responsibility. So, we have to embrace that, and figure out how we bring all the power of everything we have to bear at UnitedHealthcare to meet those expectations and avoid and any problems for the consumer or getting them caught in any unexpected situations.
Evan Sweeney 13:07
And to your point, consumers don’t differentiate, you know, their experience on Amazon with their experience interacting with the healthcare system, right, those expectations that they’ve come, you know, to see, when they’re, you know, buying something online is the same trickles over into healthcare is what you’re saying?
Rebecca Madsen 13:26
Yeah, but the burden of responsibility on us is so much greater, you know, if you don’t get your package, and you don’t get your new pair of shoes, okay? If you don’t get the health, health care you need when you have cancer, if you feel you can’t see your doctor, if you don’t understand how your bill was processed and paid. Health care is stressful. And when people are in stressful situations, their patients lowers and their expectations rise. And for us, we are in an incredibly pivotal and important role to be able to help them and so it’s not only the consumerism you mentioned, but it’s that times 1000 because it’s something that really matters, which is their health. And our responsibility in that process is to try and take away all that stress and make it as easy for them as possible.
Evan Sweeney 14:19
Right. Great point. Rebecca, thank you so much for joining us. This has been a great conversation.
Rebecca Madsen 14:24
Yeah, I really appreciate it. And thank you for having me and allowing me to talk about consumerism. Absolutely.
Evan Sweeney 14:31
That’s it for this episode. Thanks for listening to UnitedHealth group’s weekly dose podcast. Have a great rest of your week.