2009 Survey of Health Care Consumers:

Key Findings, Strategic Implications

Produced by the Deloitte Center or Health Solutions

2009 Survey of Health Care Consumers

Key Findings, Strategic Implications 3

Foreword

On March 5, 2009, the White House hosted a Health Summit to ocially launch a bi-partisan eort to rein in health carecosts while expanding access to health insurance or the 46 million Americans who are currently uninsured.Anticipating the importance o health care reorm to economic recovery, the Obama team in December 2008 conducted3,276 community discussions about health reorm involving 30,608 consumers. The ndings, although not surprising,underscored the public’s discontent with the status quo and desire or needed reorm. Poor service, high costs and rustra-tion in navigating the complexities o insurance topped the list o concerns.The transormation o the U.S. health care system requires a deep understanding o the role that consumers play – howthey think and behave relative to the liestyles they choose, the purchases they make and the assumptions they ollow inpreparing or uture health problems and possible costs.Consumerism in health care is to some an ill-conceived notion: The idea that individuals have the ability to make inormeddecisions about diagnoses, therapeutics, healthiness, insurance and over-the-counter products and services is thoughtrisky since these matters are complex. Others believe that engaging consumers is key to correcting faws in the system.This group reasons that the disconnect between the goods and services consumers use and the costs associated withconsumption contributes to avoidable costs and suboptimal care.The

2009 Survey of Health Care Consumers

, conducted by the Deloitte Center or Health Solutions, is Deloitte’s second-annual study o health care consumers’ attitudes, behaviors and unmet needs. It oers health care industry leaders andpolicymakers a timely look at how health care consumerism is evolving and a comprehensive perspective about howAmericans approach their health, health care and health insurance.The study’s ramework refects a broad-based view o consumerism in six zones: (1) wellness and healthy living, includingsel-care and health management; (2) inormation sources helpul in consumer decision making; (3) traditional healthservices provided by medical proessionals, hospitals, and retail clinics, as well as prescription medications and medicaldevices; (4) alternative health services sometimes described as complementary medicine; (5) insurance coverage and othernancial considerations; and (6) opinions about health care reorm.The results o this study are conclusive: Consumers want better perormance rom their health care system. They think it iswasteul, inecient, complex and expensive. They are rustrated that the tools useul to them in making decisions abouttheir health are not readily available. They like innovations that result in lower costs and more convenience. They wantbetter value or the dollars they spend and believe undamental changes are necessary to achieve these goals.Although the health care consumer market is complex, it is imperative that providers, payors, policymakers, device, phar-maceutical, technology and biotech organizations understand and respond to consumers’ expressed concerns, interestsand needs. Engaging consumers appropriately is undamental to health care reorm. Consumerism in health care is atrend, not a ad.Paul H. Keckley, Ph.D.Executive DirectorDeloitte Center or Health SolutionsWashington, D.C.

Conceptual Framework

Initiated in 2008, Deloitte’s longitudinal study o healthcare consumers is designed to provide a comprehensiveview o health care consumerism in the United States, aview that goes beyond the conventional boundaries owhat health and health care are commonly thought toencompass. In addition to the traditional services thatdoctors and hospitals provide, the study’s ramework takesinto account the expanding spectrum o treatment alterna-tives, delivery settings, inormation sources and programsthat are coming into existence to promote wellness andsel-care, address health needs and nance health care.The 2009 survey builds on Deloitte's 2008 survey byexploring consumers’ behaviors, attitudes and unmetneeds in six areas (Figure 1):Wellness and healthy living

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Traditional health services

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Alternative health services

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Inormation resources

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Health insurance

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Health policy

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Highlights o the results are included in this summary.Additional and more detailed ndings are reported inaccompanying charts.

Methodology

A nationally representative sample o 4,001 Americanadults, ages 18 and older, was surveyed between October2 and 10, 2008, using a web-based questionnaire. Theresults were weighted to assure proper proportionalrepresentation to the nation’s population, as refected inthe U.S. Census, with respect to age, gender, income, race/ ethnicity and geography. The margin o error around theU.S. point estimates is +/- 1.6% at the .95 condence level.The survey consisted o 95 questions, with 42 potentialollow-up questions. English and Spanish versions wereavailable. Participants were asked about behaviors beoreattitudes within each topic area to reduce response bias.Comparisons are made to Deloitte’s

2008 Survey of Health Care Consumers

wherever possible, but dier-ences in question wording and response scales – pursuedin an eort to improve the survey instrument – precludedirect comparison in some cases until those questions arerepeated in uture surveys. Questions rom the 2008 and2009 surveys will be repeated periodically in uture surveysto assess how health care consumerism is evolving in theUnited States.

Figure 1: Zones o Health Care Consumer Activity