The Kitchen Sink: What consumers think about a variety of healthcare topics

1. The Kitchen Sink: What consumers think about a variety of healthcare topics Prepared for: Executive Healthcare Forum Prepared by: Klein & Partners, Inc. November 10, 2008

2. Introduction Background and Purpose • The purpose of this quantitative survey was to understand consumers’ current thinking on a wide range of healthcare-related topics. These topics were recommended by EHF members. • Topics included: • Concerns with the healthcare system • Information seeking behavior • Transparency/Price shopping behavior • Retail medicine/New methods of delivery of care • Medical tourism • Health and health behaviors Methodology • A national online survey was conducted among 401 heads of household, 21 or older who are involved in the healthcare decisions for the household. The interviewing was conducted from October 14-16, 2008 by our research partner The Dieringer Research Group (DRG) in Milwaukee. The sample frame used was e-rewards’ online consumer panel. The final data were weighted by age, education, and ethnicity. • The total sample size of 401 yields a sample error of +/-4% at the 90% Confidence Level (CL). For example, if this study were repeated 100 times, in 90 times out of that 100 (i.e., 90% confidence level) we would find a total sample statistic of 50% to fall within 46% and 54%. • In the charts, letters (e.g., A, B, C) and arrows indicate a statistically significant difference at the 90% Confidence Level. Colors and bolding are used to indicate interesting patterns and/or findings.

3. Demographic profile

4. Quiz • Over time, about 25% of the population has felt the government should step in and fix the healthcare system – this statistic has been consistent for years. What do you think it is today? Choices: A 25% B 29% C 34% D 40% ? The answer is… 40%

5. Is our system broken? In a national poll conducted over the past several years, desire to have the government step in and fix the system has steadily increased: 26% in 2005 32% in 2006 39% in 2007 40% in 2008 Our healthcare system is so broken the government needs to step in Our healthcare system needs corrections and improvements but system can correct itself Desire to have the government step in is more prevalent among men (49%), Gen X’ers (49%), and among those who find it harder and harder to see their doctor or don’t think people should be held financially responsible for their health behaviors. Not sure Our healthcare system is functioning just fine the way it is Q1: Which of the following statements best reflects how you feel about our entire healthcare system?

6. Health behaviors accountability Men (72%), Gen Y’ers (70%), college educated (67%), and non-parents (64%) are significantly more likely to agree with this statement about accountability. Q2a: “People who choose to make poor health choices should pay more for health insurance coverage.” (Agree/Disagree)

7. Access to doctor Everyone but seniors really agrees with this statement; as do those with lower socio-economic status... And, three-quarters of those without health insurance find it harder and harder to get in to see their doctor. Q2b: “It’s getting harder and harder to get in and see my physician in a timely manner.” (Agree/Disagree) Q3: In the past couple of years, have you or has a member of your immediate household used a walk-in clinic or emergency room because you/they couldn’t get in to see your/their regular doctor in a timely manner?

8. Quiz • What is a PWP? ? The answer is… Patients with Printouts

9. Health-related information sources Gen Y’ers are most likely to go online (they love Google) and/or talk with friends and family for health information. The more affluent and educated are more likely to talk with their physician and/or specialist. Parents visit WebMD to a greater extent as does everyone but veterans (but veterans Google!). Q4: Which of the following sources of health-related information have you ever gone to?

10. Information researched on the Internet College Gen Y and college Gen X and Baby Boomers Baby Boomers Baby Boomers and College Gen X and parents Gen Y Gen Y and Gen X and parents Q5: Which of the following, if any, have you researched on the Internet?

11. Quality awards looked into Not Gen Y Not Veterans $50k+ and college There is very little demographic variation mostly because few folks have checked out any quality awards sources. Quality awards and rankings remain a very limited source of information and have little to no impact on hospital choice. Q6: Which, if any, of the following hospital quality awards have you ever checked out?

12. Willingness to pay more for quality award Definitely would pay more out-of-pocket for recognized highest quality hospital Not sure Quality rating/award would not get me to pay more for any hospital Men, Gen X’ers, and non-parents are significantly more likely to pay more for a recognized quality ranking. Maybe but other factors would also be important to look at Q7: Would you pay more to go to a hospital that scored the highest in quality from one of these independent quality sources?

13. Online activities participated in recently Baby Boomers Gen Y College Gen Y, college, no kids Veterans Q8: Which of the following online activities have you participated in over the past year?

14. Transparency/Price shopping 33% have called for pricing 36% who called for pricing actually went with the lowest priced provider = 12% total! Q9: Within the past year, did you or did a member of your immediate household contact any healthcare organization, hospitals, or physician offices to ask about the price for a specific visit, test, treatment, or surgery? IF YES IN Q9  Q10: What type of health service did you ask about pricing for? IF YES IN Q9  Q11: Did you end up choosing the least expensive provider?

15. New methods of care delivery Gen Y and Gen X and Baby Boomers, and parents Gen X and < college Gen Y Baby Boomers and Veterans, no kids Q12: Which of the following medical services/facilities have you used in the past year? IF USED RETAIL HEALTH CLINIC IN Q12  Q13: Would you go to a retail health clinic again for care?

16. Medical tourism Yes, I have or a member of my immediate household has (mostly Gen X’ers) No I haven’t and don’t know anyone who has I know someone who has More appealing to men and not veterans Q14: Have you ever or do you know anyone who has received elective medical care internationally? Q15: If you needed hip or knee replacement and your employer offered to pay for the entire trip including all medical expenses and travel expenses for you and your family to go to Singapore or India, for example, how likely would you be to take them up on this offer?

17. Personal health situation Most of these medical conditions/situations are age specific (i.e., more prevalent among older folks), but a few do afflict non-seniors more – I don’t have enough time for myself, low energy, and migraines. Women also tend to suffer more from not enough time for themselves and migraines. In fact, Baby Boomers seem to be the least healthy. Q16: Please check any of the following medical or health situations that relate to you personally.

18. Health behaviors Activities to reduce stress are most popular among Gen Y’ers. Veterans are most likely to pray and/or attend religious services, as are women. Working out at a gym is most popular at both ends of the age spectrum – Gen Y’ers and Veterans. Q17: Which of the following do you go to or use on a regular basis?

19. Medical utilization Most of the “exams” are correlated with age. Q18: Which of the following have you had done in the past year by a medical professional?

20. Where do we go from here? • Assign “topic” chapters to teams of EHF members to write-up a reaction paper (e.g., how findings are pertinent to our world and what hospitals are doing/not doing in response). • This “collective” response could be published in any number of publications (e.g., MHS, Spectrum, H&HN, etc.) as a think piece from leaders in healthcare. • What do you think?