Danny Fell, senior strategist at Optum, is here to share volumes of research hot off the (virtual) press about consumer sentiment toward seeking medical treatment, and how it has changed over the course of the pandemic. Danny examines the challenges that happen when we assume all consumers are feeling and acting the same way about their healthcare. In this episode, you’ll learn how providers can use this information when planning patient outreach, the importance of basing it on data, and the likelihood that consumers will still choose to put off emergency care.
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Full Transcript
Announcer: It’s time to think differently about health care, but how do we keep up? The days of yesterday’s medicine are long gone, and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans. And many of those humans have unbelievable stories to tell.
Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together. And here are some amazing stories along the way. Ready for a breath of fresh air? It’s time for your “Paradigm Shift.”
Michael: Welcome to the “Paradigm Shift” of healthcare. And thank you for listening. I’m Michael Roberts here today with my co-hosts Scott Zeitzer and Jared Johnson. On today’s episode, we’re speaking with Danny Fell. He’s a senior strategist at Optum. Danny, thank you so much for making time to come on the show today.
Danny: Hey, thank you, guys. I’m looking forward to the conversation.
Michael: We are too. So let’s dive right in. Optum, they recently completed a summary of several waves of research about consumer sentiment toward seeking medical treatment through all of this, and how that sentiment has changed over the course of the pandemic. So I had the chance to read it before our show, it’s definitely one of the most in depth and updated reports that I’ve seen kind of through all of this. So, let’s just start at the beginning, you know, what do you think are some of the most important findings out of this research?
Danny: First of all, I think the timing was a big factor in this. We started the survey the 1st of May, and the idea was to set up a tracking survey, something that would be in the field pretty frequently. There’s a lot of great research being done other consulting firms, market research companies, big firms like Gallup, but we wanted to do something that, A, was a little more in the moment and, two, was…B, whatever, was a little more specific to actual healthcare utilization by consumers, you know, where they’re holding off on going in for health care services. So I think that was part of it.
And as that developed, as you probably saw from the research, we actually were able to track sort of in real time what was happening as the virus was moving from predominantly the Northeast down to other areas of the country. So I think that was one was sort of the timing, the framing of it. We’re stepping back now and we’re gonna come back in the market with another version of it. But understanding those regional differences in particular, in the last few weeks that we did the serving, I think was a big takeaway.
The other was that the high percentage of consumers overall that still were telling us they were hesitant or likely to postpone care, they were hesitant to go back, they’re likely to postpone care. And even in some certain areas, like, all throughout the research, about one out of five, about 20%, said they wouldn’t go to the ER even if they were having life-threatening symptoms of a heart attack or something. So, I think those were some of the top-line takeaways that were big for me.
Michael: It’s pretty amazing, you know, I remember having some conversations with folks like right as all the pandemic stuff was getting started, and everybody was just kind of scared to go to the hospital. But to still see that high a number of people saying like in a legitimate pure emergency situation, you’re still not thinking about going into hospitals like, oh, my goodness, that’s huge. That really does kind of lead into, like, you know, these results are changing pretty substantially over time. How is it that, like… You know, we end up doing a lot of work with medical practices specifically. So how can medical practices really keep their ear to how these sentiments are changing? How can they keep up with all of that?
Danny: Yeah, so a couple of thoughts on that. One is our survey was national, right? We were surveying about 700 consumers nationwide, pretty reflective of the demographics of the country, and we could drill down regionally, and we could drill down a little bit into some demographic groups. But one of the things that we’ve been careful to say is, look, you should be doing similar research in your local market if you can. You know, if you can afford to do it formally and hire a research company, that’s ideal. If you can’t, you can be doing it informally. If you’re a smaller healthcare organization or a physician practice, you can be doing sort of ask the man on the street or ask patients coming in the door kind of thing, but have some kind of local sense of how it’s impacting you. So that’s one.
I think the other is, one of the positives that came out of the research was if you put every type of healthcare location or provider on a spectrum, the good news is consumers were most positive, most comfortable going to a physician’s office. Now, a lot of them told us that they still wanted to do that via telehealth or virtually, but that was at one end of the spectrum. The other end of the spectrum was in the hospital or in the emergency room, that’s where you saw the biggest number of consumers who said they just had second thoughts or might reschedule.
So that’s the good news if you’re talking about smaller providers or physician practices, it’s probably a little easier. And I think the other thing we’ve learned both from our research but also, we also did some other qualitative research along with this, one of the things we learned is that word of mouth is still very powerful in health care. So consumers hear from other neighbors, patients, friends, you know, “Hey, I went to the doctor’s office and this was the procedure they followed, you know, I sat in the car, they walked me in, I had a bass,” when they hear that then I think it alleviates a lot of concerns. And so I think that’s a really positive too. And so getting that message out, relying on, you know, communicating that and getting patients to share that with other patients or other people in the community I think is really important.
Scott: Yeah, you know, Danny, it’s interesting you bring that up. I talk to a lot of practices on a regular basis and I literally beg them like, please, put very detailed information on what you’re doing regarding COVID on your website. Have a separate page for that. Google seems to be linking to that. The patients are nervous about it, they want to go. And I know that all of them are talking about telehealth like, “We’re gonna go do more telehealth.” Are you seeing that they’re embracing that fairly well, the option of telehealth now that it seems that it’s getting reimbursed correctly?
Danny: Yes. So when you say “they” are you referring to the providers or the patients?
Scott: Let’s go with both, let’s start with the providers first. Like, are the providers, now that they seem to be getting paid appropriately for telehealth, do they seem to be embracing it more, the providers?
Danny: I think so, at least at the hospital level that the systems that we work with seem to have jumped in pretty hot and heavy, you know, almost became a little bit of a badge of honor. You know, the COVID, the run-up to what’s been going on in the last few months, you know, sort of health systems touting we did, you know, 50 before COVID, and now we’re doing 5000. So, I think there was both a practical, “Yeah, we’re doing this, we’re flipping the switch.” And I think there were people who were also sort of using it as, you know, “Look what we’re doing,” you know, celebrate kind of thing. And there’s nothing wrong with that, I think it is the right thing to do.
And then you had some folks that were way on the really cool end of the spectrum. So if you’ve looked at some of the stuff that people like Atrium Health in Charlotte, you know, with an actual virtual hospital that they leaned up with two virtual floors to treat COVID patients, and now they’re talking about, you know, beyond COVID, actually keeping that virtual hospital in play. Those were some really cool things. At the smaller provider level, I think it’s been tougher, right, you know, to find the right solution to lean that up from a scheduling standpoint. I’m sure with smaller physician groups, offices, that might be logistically a little harder to do.
Scott: Yeah, it’s interesting that you say that, it’s like habit, you know, the power of habit can be positive and negative. When I talk to some providers, some good friends of mine, I personally have found that the smaller groups and they just get together, you know, three, four guys are like, “This is what we’re gonna do, this is how we’re gonna do it,” and they’re better, you know, at moving forward.
It’s the ones that are like 12 in a group where they…you couldn’t get them to agree on, you know, what soda they have in the refrigerator before COVID, getting them to agree on what telehealth option and how to employ it? I can only imagine. I think that’s been an interesting conversation regarding telehealth. How have you seen the patients? Do they seem to be embracing telehealth? Do they want it?
Danny: Yeah, so our data suggests that there’s some interesting takeaways from it, from a telehealth standpoint. So if you look at it from a high level, high number of consumers like 60%, 65%, tell us, “I would go to my physician office today, and, you know, if the option were available, I would do telehealth.” And we even see that number with some of the older demographics as well. So even among those who are 65 or older who you would think would be maybe less inclined or a little more reserved, we see pretty high numbers saying that they would consider telehealth or telemedicine. Now, obviously, I think that trails off when you get into some of the, you know, 70, 80-year-old age range.
And then we saw that pretty strong in the middle age range, and I suspect…but it falls off a little bit in some of the younger groups. And I suspect that might be partly not that the younger groups are opposed to it, they’re just not really oriented to healthcare. And by younger groups, I’m saying like 18 to 25 or something. It’s just they don’t really think about healthcare in general, and so they don’t really spend a lot of time worrying about it. Whereas somebody in our age group with kids, right, they are and they’re very predisposed to it. So that was where we saw…you almost see kind of a bell curve, if you will, but not trailing off on the older side of it, if that makes sense.
Scott: No, it makes a lot of sense. You know, I was thinking about consumers in emergency care, I recently actually had a biking accident, fractured my wrist and needed surgery. I’m bleeding, standing and all I’m thinking about isn’t that I’m bleeding or that I think my wrist is fractured is that “Oh, no, I need to go to an ER and how do I avoid that?” Right? It’s insane, but that’s what I’m thinking about.
And I actually ended up going to an urgent care rather than an emergency room because I thought, “Hey, man, I might have a better shot of avoiding COVID.” And then when I picked my particular orthopedic surgeon, one of my first questions was, ” Do you have an ambulatory surgical center where you’re gonna do the surgery?” Are you seeing those kind of very specific questions about how they’re managing COVID? Like, you know, I see use for COVID only, or hospitals like where they have multiple hospital locations where they’re trying to say, “Don’t worry, we’re doing a lot of testing, no COVID patient is allowed to be here,” you know, that kind of thing?
Danny: A couple of thoughts. I should have elaborated a little bit when I was talking about the physician versus hospital it is that continuum, right? So people seem to be most comfortable, confident in my physician practice, followed by a freestanding surgical center, or an outpatient center, or an urgent care, and then inpatient and big hospital is kind of what they want to avoid. Obviously, a lot of this is the dynamics of how it’s unfolded, right? So in the Northeast, we saw really high concern, you know, versus places like where I am in the South initially, and then that curve kind of reversed as we get later in the summer and the virus picked up across the South and in the West.
So what was happening regionally was one impact what people were hearing and reading in the media about their local hospital and how many cases. And I think hospitals had to pivot a little bit too, right? So there was the initial “We’re shut down, we’re not actually seeing any patient,” so they were more or less saying, “Hey, the whole hospital’s open for COVID.” And then as they reopen, what they had to do was re-message to say, “Okay, we’ve got a dedicated area for COVID,” or “we’ve got a wing that’s focused on COVID but you’re not gonna be near that,” right?
So I think the takeaway for me wasn’t so much the logistics, it was throughout this whole pandemic, we have really sent consumers a lot of mixed messages. You know, in the beginning, it was don’t wear a mask because we need masks, and we’re running out, then it was wear a mask, but some people don’t want to wear a mask. And then it was, you know, you’re not coming into the hospital because we’re treating COVID but now we want you back.
So I’m not saying anybody was at fault, but I think when you sit back and you think from a public health and from a marketing communications, which all of us are marketers, we really did a disservice to consumers. We sent a lot of mixed messages, we still are to a certain degree. And I predict there’s gonna be another “wave” when we get into an actual vaccine of mixed messages. So I think it’s been hard on consumers and I think that’s why we see confusion and overly concerned maybe where they don’t need to be, and frankly, just confusion, like what is open? What door do I go to?
Scott: Right. What’s safe? What’s not? If you were running a specialty practice, like, how would you be engaging with patients right now?
Danny: Yeah, so I should give a shout out to our sister company organization, the Advisory Board Research took some of the work that we’re doing from this tracking survey and they started going deeper into what kind of messages do consumers want to hear? What will make them feel comfortable, safe, and returning? And to your point earlier, it is. There’s a certain percentage of the population that wants very detailed information.
And I should caveat this by saying one of the things that our team developed, we work a lot in predictive modeling for consumers, and one of the models we developed was called the COVID…or is called the COVID concern index. So what we were essentially trying to do was segment consumers in a market based on how likely they are to be fearful or hesitant to return. So I want to be careful to say all consumers aren’t the same, right? We’re marketers, we know the segment. There are a couple of groups of consumers we call the fearless first, they’re less concerned, they don’t want to be bombarded with kind of safety messaging.
The other end of the spectrum, the what we call laggards going last and the hesitant to return, those consumers want a lot of detailed information. They want you to reach out to them about the procedure. They want to be contacted the day of they’re coming in, they want somebody to walk them through, they want to see a video, you know, that shows them what you’re doing differently. They want to know that you’re doing something differently than you normally would do in a practice, right? Because they assume practices practice good, you know, hygiene, but you’re going above and beyond now, what’s different?
That group I think emails been pretty common if you have a patient database with email, some phone calls, I actually saw some research from Klyne [SP] group, Rob Klyne’s team that I think it was 60% or 70% of consumers said when it comes to COVID information, they wanted to talk to somebody on the phone. So a pretty high percentage of consumers would prefer to actually have a phone call versus just get an email or go to a website. So I think that’s important, too, to the extent you can do that as a small practice or a care provider, if you can do that personal outreach, I think that’s important.
Scott: Yeah, that’s actually a very good takeaway, you know, for the smaller practices where they perhaps could be a little bit more nimble, and essentially, just reach out to those specific patients, especially you think about like an endocrinologist, say, that sees a lot of diabetic patients and they’re afraid to come back in and they know, you know, the provider knows you’ve got to come back in there. I mean, this is not a disease that takes a break because of COVID.
Danny: Yeah, so I’ll tell you a funny anecdotal story. So pretty early on, my dentist started reaching out to me. The first thing I got was like a link to a survey and the survey was “How likely would you be to come back if we did these things?” I thought, “That’s pretty innovative.” And then I got some phone calls about, you know, you’re due for your cleaning, you’re due for your whatever, then I started getting text messages.
And the ironic thing was, I was not going because of COVID, the fact is they had switched insurance and they didn’t take my insurance anymore, and I just hadn’t come up with a better plan. So at the end of the day, there are still some things that kind of drive people’s, you know, where they go for health care and we can’t, like, overlook that, but I do give them credit. I thought as a small dentist’s office, they did a really pretty good job of reaching out personally and I think that goes a long way for consumers.
Jared: That’s interesting. You mentioned that you are not the first actually for me to hear recently of an example like that from somebody outside maybe a hospital or larger group setting, like larger practice setting. And maybe it is because they are able to focus if it’s somebody with just one specialty going on, or if it’s just somebody who’s already got that set up in the background.
I think even when you were talking about, yeah, the necessity of just having the email database, of having a simple way to engage patients, whether it is email, or texting, or phone call, or whatever, if you didn’t have that in place already, then you’re gonna have to go back and you’re experiencing this growing pain right now of having to put the system in place, the technology in place, some kind of platform to be able to do that basic engagement.
And you might see how important it had been already to have that connected with the patient’s personalized health information, wherever it came from, there’s so many different ways to configure that. And there’s a lot of time that it takes to set it up. And so, I do see that those things are related, they’re connected. The ability for some of those who already had a system in place to be one of the first to reach out and do, like you said, send out that first piece from your dentist, you know, about, you know, what would it take to come back, that kind of thing.
So I think it’s just realizing, you know, partially that there is that spectrum and that the more things were in place before COVID, those were likely the ones who were easier to have the ability to go right back out and start engaging with patients digitally a little bit more in the first place. And so that kind of brings me to this other part of everything you’ve been sharing, the data itself, it feels pretty clear, you know, that the sense of being able to go back to the data itself, that the research this group has done, that you guys have been able to put together, that’s what’s driving so many different decisions.
And when everyone’s asking right now, how do we know? How do we know when to do that thing? How do we know how often to reach back out? When do we do this? What do we say? How do we show?
All the questions that I think the majority of providers have been asking for several months now, all those things can be answered in one way or another by some kind of data. So whether it is first-party data that a practice, or a provider, or a hospital is keeping already and they just they know how to find it, or they’ve got it but they don’t know where to find it, or they’ve got something like the research that your team has put together. I think it all just reiterates the fact of data being the linchpin to all of this. So my question would be, how does the data itself healthcare brands to understand how to engage consumers?
Danny: Yeah, I think the big takeaway, Jared, from that is organizations healthcare is maybe lagging a little bit as an industry need to be more data-driven in their decision making. And so, let me kind of put this in context. One of the things that a lot of hospitals are doing right now that I don’t think is necessarily working is they’re running these broad, we’re open, we’re safe, you can come back come kind of ads, there’s a nurse with a mask, and it’s a generic headline.
And to me, there’s nothing wrong with keeping your name out there. I’m a branding guy by training and career, I think brand is important. But running that kind of generic, we’re clean, we’re safe, you can come back in, I don’t think is the answer. I think there’s ways to use the data, to your point, to be a lot more precise, to be a lot more targeted. As I said earlier, you can’t, A, assume all consumers are fearful because they’re not, there are certain segments, demographically, psychographically that are more concerning than others.
There are high-risk groups, right? So whether it’s age or chronic illness, or I’ll give you one from our research, one of the really stunning numbers that jumps out of our research is about 9% of the survey respondents in our survey report is being unemployed, but seeking employment, right? So these aren’t stay at home parents or retirees, that’s a different category. These are people who are actively seeking work, but they’re currently unemployed. Fifty percent of those consumers said they wouldn’t go to the ER even if they were having life-threatening illnesses. A high percentage said they wouldn’t go to a physician’s office just because they’re not in a position to do it.
So there are segments of the population in the community or in a market that I think you can use the data to really go after, educate, address their concerns, whether it’s a psychographic segmentation issue, or it’s a high risk, you know, audience that you’re going after. Or conversely, if you’re truly trying to drive marketing volume and replace lost revenue, then go after the fearless first. Find the consumers who are ready to come back that aren’t fearful that you’re not going to spend a lot of time trying to convince, and get those people before your competitor does, right?
So I think to your point, there’s lots of ways to use data both kind of the anecdotal trending type research as well as actual data from your organization or your local market that can help you be much more precise. And the important thing for that is marketing is gonna be under more and more pressure to cut budgets. People aren’t gonna want to spend tons of money going forward on broad-based marketing, they’re gonna want to say, you know, “What’s the return on investment for this? What’s the real value for this?” And I think that’s where data can help answer that question or at least provide some meaningful, you know, justification for what you’re gonna do.
Jared: I really like that thought because it’s the precision involved, right? And it’s… I like how you keep coming back to the thought of segments, that not all consumers are thinking or feeling the same right now. And there are the regional differences, there are the psychographic differences. I almost said demographic differences, but I’m learning here too, you know, about how more important it is to zero in on the psychographics, how do you feel about things? How do you behave? Versus trying to lump everyone in a certain age group or region into the same types of behavior because that’s what we’re seeing with more data being presented as well is that’s very much not the case we’re generalizing a lot when we’re saying, “Hey, everyone in a certain region is gonna act the same.”
And so I think it’s great, this is the foundation, this is how a lot of decisions should be made. And if they’re not being made yet, then let’s take some strides, let’s make some first steps along this path and figure out how to start using data a little bit more and recognize that it is going to keep changing. I think you’re right in terms of we don’t know exactly what’s gonna be happening when the next wave comes. When a vaccine comes or even before then, things are gonna keep changing with consumer sentiment. And so, I appreciate bringing all these different pieces to the table because it’s helping us all to understand how better to engage with patients at the end of the day.
Danny: It extends to things like the vaccine, right? We don’t exactly know what…not even exactly, we don’t know what the timetable for it is, but there’s some consumer research out there that suggests only about 40% of people right now said they would definitely get it, 20% said they wouldn’t get it, and maybe another 30% are saying they’re not sure. So that could have, you know, profound impact on the timing of everything and getting to some type of, you know, herd immunity and what happens there?
I think a few months ago, the thinking was okay, we’ll just get through this really tough spring-summer, and then we’ll be figuring out how to get back to business as usual in the fall, the reality is we’re not back there and I doubt we’ll be back there before the end of the year. So now people are having to think in a much more extended, okay, what am I gonna do over the next six months? You know, okay, I’m at 90% capacity, but is that because I’m getting the people that were backlogged and all the sudden that’s going to fall off? I think that’s a very real question that people are asking.
And one of the ways to get at that is to understand, okay, of the patients coming in, what do we know about them? What can we learn about who’s coming in and who’s not coming in and how likely this volume will be to continue? Because you may be at 90% or 95% today at the beginning of September, but if you’re not there in December or January, that could have profound impact on your bottom line. So, you know, using that data to kind of understand where things gonna be a few months from now or next quarter, first quarter next year, I think could be really important.
Michael: Absolutely, absolutely. Danny, where can people keep up with this kind of information if they wanted to follow Optum’s research and where can they find that kind of information?
Danny: Thanks for asking. Optum has, like, a lot of companies, right on our homepage, you can get optum.com. Right on the homepage, there’s a link to a lot of the material that we have made available around COVID research. And we’re not the only group within our organization, we’re a very large healthcare organization. A lot of different groups like the Advisory Board and others are doing research, there are some really cool.
We have a partnership with an architecture group called Array, they were very early on putting out some tools, I want to call them calculators, that’s probably not the right term, but some planning tools to understand, you know, how many ICU beds do you need? So there’s a lot that our organization has made available and folks can tap into whether you’re an existing client, or a partner, or simply looking. We’ve been doing a lot of webinars, educational things, and you should be able to link to that material there as well. Or they can reach out to me personally if they just want a copy of the research or some help navigating, you know, different resources that we have, I’m happy to communicate with folks directly.
Michael: Awesome. Danny, I really appreciate it. I appreciate you coming on the show and sharing all this data with us. I think this is gonna make a huge difference in how practices, and hospitals, and different groups should be thinking about marketing going forward. So that’s very exciting. Guys, we’re gonna wrap today, but thanks so much, Danny. Guys, thank you for listening. Have a great week.
Announcer: Thanks again for tuning in to the “Paradigm Shift” of healthcare. This program is brought to you by P3 Inbound, marketing for ortho, spine, and neuro practices. Subscribe on iTunes, Google Play, or anywhere you listen to podcasts.
