The Impending Consumerization of Healthcare

Consumerism in the healthcare industry is an inevitable growing trend. Consumers desire to control their healthcare decisions and therefore are increasingly taking an active role within this realm.

by Rita Ferrari, Senior Marketing Manager, Zelis Healthcare

Buying behaviors in healthcare will change in the future as a result of trends shifting from group to individual preferences. Large groups are shifting coverage decisions and management to their members, thus a new surge of individual insurance buyers will entice payers to develop new business models which are focused on consumer choices. Consumers are taking a more active role in planning for their healthcare needs by taking the management of healthcare into their own hands and making decisions based on personal choices. This shift is a direct consequence of an unsatisfactory healthcare system which is characterized by high costs, lack of access, and unsatisfying patient experiences. Medical insurers, hospitals, and providers are trying to answer the demands of consumers who want more timely care, greater education about treatment options, and lower costs by consumerizing healthcare.

What exactly is the consumerization of healthcare? The word consumerization is used to describe the transformation of an industry from a primarily business-to-business (B2B) enterprise to one that focuses on business-to-consumer (B2C) activities. In today’s B2B healthcare marketplace, business is transacted among large employers, payers, providers, and pharmaceutical companies. The people being insured and treated have little involvement in or responsibility for their own care and cost choices. In the years ahead, healthcare will evolve into a B2C industry, in which consumers will take a much more active role in their healthcare decisions and expenditures. And, as a result, every healthcare company and organization will need to become more consumer-centric. The deck is being reshuffled, and there will be new winners and new losers, depending on how companies play their hand.1

In order to adapt to a future consumer-driven healthcare system, healthcare organizations will need to adapt in three main areas:

  1. Offer products and service portfolios based on consumer insights and personalize according to preferences, health status, care utilization patterns and likelihood to purchase. Healthcare organizations will need to research and segment consumers by performing complex compilations of consumer data and integrating with demographic and behavioral information to create customized offerings.
  2. Engage consumers in the care delivery process with tools and programs that give them incentives to practice healthy behaviors and participate dynamically in their treatments. For example, employers can provide healthy incentive programs which encourage employees to become healthier based on pre-established criteria and thus receive discounts or bonuses based on levels. This not only reduces healthcare for employers, but also incites consumer engagement in healthcare decisions.
  3. Provide compelling end-to-end consumer experiences that increase satisfaction, trust, and brand loyalty. Currently, consumer involvement in healthcare decisions tend to be passive and disintegrated since there is little coordination among touch points and consumers are passed from one area to another. Establishing robust consumer experiences will require accessible and logical plan options with straightforward enrollment processes, simplified claims processes and uncomplicated billing methods. However, before the consumer experience can be modified and improved, it first needs to be understood through consumer research, interviews, and site visits performed by healthcare organizations.

Consumerism in the healthcare industry is an inevitable growing trend. Consumers desire to control their healthcare decisions and therefore are increasingly taking an active role within this realm. In order to successfully convert from B2B to B2C, payers will need to use business intelligence tools and advanced analytics to derive patterns and consumer trends which will provide personalized care and drive loyalty. Factors such as cost of care and quality and ease of service are crucial factors in determining how well consumerism of healthcare will be accepted as the new normal. Moreover, integration of mobile technology and social media will be essential for today’s modern healthcare provider seeking to initiate change in an ever evolving industry.


1Gil Irwin, Jack Topdjian, and Ashish Kaura, “Putting the I in Healthcare”, Strategy+Business –booz&co.