Another Kitchen Sink Survey: What consumers think about a plethora of healthcare topics…

1. Another Kitchen Sink Survey:What consumers think about a plethora of healthcare topics… Presented by: Rob Klein, President Klein & Partners, Inc. 4th Quarter, 2012 Disclaimer: Please feel free to use these charts in any of your presentations; just cite Klein & Partners as the source of the information.

2. Introduction

3. Introduction Background • The purpose of this nationwide quantitative survey was to understand consumers’ current thinking on a wide range of healthcare-related topics, including: Methodology • A national online survey was conducted among 404 heads of household, 21 or older who are most responsible for healthcare decisions for the household. The interviewing was conducted from September 25-October 5, 2012. The sample frame used was Research Now’s online consumer panel. The final data set was weighted by age, education, income, and ethnicity. • The total sample size of 404 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 highlight interesting patterns and/or findings.

4. ...and now the rest of the story

5. Top concerns

6. Significantly higher among African Americans and non-seniors Significantly higher among women, seniors, and <college degree Q1: Which of the following issues is MOST important to you?

7. Reactions to health reform

8. Q2: If you currently have health insurance, do you think there will or will not be a specific benefit to you with this new healthcare reform?

9. Q3: Do you expect to see lower healthcare costs for you if health reform passes in Washington?/… now that health reform has passed?

10. Q4: If you had a choice to buy health insurance through you employer, individually, or through an exchange, which do you think you would prefer?

11. (18% in 2010) (17% in 2010) (14% in 2010) (11% in 2010) Q5: What do you think will get better or worse for you personally under healthcare reform?

12. 2010 41% 24% 18% 21% 15% 13% 10% 11% 6% 6% 9% 4% 19% 8% ACOs??? Q6: Who do you really trust to help you figure out and navigate the new healthcare system that will emerge through healthcare reform in the coming years?

13. Especially African Americans and Hispanics. Sometimes we just need the right carrot! Q7: If you were offered a financial incentive to change a certain aspect of your lifestyle (e.g., stop smoking, lose weight, exercise, etc.), how likely would you be to change that behavior or lifestyle?

14. Significantly higher among African Americans, seniors, and men Q8: Based on this basic description of health care under reform, how comfortable are you in having this ACO manage all aspects of your health and wellness?

15. Hospital safety

16. In late 2009, 16% of people said they had experienced a serious quality issue or medical error at a hospital in the past 3 years. In 2011, that number was 12%. Now, in 2012, the number is 18% (mostly non-seniors). Seven in ten (71% vs. 75% in 2011) folks across the country say it would be important to them to receive a copy of the hospital’s patient safety guidelines before going to the hospital (38% very important + 34% somewhat important). Q9: Do you perceive there to be a problem at hospitals today regarding patient safety in terms of preventable medical errors? Q10: In the past 3 years, have you personally or someone in your immediate household experienced any serious quality issues or medical errors while being treated at a hospital? Q11: If you were going to be hospitalized for care, how important to you would it be to receive a copy of the hospital’s patient safety practice guidelines before you go to the hospital?

17. Primary care physician

18. Nearly unchanged from past waves, more than eight in ten folks have a primary care physician (83%). But only 68% among those under 45. Going online to rate a doctor or hospital has more than doubled in the past few years: 6% in 2009 9% in 2011 14% in 2012 (especially women, younger, <$45k income) ZAGAT Primary Care Doctor Q12: Do you have a primary care or personal physician? Q17: Have you ever gone online to a social networking site and shared your experiences about a doctor or a hospital you recently visited?

19. Plan B Especially those 21-44 (45%) Q13: In the past 12 months or so if you have needed to see your primary care physician, was there ever a time when you had problems access your physician? If so, what was the issue that made it difficult to access or kept you from accessing your physician? Q14: Think back to times when you were sick and your doctor’s office either was closed or you called during office hours and couldn’t get a timely appointment. What did you do for medical care?

20. Word-of-mouth! Significantly higher among African Americans and Hispanics (23% vs. 3% Caucasians) Q15: When you were first looking for a new primary care physician, where did you look or who did you talk to about finding a new doctor?

21. Increases with age Increases with age Increases with age Increases with age More impto women These are game changers! Q16: Now, when you chose your current primary care doctor which of the following factors had the biggest influence on which doctor you chose?

22. Medical home awareness and perceptions

23. 3%believe they are part of a Medical Home with their physician which equals 1% of the adult population. And consistent with other Klein & Partners research, half (53%) learned about a ‘Medical Home’ after they chose that physician. Q18: Prior to this survey, were you familiar with the term ‘Medical Home’ or what also is called a ‘patient-centered medical home’ which is a team-based healthcare delivery model led by the physician? Q19: Are you part of a Medical Home through your primary care doctor? Q20: Did you choose your doctor because he/she was part of a Medical Home or did you learn about that after you choose your doctor?

24. Other Klein & Partners research indicates a growing comfort with mid-levels as long as the physician has introduced the mid-level as a key care team member and defined their role properly for the patient. Q22: How comfortable are you or would you be in being seen by one of the mid-level care givers instead of your primary care physician? Q23: Given this explanation of a Medical Home, would you switch primary care physicians to receive care like this? Would you…?

25. Mobile messaging

26. Interest is significantly higher among women and those 21-44. Source: Fast Company March 2012. Q24: How interested would you be in receiving MOBILE MESSAGING from these caregivers about your own health?

27. Klein & Partners hears this a lot in focus groups also. Q25: What type of health-related information would you most like to receive via mobile messaging from a caregiver?

28. ‘Can you hear me now?’ Smart phones

29.  Significantly higher among women Not too surprisingly, use of a smart phone declines significantly with age across all of these health-related uses. Q26: Have you used a smart phone or any phone that can access the internet to go online and do any of the following…?

30. From a market segmentation standpoint, potential use for most of these Apps is higher among women, those 21-44, and those with lower incomes. Q27: If a hospital you used offered a mobile application for your smart phone, which of the following features would you MOST LIKELY USE?

31. Electronic medical records

32. Increases with age Especially 21-44 Women Seniors Women and 45-64 Seniors South and West, 21-44, <$45k Q28: How interested would you be in having online access to your own personal health record called an Electronic Medical Record to track your own health through a secure website that only you and your doctor and hospital can access? Q29: Which of the following features, if any, would you definitely be very interested in accessing through your electronic medical record? Q30: If your current primary care physician could not provide you with access to your Electronic Medical Records how likely would you be to switch to a new primary care doctor that could provide you access to your Electronic Medical Records?

33. Communicaton methods

34. Look at what is popping up this year! Other Klein & Partners brand research is indicating that EMR is a key component of being a successful ‘system’ in the future… patients really get the value-add it provides in their care: 1) better access to their health and caregivers; and 2) better coordinated care for them across caregivers and care settings. Q31a: Which of the following communication methods have you used to communicate with your primary care physician?

35. Q31b: Which of the following communication methods have you used to communicate with your hospital?

36. Q31c: Which of the following communication methods have you used to communicate with your health insurance company?

37. Websites visited

38. Women and younger visit hospital websites while non gender differences for health plan websites just age (45-64 higher) and income (>$45k higher). Q32/33: Have you been to a hospital/health plan website in the past year? Q32a/33a: What got you to go to that hospital’s/health plan’s website?

39. Interest in new information sources

40. 2011 58% 48% 31% 23% 19% 14% 11% 8% 8% 8% 7% 7% 6% 5% 5% 3% 2% 2% 3% 1% 1% Green = old school Blue = new school Q34: Besides your physician, which of the following have you sought health-related information from in the past year?

41. Increases with age Increases with income Seniors Q35: Which of the following information, if any, have you sought on the Internet?

42. 45-64, college, higher income Higher income Men, Seniors Q36: Next, which of the following online health-related activities have you participated in over the past few years?

43. Down with age Up with age Q37: If you could receive a general health and wellness newsletter from your hospital, health plan, or employer in any of the following formats, which one format would be your most preferred way to receive this newsletter? Q38: Now, if you had a specific medical condition that you were being treated for and could receive patient education (i.e., information related to your diagnosis, treatment, or procedure) from your hospital, health plan, or employer in any of the following formats, which one format would be your most preferred way to receive this newsletter?

44. Q39: Which of the following healthcare topics have you recently read something about?

45. Interest in price shopping? Transparency Price shopping

46. Price check in aisle five! West 2010 & 2011 Called = 71% Q42: 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… Q43: How did you check on pricing? Q44: What type of health service did you ask about pricing for? Q45: Did you end up choosing the least expensive provider?

47. Quality perceptions

48. 2011 31% 31% 29% 28% 24% 23% 22% 19% 15% 14% 14% 13% 13% 13% 13% 12% 11% 11% 11% 10% 10% 10% 9% 8% 6% 6% 6% 5% 5% 4% 4% 4% 3% 3% 3% 3% 3% 2% 2% 1% MRSA is the poster child for poor quality in hospitals. Patient in a recent focus group: ‘MRSA is an infection the hospital gives you.’ Cleanliness is no longer a given. Quality has as much to do with the ‘experience’ as it does clinical quality and safety. Red= Patient safety Purple=Quality (clinical) Green=The experience Q46: As you think of hospital quality and how you define it, which of the following would you include in your definition of hospital quality? While any and all of these things could be important, which ones truly define quality to you?

49. Yet few find these sources credible and even fewer have ever used them to choose a hospital. Q47: If you wanted to learn more about a hospital’s quality, which one of the following methods would you most prefer to receive quality information from?

50. Choosing a hospital