Healthcare And Brand Perceptions: Millenials

Part
01
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Part
01

Telehealth Perceptions: Millenials

Millennials have been found to be more technology-driven, health-conscious, convenient, and socially accountable than older generations. These principles hold true in the world of telehealth as well according to reputable research, market, and health sources. In 2020, 74% of millennials stated that they prefer telehealth to a primary care provider due to the convenience of technology and personalized, real-time communication, streamlined treatment, and social and corporate responsibility. Details of our findings have been provided below.

Key Perceptions And Attitudes (Summary)

Driving Growth

  • The most prominent opinion that millennials have for telehealth services in the United States is not only support for the service, but demand for it. According to research conducted by WELL Data Analytics Team and Amwell's Telehealth Index, millennials have been showing interest in telehealth services for several years prior to the COVID-19 pandemic.
  • Immediately following the onset of the pandemic, around 80% of all appointments were canceled. At the time, individuals under the age of 40 had the highest adoption rate of telehealth services. In addition, throughout the pandemic, millennials scheduled an average of 20% of all appointments through telehealth services which was almost double any other age group.
  • One of the features that millennials looked for in telehealth services in 2020 was "real-time, personalized and two-way communication."
  • A study conducted by the University of Central Florida analyzed 72 articles published by health and science experts relating to millennials and telehealth. The study found that millennials are the most likely age group to fully adopt telehealth medicine for use of mild to moderate symptomatic conditions. The main drivers of these findings are that millennials are more knowledgeable about technology use, appreciate the "convenience and timeliness of care, as well as trust in the provider established through web-based reviews and ratings offered by other telehealth users."
  • Millennials were also exposed to direct-to-consumer advertising for pharmaceutical products at a younger age than other age groups. This means that they were encouraged to play an active and influential role in modern medicine. This can be seen in behavioral changes following the AIDS outbreak and the opioid crisis with the demand for more information and accurate care in the health field.
  • Millennials are more likely to trust telehealth services than Gen X or Baby Boomers due to their trust in technology as well as their knowledge of how to troubleshoot, problem-solve, collaborate, and integrate technology.
  • In a survey of millennials and Gen X, it was found that millennials' views on the perceived usefulness, customer experience, and usage frequency were exponentially higher than Gen Z showing 0.901:0.048, 0.83:0.049, and 4.248:0.243, respectively. The study states that the most likely reason for this difference is that millennials do not relate the usefulness of technology or ease of use to the value or experience of the product, in this case, telehealth.
  • While support for telehealth is strong among millennials, they are still concerned about what it means in a digital age. According to research published by Business Wire, 40% of millennials are concerned about data security and privacy in telehealth.

Health-Focused

  • Technology is only part of what drives millennials to seek telehealth options. Millennials view the benefits of telehealth as necessary due to being focused on getting the specialized care that they need as fast as possible. According to a study from 2017, 40% of millennials supported the use of telehealth compared to 74% in 2020 that stated that telehealth is the preferred method of initial doctor visits.
  • According to a study conducted by Harvard, millennials view a primary care provider as an unnecessary stepping stone on the way to getting the care that they need. Instead, they would prefer to cut out the middle man and start their care with the specialists that can treat them. This means using telehealth in the place of their primary care provider.
  • NCBI published a study in 2020 about patient relationships with technology i.e. telehealth. In the study, it is mentioned that millennials have been labeled as the "most health-conscious generation." The publications states that ignoring the generational differences in the telehealth market would be a "serious oversight."
  • In addition, the study stated that millennials have influence over the health decisions of other generations including their children and parents ranging from Gen Z to Baby Boomers.
  • It also states that changes such as telehealth are necessary due to the generational differences in experience and necessity. This includes generations growing up with working parents or single parents and having no stability in the job market, retirement, and societal changes as opposed to their non-technological counterparts (baby boomers) that were not in need of convenience in healthcare.
  • Research on millennials' use of telehealth has also shown that because they are so health-focused they rely heavily on the customization options in telehealth, particularly, communication channels due to the wide variety of available technology when it comes to communication, personal need, and preference.
  • In addition, the freedom to choose what healthcare they are receiving may impact millennials' support for telehealth with 60% stating that proximity to a healthcare provider greatly influences their decision when choosing a provider which contradicts their otherwise health-conscious behavior.

Social Responsibility And Diversity.

  • According to research from Brookings Institution, millennials are considered "independent, entrepreneurial, economically optimistic, culturally skilled, globally oriented, demonstrating positive social habits, and valuing diversity."
  • It is a widely accepted fact from almost all academic, medical, and scientific sources that a key consideration for millennials when selecting any service, especially healthcare, is the company or brand's social and corporate responsibility and response to diversity. One of the key drivers of this issue is that millennials are the most diverse age group in America with 44% belonging to a minority or ethnic group.
  • Millennials have been found to "value community, technology, and prosperity." This means that not only do millennials put value on working with individuals that share their moral and ethical beliefs, but they also put value in choosing a healthcare provider, system, or brand that recognizes cultural and racial differences in terms of health conditions and treatment.
  • NCBI ranked social elements during the customer journey with healthcare providers as having the same importance to millennials as cognitive, physical, and mental elements.
  • Research shows that telehealth services support the desire for social responsibility and diversity by providing support for ethnic and cultural competency, cultural factors in virtual visits, language differences, social sensitivity and identity topics, and ADA considerations.
Part
02
of five
Part
02

Urgent Care Perceptions: Millennials

According to experts, millennials are more likely than any other generation to use urgent care services with more than 25% replacing their primary care provider completely with emergency or urgent care services. In addition, millennials put value on urgent care services being available through telehealth, especially post-pandemic with only 12% of people willing to get in-person urgent care in 2020. Details of our findings have been provided below.

Substituting A Primary Care Provider

  • Millennials have been proven to value immediate gratification more than other generations and it shows in their healthcare. In general, millennials rely on the "internet, employers, and urgent care centers" to manage their healthcare rather than having a regular primary care provider (PCP). Research shows that 50% of millennials do not visit a primary care provider regularly and women often substitute a regular OBGYN as a PCP after establishing a relationship.
  • The most prevalent reasons for this substitution are convenience and cost. Millennials can visit an urgent care center at any time including some nights and weekends. In addition, most coverage covers urgent care with an average out-of-pocket cost of $50.
  • In addition, the University of California, San Francisco found that millennials move more frequently than older generations with 50% of occupants living in their homes for less than two years in 2017 making it harder for millennials to build a relationship with a PCP.
  • According to Forbes, 66.5% of bankruptcies in America are because of medical debt and 41% of millennials ask about cost before deciding on treatment. In addition, almost half of millennials do not have a relationship with their PCP with 55% believing they can obtain the same information online.
  • In February 2020, 25% of millennials admitted to using emergency services as their primary care provider.

Convenience

  • According to research conducted in 2020, 65% of patients that went to the emergency room in 2020 would have chosen an alternative urgent care option if they had been educated on the availability of care.
  • Another driver for the adoption of urgent care among millennials is the growing "gig economy" including freelancers as well as remote workers that do not work on a normal 9-5 schedule and need the convenience of extended hours and short wait times.

Telehealth

  • According to a study conducted in 2020 post-pandemic, millennials are the most likely generation to use telehealth for urgent care appointments.
  • Covid-19 greatly impacted the view on telehealth services, especially in urgent care with only 12% of patients willing to go in to get urgent care treatment during the pandemic.

Research Strategy

In order to determine the sentiment of millennials towards urgent care, we began our search by scouring research publications, medical and scientific journals, market reports, and media publications. Through this search, we found data that supports millennials' interest in using urgent care services in the place of traditional care due to the convenience and cost benefits. Unfortunately, most data is centered around behavioral health treatment and telehealth data (noted in our other research), however, there was very little data supported by reputable research sources that provide comprehensive statistics surrounding urgent care specifically. All credible statistics found in the course of this research has been provided above.
Part
03
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Part
03

Behavioral Health Perceptions: Millennials

According to research from several reputable health companies, financial companies, and research companies, millennials are considered one of the most impacted generations in terms of mental health, however, they are vigilant in raising awareness and searching for solutions. Millennials view behavioral health as having a huge generational gap in prevalence and treatment options, advocate for changes to behavioral healthcare including treatment approach, attainable options, and cost. In addition, millennials have seen an increase in behavioral health issues due to Covid-19 and support telehealth advancements provided they address digital capabilities, privacy concerns, and remain attainable and convenient. Details of our findings have been provided below.

Generation Gap

  • Millennials have a strong focus on mental health and wellness due to the increase in behavioral health awareness of the generation. According to a research study published by Blue Cross Blue Shield, millennials have been labeled the "burnout generation" with women being 20% less healthy than men. This statistic is supported by increasing cases of depression brought on by chronic diseases like diabetes and endocrine conditions.
  • In a national survey, it was found that there is a 19% gap in perceived mental health between Gen X and Millennials; 68% and 49% respectively feel they are in good mental health.
  • Some factors found to impact millennials more than previous generations include "financial debt, consumption of social media, always-connected work environments or heavier workloads with fewer resources." In addition, Business Insider states that millennials are affected by "longer work hours and stagnant wages" and even list mental health as a reason to quit their jobs in about half of millennials compared to 10% of Baby Boomers.
  • In Iowa, an initiative is building to encourage millennial employees to avoid burn out. Participating employers spend time and money to encourage employees to use their vacation days and even block them from logging into work during vacation time.
  • According to government research that documents mortality rates related to behavioral health, millennials face the same mortality risks in 2020 as the Silent Generation during the Vietnam War and recreational drug and Baby Boomers during the AIDS outbreak. The mortality rate has been calculated at 40% higher due to behavioral health than Gen X.
  • According to Forbes, millennials face a 33% increase in the cost of healthcare compared to baby boomers with a $4,500 decrease in income due to "health-related hour cuts."
  • 37% of millennials do not have a primary care provider covered through insurance compared to 9% of both Gen X and Baby Boomers.

Changes To Behavioral Healthcare

  • According to a study done by Blue Cross Blue Shield, 73% of millennials feel that healthcare needs to change in the following ways:
    • Removing the stigma around behavioral health: According to research, millennials struggle with seeking care for behavioral health issues including refusing to take time off work to seek care due to perceived employer or social stigmas.
    • Treatment should be targeted as "whole person" care: Millennials have shown a demand for expanded behavioral health access as well as doctors that provide "whole person" care from mental to physical conditions as well as making mental health screening standard as part of preventative care. ;
    • Holistic Approach: Research shows that millennials are concerned about more than just the care receive but also how they receive it. They want data to be shared more appropriately and interoperability.
    • Cost and access: Millennials have stated that some of the biggest barriers to receiving behavioral healthcare have been time and cost. Behavioral health can result in ongoing treatment with weekly copays and prescription payments and lack of doctors in rural areas which deters millennials from seeking treatment.
    • Establishing relationships and trust: Millennials operate on trust, especially with their own health. It is common for millennials to feel like doctors will not understand them or will ignore them. According to Blue Cross Blue Shield, trust needs to be built through all reaches of care including payer-provider solutions and follow-up engagement.
  • In a study conducted on mental health and the workplace, 56% of millennials stated that they believe their workplace lacks adequate mental health benefits and 45% of supervisors reported not knowing how to handle behavioral health issues in the workplace. However, the study also stated that millennials are moving to destigmatize therapy and view it as a form of self-improvement.

COVID-19

  • While the concern for millennials' mental health was apparent prior to COVID-19, research shows a sharp increase in behavioral health concerns in millennials in 2020. Prior to the pandemic, millennial behavioral health was already in decline with a "12% increase in major depression, 7% increase in alcohol use disorder and a 5% increase in tobacco use disorder and substance use disorder."
  • Pre-COVID-19 research:

  • Since COVID-19, behavioral health conditions have become exponentially more prevalent:

Telehealth

  • Research conducted by Blue Cross Blue Shield showed that most millennials were aware of telehealth prior to the pandemic and 80% of respondents were open to trying telehealth service or undecided. After the COVID-19 pandemic hit, millennials increased interest in telehealth for behavioral health to 96% by October 2020.
  • According to Forbes, millennials want the most from their technology, personalized care, and affordable treatment. Studies show that millennials are more likely to seek treatment of chronic and behavioral health conditions through a digital platform than other generations.
  • Millennials still have concerns with telehealth with 50% stating that they are concerned about data breaches and want more security in the telehealth space before committing to telehealth treatment and 40% being concerned about the privacy of their sexual health.
  • After an extensive study was conducted in 2020, it was found that millennials are looking for the following features in digital healthcare services:
Part
04
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Part
04

Telehealth Use: TX, IL, NC

In 2020, 74% of Texan physicians joined teleservices, telehealth adoption increased by 47% in Illinois, and 9 of 11 state health systems offered telehealth services in North Carolina. Details of our findings have been provided below.

Texas

Health Systems Expanding Telehealth

  • According to a survey from the Texas Medical Association, 74% of Texan physicians joined teleservices in 2020.
  • In 2020, Reliq Health Technologies Inc. signed 8 new contracts in the state of Texas to improve telehealth services by expanding their proprietary iUGO Care Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Principal Care Management (PCM), and Telemedicine platform.
  • Austin-based telemedicine company Medici stood at the forefront of telemedicine innovation in 2020 with a growth of 1000% in two weeks according to the CEO. The company has several technologies rolling out including messaging in 25 different languages, new partnerships with reputable health organizations, and attaining industry-leading accreditation and recognition which have legitimized telemedicine.
  • Other Texas telehealth companies that contributed to telemedicine expansion in 2020 are as follows:
    • Iris Telehealth: Mental health and video conferencing software.
    • MAP Health Management: Behavioral health and substance use outcome tracking software and technology support.
    • Medsolis: Holistic and personalized behavioral health technology.
    • MobilDrTech: Integrates cloud-based, HIPAA-compliant video conference platforms with telemedicine equipment.
    • MyTelemedicine: API integration and language options.
    • Remedy: Telehealth discounts.
    • Sensogram Technologies: Remote vital signs monitoring using biosensor technology.
    • Therapractic Management Systems: HIPPA-based training systems.
    • Vivify Health: Personalized care plans, biometric data monitoring, and patient education.
    • Vyopta: Video and voice collaboration through monitoring.
  • In addition to adaptations and expansions by health systems, Texas saw a lot of support for telemedicine in 2020 from government agencies including the following:
    • Texas Department of Insurance (TDI): Passed legislation requiring insurance providers to cover telemedicine by the same amount as physical visits.
    • Governor Greg Abbott: Suspended limiting insurance laws relating to medical care provided over the phone; Approved Texas Medical Board's (TMB) request to allow virtual visits for new patients which were previously blocked.

Health Systems Telehealth Forecast Post-Pandemic

  • Experts say that the legislative and medical advancements in Texas due to the emergence of telehealth service among the COVID-19 pandemic may improve healthcare post-pandemic including permanent insurance regulations on telemedicine and removing barriers to receiving medical care.
  • In addition, experts have stated that telemedicine could open the door for unified healthcare systems without limitations of geological location.
  • The Chief Digital Officer for the Texas Hospital Association (THA) stated, "As the pandemic continues, more aggregated data will be made available, allowing artificial intelligence algorithms and predictive analytic engines to analyze massive data collections, identify health trends, and infer actions to be taken... Whether it's health solutions for an urban setting or a rural geographically dispersed situation, you're going to see the adoption of technology far greater and much faster as a result of that need"

Consumers Response

  • Interest in telemedicine in Texas increased drastically in 2020 with 15% more occupants stating that they trust telemedicine more than in-person visits than in 2019 up to 45%.
  • In a study conducted in Texas with 1000 participants, 75% stated that they have been in some way satisfied with telemedicine during the COVID-19 pandemic.
  • Experts stated that consumer groups are likely to have an impact on future legislation for telemedicine post-pandemic through demand for service.

Illinois

Health Systems Expanding Telehealth

  • Telemedicine adoption increased from 0% in February 2020 to 47% in April 2020 in Illinois. Due to the massive undertaking, there is little data regarding what health systems did in 2020 regarding telemedicine since the focus was mostly on integrating technology not innovating. There has been no data published regarding the number of health systems that adopted telehealth or what they did to expand it.
  • In addition to adaptations and expansions by health systems, Illinois saw a lot of support for telemedicine in 2020 from government agencies including the following:
    • Governor Pritzker: Implemented legislation regarding insurance reimbursement for telehealth services.

Health Systems Telehealth Forecast Post-Pandemic

  • Experts expect telehealth use to increase post-pandemic based on current adoption rates and positive patient response. The Illinois Hospital Association released a presentation detailing the benefit of telemedicine and the association's plan to take the new developments long term.
  • In Illinois, telehealth use increased by 32% in 2020 and they expect it will plateau at a rate of 6% post-pandemic.
  • Experts believe that telemedicine will have the greatest impact on large practices with an increase of 9% telemedicine visits, while small practices will only see a 4% increase in telemedicine visits post-pandemic.

Consumers Response

  • In a study conducted in Illinois, consumers were found to view telehealth visits as more convenient, however, the concern is apparent regarding privacy.
  • Consumers noted that the convenience of telemedicine can help them focus on their health without the concerns of exposure, child care, or taking time off work.
  • It has also been noted that consumers are very concerned about the privacy of their information in terms of storage of information shared, technology breaches, and virtual platforms used during visits and data collection.

North Carolina

Health Systems Expanding Telehealth

Health Systems Telehealth Forecast Post-Pandemic

  • Experts agree that rapid technological rollouts of telemedicine and telehealth services are expected to maintain traction even after regulations are lifted, however, they believe that progress will be hindered by several barriers.
  • Concern about privacy, technology regulations, payment processing and coverage, and business deals bring experts to say that the future of telehealth in North Carolina is "hazy."
  • In 2020, funding for digital health rose to $9.4 billion USD, however, experts say that it failed to deliver on its potential, stating that the space is in need of smart business deals to regulate privacy policies and data protection for telehealth.

Consumers Response

  • After scouring academic research reports, medical and science journals, research databases and institutions, and media publications, we were unable to find any credible data published regarding consumer response to telehealth offerings in the last 24 months in North Carolina. All research found focused on physician's adoption rate and institutions' transitions to telehealth.

Research Strategy

In order to determine what health systems in Texas, Illinois, and North Carolina did in 2020 to expand telehealth services, we began research by scouring several reputable sources including academic research, medical journals, scientific publications, tech publications, business databases, and media reports. Through this search, we were able to find mostly what each state implemented through legislature. We were able to find some companies that innovated telehealth offerings in 2020 to connect health systems to attainable technology. In addition, we were able to find statistics regarding the adoption rates of telehealth for health systems in some states. Unfortunately, because each state was at a different point in telehealth adoption, they do not all have data published that accurately provides details of efforts specifically from health systems in the last 24 months due to shifted focus on viability and usability. According to our research, we believe that more findings regarding the innovations made in the space, adoption rates, and success metrics from telehealth transitions in 2020 will emerge after restrictions are lifted in all states.
Part
05
of five
Part
05

Telehealth Use: FL AND TN

In 2020, the adoption rate of telehealth services by physicians increased by 21%, and Tennessee companies WellCare and Centene launched financial and technological initiatives to increase access to telehealth services. Details of our findings have been provided below.

Florida

Health Systems Expanding Telehealth

  • In 2020, Florida saw an increase in the adoption of telehealth services by physicians by 21% in the first 6 months.
  • The Florida Atlantic University began offering a telehealth certification program that requires 20 credit hours.
  • MDLive expanded its telehealth platform to become accessible to more healthcare providers in Florida as well as expanded hours and services to
  • In addition to health systems efforts in telehealth, government entities that implemented expansions in telehealth in 2020 include the following:
    • State Government: Permitted telehealth service both in and out-of-state for temporary treatment not exceeding 30 days and providing insurance reimbursement legislature.

Health Systems Telehealth Forecast Post-Pandemic

  • Telehealth will most likely maintain popularity among physicians in Florida post-pandemic with 94% of physicians stating they will likely use telemedicine for prescription referrals post-pandemic and 93% stating they will use it for chronic care treatment.
  • While most physicians plan to continue using telehealth services, they also state that they expect to see barriers in the following areas:
    • Technology challenges: 72%
    • Uncertainty about reimbursement: 64%
    • Questions about clinical appropriateness: 58%

Consumers Response

  • In 2020, consumer adoption of telehealth services increased by 59% with 91% of those consumers stating they were in some way satisfied with the care they received.
  • There are no additional publications, reports, or statistics publicly available regarding the consumer response to telehealth services in Florida from the last 24 months.

Tennessee

Health Systems Expanding Telehealth

  • Tennessee companies WellCare and Centene were rated among the top institutions in the United States in their response to the COVID-19 outbreak and were at the forefront of telemedicine advancement in 2020 through new initiatives and enhanced existing programs and partnerships in the telehealth space.
  • WellCare implemented a provider support program that gave their in-network providers access to benefits made available through the CARES Act which assisted in transitioning some services to telehealth.
  • Centene invested $18 million in grants to rural providers to provide affordable technology. In addition, the company created several partnerships in the telehealth space including the following:
    • Medicaid Telehealth Partnership: The National Association of Community Health Centers partnered with Centene to connect federally recognized providers to telehealth services.
    • Samsung: Distributed 13,000 smartphones with plans to 175 health care providers to give to patients who don't have access to telehealth services.
  • Additional institutions providing expansion of telehealth services through innovations in the past 24 months include the following:
    • Stroke Link Health: Care management and telehealth model that provides end-to-end care for an entire year.
    • Thinklabs: Integrates mobile health platforms with technology to record and share sound.
    • WeCounsel: HIPAA-compliant video sessions and instant chats.
  • In addition to health systems efforts in telehealth, government entities that implemented expansions in telehealth in 2020 include the following:
    • State Government: Established telehealth reimbursement parity and removed geographic restrictions on originating sites.

Health Systems Telehealth Forecast Post-Pandemic

  • Tennessee telehealth experts expect to see the growth in telehealth interest continue at the same levels post-pandemic. This could be attributed to the fact that Tennessee has one of the most complete insurance parities compared to other states with coverage and payment streamlined for all telehealth services.
  • This optimism is supported by the Centers for Medicare and Medicaid Services (CMS) efforts to implement new regulations for digital care and telehealth.
  • In addition, Tennessee companies are seeing a decrease in hospital readmissions, improving clinical outcomes, and enhancing care including treating healthcare like a life-long process.
  • According to experts, the pandemic has rapidly tested many of the challenges to implementing telehealth. Some of these challenges included proper insurance procedures and privacy laws. Sources say that as long as the United States continues on a long-term regulatory path, telehealth will continue to provide wide-spread healthcare for residents.

Consumers Response

  • The overall healthcare of patients has increased over the past year in Tennessee as a result of telehealth including a 70% increase in patients taking medications on time, 35% improvement of diet and nutrition, and a 60% decrease in patients at risk for anxiety.
  • There are no additional publications, reports, or statistics publicly available regarding the consumer response to telehealth services in Tennessee from the last 24 months.

Future United States Telehealth Forecast Post-Pandemic

  • The United States telehealth market is expected to increase with a CAGR of 29% between 2020-2025 according to post-pandemic reports.
  • A main driver of growth is expected to be the convenience and personal care benefits for patients with chronic disease.

Research Strategy

In order to determine what health systems in Florida and Tennessee did in 2020 to expand telehealth services, we began research by scouring several reputable sources including academic research, medical journals, scientific publications, tech publications, business databases, and media reports. Through this search, we were able to find mostly what each state implemented through legislature. We were able to find some companies that innovated telehealth offerings in 2020 to connect health systems to attainable technology. In addition, we were able to find statistics regarding the adoption rates of telehealth for health systems in some states. Unfortunately, there was very little data published regarding the response consumers have had to telehealth advancements in the past 24 months. The available data that was compiled has been provided above.
Sources
Sources

From Part 04