It’s little secret that younger generations—millennials and Gen Z—aren’t seeking or receiving healthcare the same way as their predecessors.
First and foremost, the younger demographic is less likely to have a dedicated primary care physician than previous generations of patients—a trend that can at least be somewhat explained by broader supply and payment challenges.
“We’re probably about 50,000 primary care docs short today, but it’s also about cost with the advent of the high-deductible health plans—a phenomenon I don’t think works well by and large for the U.S. health system,” Patrick Carroll, M.D., chief medical officer at Hims & Hers and a former primary care practitioner, said this week at the HLTH 2021 conference while speaking on a panel about healthcare offerings for younger patients.
“We now have folks who are having difficulty getting access and difficulty paying for the care they are trying to receive,” he said.
But while supply may account for much of the generational shift, the next wave of healthcare consumers’ unique demands for convenient, accessible and transparent care services are also leading them away from “traditional” healthcare providers, Carroll and his fellow panelists said.
“They don’t want the paternalistic nature that’s long existed in healthcare, where the patient is subordinate to the doctor and the doctor has a white coat on and there are white walls and he has his white chart in front of him,” said Gina Bartasi, founder and CEO of women’s health and fertility startup Kindbody. “That entire experience has been disrupted and arguably needed to be disrupted.”
Bartasi went on to note that millennials and other younger consumers are generally more proactive than reactive, meaning that they’re more likely to seek out a specific service they want (often online) and then go with the provider that most quickly addresses that need.
That tendency is also starting to play out on the employer benefits side, which the panelists noted is the primary avenue to care for many younger adults. Bartasi said that this has led to fertility benefits services like Kindbody becoming “table stakes” demands for employees interviewing for new roles in certain sectors like tech.
“The desire … is coming from the population. It’s coming from the millennial up,” she said. “Instead of being reactive and waiting for the doctor to tell him or her what to do, they are well educated and taking initiative and telling employers what they want.”
Similarly, the movement away from traditional primary care providers doesn’t necessarily mean that millennials don’t want primary care, John Moore, M.D., medical director at Google's Fitbit Health Solutions said.
He pointed to so-called concierge primary care providers like One Medical and employer-offered onsite clinics, which he said are “incredibly convenient and have better outcomes” but still not widely available to much of the demographic.
As more young consumers vote with their feet, “a lot of the disruptive services will compel traditional care channels to advance and I think we’ll see equilibrium there,” he said. “But millennials, because on average they have fewer conditions, are more willing to take that risk of fragmentation in favor of innovation and convenience. So it’s more this temporary piece that’s more about their willingness to try something new than it is their true preference.”
There’s already some evidence that the traditional players are starting to adjust to the times, Bartasi said
“You are seeing them take note. You go into a local hospital and it is more aesthetically pleasing,” she said. “Now I’m generalizing—a lot of hospitals are still very dated and very archaic—but you will see them now think twice about making the waiting room more aesthetically pleasing about embracing digital solutions.”
Still, most hospitals, health systems and practices have far to go before they can rival these consumer-friendly startups on accessibility. To close the gap, the panelists offered a quick checklist of changes traditional players will need to embrace before winning over younger patients en masse.
Ditch the phone calls and fax machines for digital: “Not a single millennial I know likes the telephone,” Bartasi said. “They prefer to schedule their appointments digitally, they want to pay their copay digitally and, historically speaking, in some of the legacy places you do that via call center and you have this enormous telephone tag. So when you think about how you offer a more premium experience at a lower price tag, you replace all of those transactional things like scheduling and copay payments … instead of these legacy systems, call centers. That’s a lot of overhead, so you can create a strong value proposition and high ROI by utilizing technology to replace a lot of what was historically human.”
Address chronic conditions as needed, not in six-month intervals: “The thing that I’d love to see is getting rid of recurring visits for chronic disease that are just based on time,” Moore said. “It’s a broken model. You need to think about providing care as needed as opposed to on a schedule because a scheduled approach doesn’t work.”
Embrace asynchronous care: “Most of our visits at Hims and Hers are asynchronous, we don’t even look at someone on a video screen. Guess what—our customers love it, overwhelmingly,” Carroll said. “They like the anonymity, we know the quality is the same on synchronous versus asynchronous visits because we track that, it’s a lot more efficient because you can actually deliver more care to more patients in an asynchronous modality.”
Help consumers avoid the hardships of surprise billing: Traditional healthcare players should be “really interested in cost, price transparency and its relationship with billing,” Carrot Fertility CEO and co-founder Tammy Sun said. “For us, we have a Carrot card, it’s geofenced into the Carrot in-network location, it’s coded specifically with your employer’s plan design, it’s integrated into your deductible and you’ll never get a surprise medical bill. … Medical debt is the number one reason for bankruptcy, so really being thoughtful about how consumers are spending money and are exposed to cost risk is important.”
Encourage agency during the care journey: “It doesn’t have to be fun—it needs to be delightful, to take away pain points that people have struggled with for a long time,” Moore said. “It needs to make people feel—control isn’t the right word because some aspects of our health are not in our control, it’s our genetics, it’s our environment—but they need to feel agency, they need to feel like they have the ability to impact things. That brings real delight."