HealthChangers Podcast: How Millennials Are Changing the Health Care Industry

August 30, 2018

Millennials are the largest generation in the United States, and their influence continues to grow and be felt across industries.

Health care is no exception.

Traditional consumer health care experiences do not align with the mindsets, influences and habits of millennials —and health care brands must either adapt or be left behind.

In this episode, we meet with three millennials who are in different places in their professional lives, ranging from a college student, an intern and a young professional, Rachel Day who is the host for today’s show. They join Heather Burton, Director of Marketing for HealthSparq, who is working to empower people to make smarter health care choices based on their individual benefits.

They share their experience with health care and are representative of some of the most game-changing ways millennials want to interact with the health care system.

Welcome to the HealthChangers Podcast presented by Cambia Health Solutions, where we share real stories of health care transformation from those experiencing it and those helping to make health care more personalized. I’m your host Rachel Day.

On today’s episode, we’re taking a closer look at one segment of the health care population: millennials.

Many of them are new to managing their own care and insurance, and most have expectations about getting information digitally and more efficiently. Millennials pose a challenge to the old ways of doing things in health care, but they also provide an opportunity for the system to innovate. 

I am joined today on HealthChangers by two millennials: John Waczack and Kelsey Akerson. Both are college students, and Kelsey is an Intern at cambia. I’m a millennial, too, so you’ll hear me pipe in with my thoughts from time to time.

Joining us in the discussion is Heather Burton, the Director of Marketing for Healthsparq, a platform designed to help people make smarter health care choices.  Healthsparq regularly interviews patients about their thoughts on the health care system.  

I begin our conversation with a question for Kelsey and John: What are your first thoughts when you hear the words “health care?”

Kelsey Akerson: When I hear the words health care, the first thing that comes to mind is: this is a complex system. It seems intimidating and very confusing for a lot of people and especially for people of my generation. It's a little bit overwhelming.

John Waczack: I think for me, just because I have some food allergies I think about where I get all of my allergy medications, like EpiPen, as well general doctor visits in case something hurts, for example. 

Rachel Day: Can you share any specific health care experiences you've had as a young adult, good or bad, and what you learned from it?

KA: I actually had three surgeries last year. I had a sinus surgery, I had a tonsillectomy, and then I had back surgery. As a young person that was difficult, and I'd previously never had an experience with that.

Especially with the back surgery I really found out how many hoops you have to jump through in order to get an MRI or to see a specialist. All of that had to do with money and budgeting and making sure that the insurance is happy.

Then finally going to a specialist and having them look at everything, and then finally having the surgery.

It was rough being in pain for three months, then finally having it fixed when it could've been done quickly.

RD: Absolutely. What about you, John?

JW: The most recent experience with health care that I have had, I think would be about the end of Winter term last year. Before leaving for Spring Break my friend had been sick during finals weeks— pretty much bed-ridden and I was terrified to go home with that. By the following Monday, I was also very sick.

I didn't really want to go to the doctor or get it checked up right away because the concern was if it's viral they're not going to do much. They're going to tell me, "Here's some ibuprofen. Manage your pain, but you have to wait it out." The final decision was when my mother was like, "You have not moved from this bed in two days. You are going and if I have to take a day off to take you, I will."

I ended up going. And they found out I had walking pneumonia. But when I finally got to the doctor, it was pretty quick, and they were like, "Oh boy, you are sick. Let's do this test and this test." It was nice because once I finally went in, it didn't seem like there was any lack of desire to check and see what was wrong.

It just seems like there's a fear of over-prescribing antibiotics and seeped into my own mind. My thinking was: I don't want to go to the doctor and spend that time if it's not going to do anything.

RD: Does any of that surprise you, Heather?

Heather Burton: It doesn't. I'm honored, first of all, to be here and be the only non-millennial in the room. The reason that I am here, HealthSparq, we put a lot of time and energy into trying to be part of the solution for fixing what we all know is a pretty broken health care system. And one of the ways that we do that is we like to bring together average, everyday people and put them in front of the industry and have them share their fears, their opinions, about health care. We do that at different trade shows and health care events where there are people who work for health plans and health systems.

We bring in these people, really kind of off the street, to share their experiences. In the last year, we have done two panels comprised of just younger folks, just millennials. I think a lot of what you guys are saying is very true. There were definitely some themes that came out. We asked people to think of one word that describes their health care experience, and overwhelmingly, something along the lines of “overwhelming” or “complex” is what they say. I will say that is actually similar, even for people who are my age and older. I think all of us feel that way. Something that I found was different that came out of the millennial panels, is a lot of people have not had to use the health care system much, and so they say, "I don't really think about it. I don't really care at this point."

When it comes to their health insurance, some who are now on employer-sponsored plans, they say, "Yeah, every year I think there's something called open enrollment. There's way too much paperwork, and I kind of read it. I kind of just pick the thing that is the lowest cost." One guy on the panel said, "I kind of teeny, meiny, miny, moe'd it and just picked something."

Millennials Seek to Understand the Health Care System, Need Clearer Information

“I think that the biggest challenge for millennials is going through all of the paperwork, all the words, all of the things that you have to read and sign and everything that you don't really understand, but you know that you have to do.”

HB: Younger millennials have said, "I know I'll need health care at some point, but right now, it's just not important to me." And that's different than people who have families and definitely are using the system more.

RD: This is a question for everyone: What do you think are some of the challenges for millennials in navigating health care for the first time and what are some of the things that can make it easier for millennials to access and use health care?

HB: I'll start because people had really interesting suggestions. There was a lot about the jargon in health care. They didn't understand what's the difference between a copay and a deductible, and what maximums are.

And they said we need a cheat sheet for millennials that insurance companies can provide with simple language and quick reads. Someone even suggested making videos. They said, "I won't watch anything that's more than five minutes, but create something that's two, and I'll watch it."

KA: Yeah, I agree. One of the biggest things for me, I think, coming into Cambia I didn't know what a copay was, I didn't know what coinsurance was, I didn't know what a premium was, a deductible, anything like that.

I think that the biggest challenge for millennials, but even for anybody, is going through all of the paperwork, all the words, all of the things that you have to read and sign and everything that you don't understand, but you know that you have to do it anyway.

Videos would make it easier, that's something that I've thought about and played around with.

Also, most people of our generation seem to be really physical learners and visual learners as opposed to oral and written. Find something that fits in that category, like experiential marketing or something like that where they have a health fair, or a speed dating for health care, something like that, where you can go through and learn about all the pieces that you have to pay.

The cost, too, that's one of the biggest challenges because people don't know. Is an ambulance going to cost me “X” amount of money or is it going to be exponentially expensive than I think it's going to be?

That prevents people from going to the doctor.

HB: Let me jump in and say, we had a hilarious moment from one of the presenters about ambulance costs. The presenter said, he has a deal with all of his friends that if he's ever injured, they're going to call him an Uber instead of an ambulance.

RD: I've heard that before.

HB: I guess it's not that funny, it's probably very true.

JW: I think for me it's just access to information because once I got to college I didn't have a television to watch the news regularly. I realized when I got back from Spring Break, that there was this whole thing about romaine lettuce having this horrible outbreak; I had no idea. I think access to information is key.

In high school and at college, we're required to take several health classes to help us figure out where can we can buy affordable and healthy food. But no one really talks about health care and actually navigating that whole web of how you protect yourself. I think there's got to be a good way to help teach people how all this works.

Learning About Health Care the Hard Way, Yet Technology Offers Opportunity for Engagement

“I do not like to call people, I'd rather text, go online…to make it easier to access health care.”

RD: Definitely, 26 years-old is pretty late in life to start learning about health care. I remember when I started working at Cambia, I had to manage my own health care.

My mom was a teacher and always had great insurance. I would just go to the doctor, pay the $15 copay. At Cambia, I'm on a high deductible plan, so I ask the doctor:

"How much is this going to cost me if we do this test? What's it going to cost?"

She tried to prescribe me a medication, and I asked, "How much is it?”

The doctor replied, "You know what, I don't know."

I said, "Please don't prescribe me something without telling me how much it costs because I'm going to be paying for this out-of-pocket."

She found out the cost was $1,000.

I asked my doctor to find me an alternative prescription instead. 

It just seemed like the doctor had never had someone ask those questions before. She had never had someone say, "How much is this prescription or this procedure? Is this vaccine covered?"

People need to be educated on the health care system too and take control of their own health care. If they are going to be asking these questions, then the health care system needs to be prepared with the answers.

I always think technology can help make health care better. I do not like to call people, I'd rather text or go online. What are some technologies that you think could make it easier to access your health care and get the information you need?

HB:  We asked that question of the folks on the panel, and I was surprised. There were quite a few people who said, "When it’s personal having to do with my health, I want to be able to call and talk to someone on the phone."

However, a lot of them did say:

"The website is out of date. It's so hard to navigate.”

“There has to be a better way. My bank has a great website, why can't my health insurance have a similar website that's easy to find what I need?”

“I don't want to download a 20-page PDF to find a physician.”

They still want that human touch, but they also want more up-to-date technology and digital tools.

JW: When I got back from the East Coast recently, I had to reactivate my car insurance and it was as simple as downloading an app. If I ever got pulled over I can pull up the app on my phone.

Putting the information in the places that people can readily access is a great way to go about informing people.

I've had to go to Emergency Care and we have a family doctor that we go to normally. I have a long list of allergies and trying to explain my medical history to other people can be scary because even if my parents aren't there, I don't know that I've remembered everything I'm allergic to.

Putting all the information in one place would be easier to find and use when needed.  

Not Just Streamlined Health Care, but Human Connection Too

“It's easier for me to call my advice nurse and be like, "Hi, this is what's happening to me," and get an answer… to get that personal interaction…and reassurance I am looking for.”

KA: I know that a lot of colleges have a health center where you can go if you have strep throat or if you need to get your birth control prescribed, for example, but they don't have all your Primary Care Physician’s (PCP) records.

Then if you go to another PCP, like Zoom care, they also don't have your information. You have to start over again and explain everything in your past history. For me, with all of these different surgeries that I've had, I don't want to have to say the same thing every single time.

I'm allergic to penicillin and saying that every single time, it gets repetitive and a little bit frustrating where somebody doesn't know your medical history, but also technology to a point, is a way to do that.

It would be easier to schedule a visit online on your phone as opposed to having to call and sit on the hold line and listen to the elevator music for twenty minutes, but a phone isn't necessarily the best way to do that as well, because like Heather said, your health is something that you want to talk to a person about.

I found that growing up it's easier for me to call my advice nurse and be like, "Hi, this is what's happening to me," and get an answer as opposed to just waiting, or scheduling a visit online and then I am not going to get that personal interaction, I am not going to get that reassurance that I am looking for.

HB: And how crazy is it that health care still uses the fax machine?

I needed to get a medical waiver for my kids' sports this fall and yesterday I called the doctor's office and I said, "How quickly can I get this filled out? Can I email it to you?" And they said, "No, we don't do email, you'll have to fax it."

RD: How is health care so behind these other industries? You mentioned someone in the panel brought up their bank app. John, you mentioned your car insurance app is easy to use. What are some brands that you all admire? Some brands with great service, and what do you think health care can learn from brands like that?

KA: Before working here at Cambia, during high school and college I worked at Nordstrom in sales and there is such a huge value in customer service. All the stories that they told us and everything that they really exemplify in their employees is something, I think, that any company can look at and benefit from.

It's important to have a relationship with the customers that you're working with, but also be able to care for them even if things get difficult and they try to return something from 20 years ago.

That is something that I admire at least from a retail brand and I think that a health provider, health insurance could definitely learn from this because, every customer, every member is important and you have to take the same time that you would with any member as you would with somebody on your team or somebody in your family because they're just as important.

HB: I also think people often think of Amazon, and people will say, "They know me. I like that it's so personalized," and that's something that we heard about health care and health insurance. Sometimes they feel like the people on the other end don't know anything about them and are not able to really say, "I know you, here's what I think you need," and people want that now.

People expect to be marketed to in a personalized way.

JW: I was just setting up some travel arrangements to go visit a family friend and I immediately received an airline confirmation email. When I clicked on the date of my flight, Google added it to my calendar instantly. It was that easy.

I think if it's possible to integrate these things into the services that already exist, it would make it easier for people to access their care.

So many of these services are already interconnected and talk to each other that it would be great for everything to work together.

RD: Heather, you work at HealthSparq. What is HealthSparq doing to address some of these feelings and these findings from millennials?

HB: HealthSparq is doing the same thing for millennials as really everyone in health care: it is trying to develop tools that health plans can use to empower people to make smart decisions.

We heard today there's a lot of questions about what prescriptions or tests costs and most people don't know they can access this information through their health plans.

HealthSparq powers this information so you can go in and you can search for MRI and it will say, "Your out-of-pocket costs are estimated to be ‘X.’"

We tell people— "No, that's not available!"

You can get this information, and I think to continue to try and push the envelope a little bit with our clients and with the industry to say, "Listen to what people have to say and try to be innovative."

We know it's really hard in health care. These are big organizations. It's hard to make a change, but I think little by little, we're getting there to really change an outdated system.

RD: Thank you all so much for sharing your experiences today, millennials. A lot of what you said today mirrors the same things that I think as a millennial, and I think it's important for people to understand us and our generation and the technologies we need and that we use. Thank you both so much for sharing your voices today and thank you so much, Heather, for sharing your research with HealthSparq and what HealthSparq is doing to combat some of these issues.

HB: Thank you for having us.

JW: Yeah thank you!

KA: Thank you Rachel!

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