WHITEPAPER

Psychographic Segmentation
and the Healthcare Consumer

Copyright @2017 c2b solutions. All Rights Reserved. c2bsolutions.com

TA B L E O F C O N T E N T S
Executive Summary 3
The Changing Healthcare Marketplace 6
Limited Effectiveness Of Traditional Approaches 9
Consumer Segmentation 12
A Deeper Look At Psychographic Segmentation 14
Operationalizing Psychographic Segmentation 16
c2b Consumer Diagnostic And Segmentation Model 18
c2b’s Psychographic Segmentation Methodology 19
The c2b Psychographic Segments 21
Insights For Immediate Business Application 25
Case Studies 28
Psychographic Segment Distribution among 315 CHF 31
Discharges
About c2b solutions 32

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 2

EXECUTIVE SUMMARY
Numerous changes in the healthcare
marketplace are driving it toward a model of
consumerism. The Patient Protection and
Affordable Care Act (ACA) gave rise to
Health Insurance Exchanges, from which 19
million previously uninsured consumers
shopped for and enrolled in coverage. Many
employers elected to shift the responsibility
and much of the cost burden of selecting
insurance coverage to employees, resulting
in millions more consumers shopping for
health insurance on the Exchanges.
Accountable Care Organizations (ACOs)
receive reimbursement through a
combination of clinical and patient
experience measures; moreover, they are
expected to achieve readmission rates for
key health issues, which will be partially
contingent upon patient behavior (e.g.,
medication adherence).
Healthcare organizations must evolve with
this shift to consumerism—designing
products, services, and experiences that
deliver against patient needs and
expectations. “One size fits all” approaches
to patient education and consumer
advertising, with a singular message and
shotgun delivery to a population of
3 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER
consumers, are limited in its effects. All
consumers are not alike—even if they share
a common health condition—and are
motivated by different things.
Successfully driving behavior change
requires a deep understanding of healthcare
consumers and how to best influence their
choices. Traditional market research, both
qualitative (focus groups) and quantitative
(surveys), is a step in the right direction.
However, these methods may only provide
limited insight if all consumer participants
are considered a uniform population with
aggregated perceptions, beliefs, and
attitudes.
Segmentation is a market research method
whereby consumers are divided into groups
based on common variables in an attempt to
homogenize them for consistent insight.
There are many approaches to consumer
segmentation, including:
 Demographic & socioeconomic
 Behavioral
 Attitudinal
 Psychographic
Each approach has its advantages and disadvantages, in terms of ease in execution to effectiveness in
identifying motivational behavior triggers. Psychographic segmentation seeks to understand the
hardwired values, interests, and lifestyles of consumers in order to uncover needs and motivations,
both articulated and unarticulated.

From a robust market research initiative fielded at the beginning of 2013, c2b solutions developed a
proprietary health and wellness psychographic segmentation model with 91.1% predictability.
Healthcare stakeholders can use this model to understand their consumers or augment and
strengthen their own market research and consumer engagement efforts. This research, referred to as
the c2b Consumer Diagnostic, included:

 A national study of the healthcare consumer, comprised of 4,878 respondents completing a

survey with 384 questions/attributes. These attributes include (but are not limited to)
 Health and wellness attitudes and behaviors
 Media preferences
 Sources of Rx and OTC medicine purchases
 Preferred attributes of a Health Insurance Plan/Company
 Attitudes on healthcare reform
 Demographic and socioeconomic variables
 Forty-four (44) health conditions
 Five distinct and differentiated psychographic segments based on consumers’ hardwired
approach to health and wellness
 91.1% predictability
 Supporting qualitative research to further understand segments’ motivations and preferred
communication styles
 Designed from c2b solutions team’s years of experience with P&G developing consumer
psychographic segmentation models and proving them in the marketplace

c2b solutions fielded its next national study among 4,039 healthcare consumers in January 2015.
This research asked many of the same questions as the 2013 study for trend analysis; however,
several new topics are covered which are critical to healthcare organizations, including:
 Extensive list of information sources influencing choice of health products/services, hospitals
and health insurance companies
 More than fifty (50+) health conditions

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 4

  Education/advertising message fatigue
 Health categories as retail trip drivers
 Retail and Urgent Care clinic behaviors and needs
 Social media
 Plus many more topics

Importantly, the psychographic segmentation model held consistently with each segments’ attitudes
and behaviors after two years; that is, there was little variance in the way each segment answered the
survey questions between 2013 and 2015. This book-ended the individual mandate of the ACA,
demonstrating that national policy did not affect healthcare consumers’ intrinsic motivations and
communication preferences.

In January 2017, c2b solutions fielded a study among 500 consumers to determine whether the
psychographic segmentation model could work in dental care (it does). The five psychographic
segments stayed consistent in distribution and attitudes relative to the earlier studies, reinforcing the
stability of the model.

The insights from the c2b Consumer Diagnostic and psychographic segmentation model are
applicable across healthcare stakeholders—hospitals, physician groups, health insurance companies,
pharmaceuticals manufacturers, retail pharmacies and employers to name a few. Successful
application of these insights can help positively influence health and wellness behaviors, and drive
acquisition and retention of the healthcare consumer.

5 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

THE CHANGING HEALTHCARE
MARKETPLAC E

healthcare

The healthcare marketplace is rapidly changing, with many factors driving it toward a model of
consumerism. A seismic consumer shift took place with the passage of healthcare reform legislation.
The Patient Protection and Affordable Care Act (ACA)—the legislation behind healthcare
reform—passed into federal law in March 2010, and was upheld by the U.S. Supreme Court in the
summer of 2012.

Moreover, rising costs have compelled employers and payers to shift more of the coverage burden to
employees and members. With consumers taking charge of their healthcare spending—and
leveraging the power of the internet, social media, and advertising—healthcare organizations face a
more-informed public that expects more choice.

The intent of healthcare reform has been to expand access to healthcare coverage for all U.S.

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 6

 citizens. The number of uninsured Americans
has declined by 17 million from a high of 45
million at the end of 2013, however that still
leaves approximately 28 million Americans
without healthcare insurance. Beginning in
2014, individual consumers were required to
have health insurance, either covered by their
employer or purchased directly from health
insurance companies on “Exchanges”
managed by the states or federal
government—or pay a penalty.
This has created an environment of both
confusion and opportunity for consumers and
healthcare providers. While consumers and
providers face ongoing uncertainty due to
legislative efforts to repeal or replace the
ACA, the market continues to rapidly evolve,
and healthcare organizations must become
more consumer-focused in order to
successfully drive health and wellness
behaviors.
For example, health insurance is an industry
historically focused on Business-to-Business
(B2B) relationships and marketing to
employers, groups and other large healthcare
intermediaries. However, health insurance
companies competing on the Exchanges must
focus their efforts directly toward consumers,
which may not be a core capability for many
of these companies.
Other healthcare stakeholders also are
adjusting to healthcare consumerism:
7 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER
 Hospitals, Integrated Delivery Systems,
and ACOs (Accountable Care
Organizations) must deliver
patient-desired experiences in order to
realize maximum reimbursement, and to
motivate positive health behaviors to
prevent hospital readmissions and
associated penalties;
 Pharmaceutical manufacturers must
differentiate in a me-too marketplace
and deliver new value propositions to
consumers and Payers with efficient
selection and use of products—or be
prepared to deliver maximum rebates;
 Employers need to consider and position
their employee coverage strategies
carefully to mitigate negative response
or to attract and retain top talent;
 Retailers are driving self-directed care,
linking front-end Treatment, Prevention,
and Wellness solutions with pharmacy
services;
Thus, healthcare providers must become more
consumer-centric in a bid to succeed in this
dynamic, experience-focused environment
—changing their mindset from patients to
consumers.
“In a new era of healthcare, those paying for care (insurers,
employers) and providing care (doctors, hospitals) need to
think more like consumer marketers by learning to target
more effectively - not only to guide consumers towards
choosing providers and plans, but also to more efficiently
deliver care and encourage healthy behaviors.”1

1. 6 Trends in an Era of Consumer-Driven Healthcare; Bob Spoeri; Becker’s Hospital Review; June 06, 2012

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 8

 LIMITED EFFECTIVENESS OF TRADITIONA L
APPROACHES

The United States healthcare system is excellent for acute care, with some of the highest quality
healthcare professionals in the world. However, for chronic care and preventive medicine, where
success is largely driven by patient behavior and adherence to professional recommendations, there
are significant opportunities for improved approaches:

 75% of adults are non-adherent to their invested; however, in 2010, the average
medications in one or more ways consumer participation in employer
 25% of patients prescribed sponsored programs was only 22%
medications for a new illness fail to nationally.
fill their initial prescription
 Half of patients taking maintenance Unfortunately, the healthcare system tends to
medications for a chronic disease view patients as a “walking disease state,”
stop taking their medications within focusing on the health condition instead of the
a year of starting therapy—including person, assuming all patients with that
transplant patients taking condition share the same needs, perceptions,
anti-rejection drugs, a consequence
of which is possible death
 The past decade has seen a decline in
overall cancer screening in the United
States
 According to a study by the Partnership
for Preventative Care, preventative
services are grossly underused
 The Centers for Disease Control and
Prevention (CDC) estimated that
worksite health promotion programs
result in a benefit-to-cost ratio of $3.48
in reduced healthcare costs and $5.82
in lower absenteeism costs per dollar

9 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

and behaviors. The “one size fits all” approach of population management, off-the-shelf disease
management programs, and non-personalized care delivery has seen limited success.

All consumers do not approach healthcare in the same way. They have very different healthcare
experiences, knowledge, expectations, and system interactions. Consumers can also have very
different motivations, even if they exhibit the same behaviors. For example, one patient may be
motivated by a sense of duty to family, while another patient is driven by a need for personal control
over a disease; both patients adhere to a physician’s recommendations and are dedicated to healthy
behaviors, but the impetus—and ways to communicate with, and motivate, these patients—differ.

The healthcare system tends to view patients as a “walking disease state,”

focusing on the health condition instead of the person, assuming patients
with that condition share the same needs, perceptions and behaviors.

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 10

 Separately, many healthcare providers believe that providing enough patient education, or the right
information, is the key to driving positive behavior change. This is a faulty assumption. Even armed
with he latest, expert information about a health condition with guidance on effectively managing it,
consumers will not necessarily adhere to these recommendations.

One only needs to consider the percentage of physicians in the United States who are overweight or
obese. Despite years of education and practice, as well as access to the world’s leading medical
information, nearly half of physicians are overweight or obese (Johns Hopkins study of 500
physicians). UCLA found that a quarter of all Licensed Practical Nurses smoke. Few people
understand better than physicians and nurses the health issues associated with obesity and smoking,
yet all their knowledge does not translate to healthy behavior for a significant portion of these
professions.

Thus, traditional, mass approaches to patient communications (whether education or marketing) will
not suffice in healthcare. To address this opportunity, many healthcare organizations will need to be
employing consumer segmentation to understand the differences among patients and attempt a more
personalized approach to patient care.

11 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

CONSUMER SEGMENTATION
Segmentation involves taking a heterogeneous marketplace of consumers and employing analytic
techniques to break the population into smaller, homogenous groups composed of individuals with
similar attitudes, behaviors, or needs. The emergent segments are then profiled and serve as key
targets for messaging and consumer behavior change. There are various forms of consumer
segmentation, each with its advantages, disadvantages, and ability to produce deep insights into
consumer motivation:

Surface  Demographic & Socioeconomic Segmentation: Grouping people by gender, age, ethnicity,

income, education, geography and other physical or situational characteristics

 Advantages: Most simple approach based on objective measures; easy to identify and
target consumer groups in a database; many third-party databases available

 Disadvantages: Limited effectiveness as it assumes everyone in a group thinks and acts

in the same way

 Behavioral Segmentation: Grouping people by their behavior (e.g., healthcare utilization

behaviors tracked by a medical claims database, shopping behaviors tracked by a retailer’s

loyalty card database)

 Advantages: Targeting based on proven patient/consumer habits and practices; easy to

identify and target consumer groups as long as they are members of the organization

leveraging the database (may require consumer opt-in)

 Disadvantages: Assumes everyone with the same behaviors has the same motivations;
messaging may not be persuasive for all members of a consumer group

 Attitudinal Segmentation: Grouping people by shared attitudes and emotions about a given
subject (e.g., how a consumer feels about preventive medicine or healthcare reform)

 Advantages: Connects with consumers’ articulated beliefs and needs

 Disadvantages: Difficult to target consumers by attitude in a database unless all
consumers in the database answered a survey including the attitudinal questions; bias

can be an issue as respondents may answer questions the way they think they should

answer them about a given topic

 Psychographic Segmentation: Grouping people by shared values, principles, beliefs, emotions,

personality, interests, and lifestyle

 Advantages: More effective in resonating with a consumer’s motivations and

unarticulated needs

 Disadvantages: Difficult to target consumers in a database unless all consumers in the

database answered the psychographic survey; Psychographic survey questions may not

be directly related to a given topic (e.g., may include personal values questions in a

Deeper survey about healthcare), so stakeholders outside the immediate research team may

not readily grasp the concept

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 12

 Demographic, Socioeconomic, and Behavioral segmentation methods are the easiest to execute, but
may be limited in their effectiveness for changing consumer behavior. Psychographic segmentation is
more effective in connecting with consumers’ motivations, but it is difficult to scale across a
population. As Alexandra Samuel states in her Harvard Business Review article, “Psychographics Are
Just as Important for Marketers as Demographics:”

“Until recently, however, it was a lot harder to get psychographics than demographics, and even if
you had psychographic data, it wasn’t always obvious how to make it actionable.” 

13 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

A DEEPER LOOK AT
PSYCHOGRAPHIC SEGMENTATION
As with other forms of market segmentation, psychographic segmentation enables organizations to
identify consumer pools based on shared characteristics. One key distinction is that psychographic
segmentation focuses on what motivates individual consumers—which can be more informative
when developing marketing plans, wellness initiatives or disease management programs.

When used in conjunction with demographic or socioeconomic data, organizations gain a clearer
picture of both internal and external factors that influence consumer behaviors. These insights can
help hospitals and other healthcare organizations understand consumers’ decision-making processes
better and improve the relevance of messaging—whether designed to boost brand awareness and
loyalty or increase patient engagement.

Psychographic segmentation starts with development of a questionnaire that uses attitudinal,

values- and belief-based statements, to which respondents react—for example, from “Strongly Agree”
to “Strongly Disagree.” Once survey responses are gathered, a factor analysis using statistical
clustering is used to identify response patterns that indicate natural clusters based on similar answers.
Once all survey data are analyzed, consistent groups—psychographic segments—are defined.
Additional social media monitoring and analytics can provide added insights based on trends in
consumer interests and attitudes.

Of course, the very nature of answering a survey requires respondents to consider their thoughts and
choose an answer. When survey questions are focused on a specific topic, as with attitudinal
segmentation, the results may be skewed because many respondents rationalize their answers based
on societal norms or, in the case of healthcare, published facts.

Psychographic segmentation, on the other hand, may include completely unrelated and
discontinuous questions about personal values or beliefs, so the respondents are less likely to
rationalize. However, effort must be made by the research team to draw connections between
psychographic insights and the topic of focus to make these insights actionable, sometimes requiring
additional research.

After using quantitative marketing research to identify psychographic segments, conducting

qualitative research (e.g., focus groups and one-on-one interviews) with members of each
psychographic segment can help interpret quantitative data from the perspective of each segment

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 14

 and avert unintentional bias based on researchers’ own attitudes and motivations.

A psychographic segmentation model must address key criteria for optimal effectiveness:
 Offer maximum differentiation when comparing segments
 Produce segments that are internally consistent
 Provide actionable insights
 Create consistent, reproducible results
 Balance predictability with practicality

While a survey with more questions may result in a higher level of predictability among a greater
number of segments, it is impractical for several reasons. In addition to the fact that too many
questions can lead to lower survey completion rates, a segmentation model that relies on too many
classifications can be more challenging to operationalize successfully.

15 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

OPERATIONALIZING A business that
PSYCHOGRAPHIC SEGMENTATION can effectively
A business that can effectively connect with consumers and guide them in their connect with
healthcare decisions will have a differentiated, competitive advantage. There consumers
are several ways organizations might scale attitudinal or psychographic and guide them
segmentation. in their health
care decisions
1) Multiple “Campaigns”: Since these segments are unique in their beliefs and
will have a
motivations, they may require their own unique messaging and propositions.
differentiated
This may not be feasible (practically or financially) for major media efforts, but
competitive
is more tenable for 1:1 engagement through digital marketing or healthcare
advantage.
professional-to-patient interaction. Identification of the segment to which a
patient/consumer belongs could be accomplished prospectively or
retrospectively.

a. Prospectively: The patient/consumer answers the battery of attitudinal/psychographic survey questions

as they enter the system, and a database flags each patient/consumer according to his or her segment.
b. Retrospectively: A sample of patients/consumers answers the battery of attitudinal/psychographic
survey questions to be classified into their respective segments. These segments are then analyzed with
variables from a broader behavioral database to which they are members (e.g., medical claims data,
hospital utilization data, retail shopper data). When unique, segment-specific variables are isolated, these
can be extrapolated across the population in a database to flag each patient/consumer according to his or
her segment.

2) Prime Prospect Focus: Across may industries, the Pareto Principle holds where a small segment of the
population drives a disproportionate share of business growth over the next 18-24 months:

a. Car rental: 0.5% of customers comprise 25% of rental sales

b. Soda: 6% of drinkers account for 60% of cola sales
c. Banking: Top 10% of bank’s retail customers equals about 90% of retail profits

Messaging would be designed for this Prime Prospect segment, engineered to (at best) having the rest of
the population draft behind the Prime Prospect, or (at worst) avoid alienating the rest of the population. In
the healthcare arena, the Prime Prospect focus can be adapted to address a critical challenge in achieving
the Triple Aim of reducing costs, enhancing patient experience, and improving population health.

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 16

 In the U.S., 5% of patients accrue more than 50% of healthcare costs2. This 5% could be examined
through a psychographic lens to determine whether there is homogeneity in motivations and
priorities. Many of the health conditions that lead to excessive utilization can be prevented or
proactively managed with greater patient engagement—and given current reimbursement trends and
initiatives to reduce preventable readmissions, healthcare providers need to prioritize ‘frequent
flyers’ and deliver messaging that inspires action.

The most influential healthcare communications will capitalize on a deep understanding of

consumer psychographics, demographics, socioeconomics, and health conditions for maximum
effect.

2. http://www.hhnmag.com/articles/7996-how-to-address-high-utilization-in-health-care

17 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

c2b CONSUMER DIAGNOSTIC AND
SEGMENTATION MODEL
Recognizing the need for psychographic segmentation to drive positive consumer behavior change
in healthcare more broadly, as well as the opportunities for helping consumers and healthcare
organizations navigate the extensive changes under healthcare reform, c2b solutions developed the
c2b Consumer Diagnostic.

The c2b Consumer Diagnostic was developed

Figure 1
with the following objectives:

1) Understand consumers’ health & wellness

habits and practices, as well as the influence
of various healthcare delivery stakeholders
(e.g., health plans, hospitals, retailers, etc.) and
media on these behaviors
2) Establish a baseline measure of these habits
and practices for ongoing trend analysis
3) Identify distinct consumer psychographic
segments based on their approach to health
and wellness
4) Understand consumers’ (general
There are many factors that play into a
population and various segments)
consumer’s perceptions and behaviors with
understanding of healthcare reform and how
regard to health and wellness—not the least of
it will affect perceptions and behaviors
which are point-in-time environmental
considerations like the economy and ongoing
legislative reform.
Figure 2
The c2b Consumer Diagnostic was designed
Identifying consumer segments based on their approach

WHO
to healthcare in a Healthcare R eform environment to capture as many of these factors as feasible,
given the restraints of a survey instrument
Understanding the deep-seated, often unarticulated motivations
behind consumer behavior, specifically towards healthcare (e.g., length of survey fatigue, biases
WHY
associated with online survey approach). The
Developing segment-specific propositions, messaging c2b Consumer Diagnostic includes insights
and products to influence healthcare consumer behavior
WHAT and guidance for the WHO, WHY, WHAT,
Understand how to reach the healthcare consumer segments
and HOW of the healthcare consumer as
with the most effective media vehicles and channels
HOW illustrated in Figure 2.

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 18

 c2b’s PSYCHOGRAPHIC
SEGMENTATION METHODOLOGY
The data captured in the c2b Consumer Diagnostic are based on two online surveys. The first,
fielded in January 2013, surveyed 4,878 U.S. respondents, with a nationally representative sample of
4,184 respondents mirroring the U.S. Census and an over-quota for certain health conditions, health
insurance plans, and other demographic/socioeconomic variables. The 2015 study included 4,038
respondents.

The robust survey examined 384 attributes, and was developed by c2b solutions with assistance from
Ipsos, a leading global consumer research firm. The large base size of the survey respondents allows
for greater response stability, and given that the segments remained consistent from the first survey,
which was conducted prior to the ACA individual mandate, to the second survey, which took place
after the mandate was in force, speaks to the reliability of the model. With its number of respondents
and scope of topics covered, the c2b Consumer Diagnostic offers more than 50 million data points
on consumer attitudes and behaviors regarding:

 Health, wellness and healthcare delivery

 The roles of healthcare professionals
 Rx and OTC medicines, including where purchased
 Media preferences
 A variety of other subjects

19 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

In addition to this wealth of data, the study identified unique psychographic consumer segments,
distinct in their approach to health and wellness. A factor analysis using statistical clustering
procedures was conducted to examine response patterns to the survey questions. More than 90
segmentation models were examined to determine the most robust solution, balanced with
practicality in application to business situations.

As illustrated in Figure 3, a set of 12 “classifier” questions were derived via mathematical process to
provide this psychographic segmentation model with a 91.1% predictive value as to which segment
a consumer belongs.

In order to bring the

Figure 3
segments to life, c2b
Population of Healthcare Consumers
(e.g. patients, members, etc.) solutions followed up the
quantitative studies with
qualitative research to
A 12 question classifier leads you to one
understand the context
of the five segments with 91% predictability
surrounding each
segments’ point of view.

Balance Seekers Willful Endurers Priority Jugglers Self Achievers Direction Takers

c2b solutions used psychosymbology, a proprietary technique to

probe segment attitudes and behaviors using a picture sorting and
interpretation technique that surfaces unarticulated motivations and
subconscious drivers unique to each segment. The same technique
has been used—to remarkable success—by many P&G brands to
inform advertising strategies.

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 20

 THE c2b PSYCHOGRAPHIC SEGMENTS

The combined results of our quantitative and qualitative research identified five distinct and
differentiated psychographic segments, unique in their approaches to health and wellness. The high
predictive value of the model exceeded that of previous models built by the c2b solutions team
while employed at P&G, due to years of honing and evolving its methodology. These segments
differed along many health attitudes and behaviors:

Figure 4  Proactive, wellness orientation versus

I believe I can Directly Influence How Long I Will Live, Regardless of My Family History
90%
reactive, “fix it when it’s broken” approach
80% 83%  Seeking professional directives versus
76%
70%
69% options and choices
60% 63%

50%
 Motivated by family versus by self
49%
40%  Future versus present orientation and
30%
motivations
20%
 Objective versus subjective regarding
10%

0%
healthcare solutions
Balance Seekers (18%) Willful Endurers (27%) Priority Jugglers (18%) Self Achievers (24%) Direction Takers (13%)

 Numerous other tensions and contrasts

Each psychographic segment approaches health and wellness differently and has unique motivations
and communication preferences.

For example, Figure 4 shows the attitudinal difference among the c2b Psychographic Segments
regarding self-empowerment and family history. Balance Seekers and Self Achievers are statistically
more likely (95% confidence) than the other segments to agree with the statement, “I believe I
directly influence how long I will live,
regardless of my family history,” and do not Figure 5
I Actively Take Steps to Prevent Illness
believe family history is an immutable sentence. 100%

Half of Willful Endurers believe they can do 90%

89%
80% 85%
little to influence their health outcome. Which 70%
68%
segment is least likely to follow through on 60%
61%
50% 55%
physician recommendations and healthy 40%

behaviors? 30%

20%

10%

The proactive attitude in Figure 4 carries over to 0%

Balance Seekers (18%) Willful Endurers (27%) Priority Jugglers (18%) Self Achievers (24%) Direction Takers (13%)

the behaviors represented in Figure 5, where

21 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

Self Achievers are statistically more likely (95% confidence) than all other segments to actively take
steps to prevent illness. Balance Seekers are also statistically more likely to do so relative to the other
three segments. What are some of these behaviors?

BALANCE SEEKERS 18%

Balance Seekers are generally proactive in their health and wellness-oriented. Balance Seekers
are open to many ideas, sources of information and treatment options when it comes to their
healthcare. However, Balance Seekers themselves - not healthcare professionals - define what
success looks like in their health. Physicians and other healthcare professionals are useful
resources, but not the only resources, for leading a healthy life.

WILLFUL ENDURERS 27%

Willful Endurers live in the “here and now” and believe there are more important things to
focus on than improving their health for the future. Willful Endurers are not necessarily
unhealthy, but they do what they like, when they like, and typically do not change their
habits. They are self-reliant and can withstand anything life throws at them, going to the doctor
only when they absolutely must.

PRIORITY JUGGLERS 18%

Priority Jugglers are very busy with many responsibilities. Because of these responsibilities,
Priority Jugglers may not take the time to invest in their own wellbeing and are reactive when
it comes to health issues. However, Priority Jugglers are very proactive when it comes to their
family’s health and will make sure their loved ones receive the care they need.

SELF ACHIEVERS 24%

Self Achievers are the most proactive when it comes to their wellness, investing what is
necessary toward their health and appearance. Self Achievers may actually have health issues,
but they stay on top of them with regular medical check-ups, health screenings and research.
Self Achievers are task-oriented, and will tackle a challenge if they are given measurable
goals.

DIRECTION TAKERS 13%

Direction Takers believe their physician is the most credible resource for their healthcare
needs. Direction Takers look at their physician and other healthcare professionals for direction
and guidance because of their expertise and credentials. Direction Takers are more likely to
go to the doctor at the first sign of health concerns. However, Direction Takers may not
always follow a physician’s advice - not because they disagree with his/her recommendations,
but because it is often difficult to work these recommendations into their routine.

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 22

 As Figure 6 illustrates, Balance Seekers and Self Achievers claim to successfully maintain healthy
nutritional habits while educating themselves on health & wellness. A substantially lower percentage
of the other segments agree with these statements.

Consumers in these segments could have Figure 6

diabetes, cardiovascular conditions, cancer, or 80%
I Am Successful in Maintaining Healthy Nutritional Habits

any other of the litany of health conditions 70% 73%

66%
measured in the c2b Consumer Diagnostic, 60%

although the incidence of disease differs by 50%

40%
segment. Should a healthcare professional 39%
30%
32%
assume that the more proactive patients need 20%
27%

one type of approach while the other, more 10%

reactive patients need a different approach and 0%

Balance Seekers (18%) Willful Endurers (27%) Priority Jugglers (18%) Self Achievers (24%) Direction Takers (13%)

motivational guidance?

That is a start, but even Balance Seekers and Self Achievers differ in their preferred methods of
physician interaction. As shown in Figure 7, Balance Seekers do not like to be told what to do by a
healthcare professional, seeking options and choices rather than directive guidance. On the other
hand, Self Achievers actually seek directive guidance.

Figure 7 Both segments behave in a similar, proactive,

I Do Whatever My Doctor Tells Me and healthy fashion, but the way a healthcare
80%

professional approaches either segment should

70%
71%
60% 65% be very different. A directive approach appeals
50%
to one segment while alienating the other.
51%
40% 43%

30% What should a healthcare professional say to

26%
20% each segment to motivate behavior change?
10%
How will an organization, at risk for medical
0%
Balance Seekers (18%) Willful Endurers (27%) Priority Jugglers (18%) Self Achievers (24%) Direction Takers (13%) outcomes, maximize its success with each
segment? Can traditional disease management
programs be improved with segment-specific
elements and messaging?

23 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

To fully understand these distinct consumer segments and the appropriate messaging that would
prove most effective with each segment, subsequent qualitative research was conducted following
unique methods to deeply understand subconscious and unarticulated motivations. This specific
combination of quantitative and qualitative research yielded valuable insights and a customizable,
proprietary consumer segmentation model that will allow healthcare stakeholders to achieve
maximum success in marketing, education, and engagement with healthcare consumers.

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 24

 INSIGHTS FOR IMMEDIATE BUSINESS
APPLICATION

The powerful insights and guidance found in the c2b Consumer Diagnostic and segmentation model
can help a healthcare organization succeed in a market increasingly driven by consumerism:

 Drive desired consumer health & wellness behaviors and maximize the success of:
 Disease management and intervention
 Medication compliance and persistency
 Wellness programs
 Differentiate products/services among consumers by linking the brand proposition to their
unique, segment-specific motivations.
 Develop effective strategies and campaigns to increase the likelihood that consumers will
take action against marketing messages.
 Effectively deliver an improved consumer experience
 As a value-added service, a company can differentiate itself and its portfolio among its
customers/clients by helping them succeed in a rapidly changing healthcare environment
driven by consumerism.

Figure 8
Proactive
Figures 8 and 9 illustrate the
30%
striking contrast found among 24%
I'll spend whatever it takes to be healthy 17%
the segments based upon their 48%
29%
attitudes and behaviors 61%
towards health and wellness. I am already healthy but I take steps
to be even better
32%
37%
Self Achievers are the most 66%
32%
proactive and wellness 83%
49%
oriented group in Figure 8. I actively take steps to prevent illness 69%
89%
This segment is statistically 63%

more proactive (95% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Balance Seekers Willful Endurers Priority Jugglers Self Achievers Direction Takers
confidence) than all other
segments for the three
attributes measured in the chart.

25 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

In addition, Balance Seekers are also statistically more proactive than Willful Endurers, Priority
Jugglers and Direction Takers, but still lag Self Achievers across all three measures.

Alternatively, Figure 9 measures attitudes and Figure 9

Disengaged
behaviors associated with consumers who do not 6%
I have an unhealthy lifestyle, 32%
prioritize their wellness, characterizing individuals I just can't change my habits 18%
7%
who are reactive or disengaged with health issues. 18%

13%
36%
I consider myself a "couch potato" 22%

Willful Endurers are the least engaged, de-prioritizing 10%

29%

17%
health and wellness to a statistically greater degree 46%
I know what I should be doing to be healthy, 34%
(95% confidence) than all other segments. After but I don’t make my health a priority 14%
34%

Willful Endurers, the least engaged groups are Priority 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Balance Seekers Willful Endurers Priority Jugglers Self Achievers Direction Takers
Jugglers and Direction Takers, both of which align
with these attitudes to a statistically greater degree
than Balance Seekers and Self Achievers.

There are hundreds of health and wellness attitudes and behaviors that can be compared and
contrasted among the psychographic segments (or any demographic/socioeconomic segment) in the
c2b Consumer Diagnostic.

The first step is to determine which segment to target based on one’s objectives and strategies. Is the
objective to target the consumers who are most likely to be in need of intervention and support in
managing health issues? Or is the objective to target the Segments that are the most proactive and
invested in their health and wellness (including the propensity to highly align with the attitude, “I’ll
spend whatever it takes to be healthy”)?

After one defines the strategy-based consumer target audience, another step is to determine the right
Marketing Mix to reach the targeted Segment(s). The initial answer can be found in the table in Figure
10, which looks at sources of information that influence the choice of health insurance company; this
sample represents a fraction of the data available (5 of more than 60 possible media, professional and
peer vehicles) in the c2b Consumer Diagnostic.

As the commentary around Figure 7 indicates, different psychographic segments prefer different
approaches in engaging them for behavior change. c2b solutions has found that there are unique
“Words to Use and Lose” with each segment, and distinct ways to communicate most effectively.

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 26

 Figure 10

Information
Source Balance Seekers Willful Endurers Priority Jugglers Self Achievers Direction Takers

n=711 n=1107 n=733 n=953 n=532

A B C D E

Health Insurance Company 17% B,C,E 11% 13% 15% C 12%

Consumer Group Publications

10% B,C 6% 7% 11% B,C 8%
(e.g. Consumer Reports)

Employer/Spouse’s Employer 24% C 19% 28% C,E 25% C 20%

Health Organization
11% 10% 10% 14% A,B,C,E 8%
(e.g. American Heart Association)

Physician 22% 21% C 26% C 33% A,B,C 32% A,B,C

Note: Statistically significant (95% confidence) differences noted by letters corresponding to columns

Developing segment-specific propositions to appeal to consumers’ motivations (the WHY) is the

step between defining the target audience (the WHO) and the Marketing Mix (the HOW), but is
beyond the scope of this white paper. Please contact c2b solutions to discuss how these insights can
help your organization succeed in a dynamic healthcare marketplace.

Data rich and deep in proprietary knowledge, the c2b Consumer Diagnostic will power your
consumer marketing, education, and communications with the insights behind consumer
motivations that drive health and wellness behaviors.

27 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

CASE STUDIES

The following case studies provide examples of how the c2b Psychographic Segmentation model
has been applied for disruptive clinical and business results.

CASE STUDY 1

Background:
TriHealth, a major health system in Cincinnati, Ohio, employs health coaches to supplement the
care provided to patients with diabetes, musculoskeletal issues and other chronic conditions. The
health coaches were effective in their efforts, but TriHealth sought to enhance their results by
leveraging consumer insights for greater personalization.

TriHealth was interested in applying psychographic segmentation to health coaching to more

quickly form trusting relationships between coach and patient and to activate positive health
behaviors among patients by appealing to their intrinsic motivations.

Approach:
In a three-month pilot involving 210 patients, TriHealth health coaches were trained by c2b
solutions to understand each of the five psychographic segments and how to best engage them
face-to-face or over the phone in a coaching session. Health coaches participated in a three-hour
training session comprised of light pre-reading, content presentation, knowledge validation and
role-playing. Patients were classified by psychographic segment through an online survey of the
12 segment classifier questions, emailed to them ahead of their next coaching session. Success
would be based on an increase in personal health goals (e.g., exercise, nutrition, lifestyle
modification behaviors leading to outcomes such as reduction in A1c) met during the pilot

Results:
83 percent of patients progressed against their personal health goals; patients with diabetes
achieved +90% increase in mean goals completed. Qualitative feedback from the health coaches
supported the effectiveness of the approach:

“The team has found using the psychographic insights “energizing,” and they found themselves
listening closer to what the patients say, looking for clues. They confirmed that the
segment-specific key words from the segment ‘code book’ are popping up among the respective
segments.”

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 28

 “The psychographic insights are significantly reducing time to form a bond with the patients and
engage in meaningful coaching.”

The results were encouraging enough to expand the pilot to more than 30 health coaches with a
target of 3,000 patients as a next step, which is currently in execution as of the publication of this
paper.

References:

Hospitals & Health Networks: “Consumer segmentation has hit healthcare and here’s how it
works”

The Commonwealth Fund, Quality Matters: “In Focus: Segmenting Populations to Tailor
Services, Improve Care”

MedCity News: “Patient Psychology is at the Heart of Successful Patient Engagement”

CASE STUDY 2

Background:
A progressive health system, part of one of the largest nonprofit hospital networks in the United
States, was achieving a 30-day readmission rate for Congestive Heart Failure (CHF) of 18.5
percent, ahead of the national average, which was above 20 percent. Its nurses followed up
with all CHF patients after discharge to monitor their status and ensure they were taking the
correct steps to ensure recovery.

Despite intensive, manual follow-up through phone calls and a relatively successful readmission
rate, this health system wanted to improve its readmission rate. The health system wanted to see
whether psychographic segmentation could enhance patient engagement and satisfaction, and
whether an automated, digital engagement platform could drive efficiencies in their efforts.

Approach:
The health system undertook a five-month pilot involving PatientBond, c2b solutions’ sister
company and platform for digital patient engagement and behavior change. PatientBond uses
c2b solutions’ psychographic segmentation model and insights to personalize communications
(emails, text messages, Interactive Voice Response) to motivate positive health behaviors.

29 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

CHF patients answered c2b solutions’ 12-question segment classifier survey before hospital
discharge. PatientBond sent 14 communications over 30 days post-discharge with education
supporting recovery. Each communication was personalized with psychographic insights and
included a patient response mechanism (e.g., short survey) to gauge recovery.

If a patient answered these survey questions in a way that flagged them as a readmission risk
(e.g., gained 2 pounds in a day or 5 pounds in a week, indicating fluid retention), then call
center nurses would receive text message and email alerts as well as a “red light” warning on
PatientBond’s dashboard. Patients who responded with no issues appeared as a “green light” on
the dashboard.

Results:
315 CHF patients were discharged during the five-month pilot. The following results were
achieved:

 90% reduction in 30 days all-cause readmissions (from 18.5% to <2%)

 62% patient response rate to 14 waves of psychographic communications
 94% of patients (age 65+) liked the electronic discharge process and digital
communications.

Response Status by Segment

800 100.0%

700 95.0%
91.7%
600 89.1%
86.9% 90.0%

500 83.5%
85.0%
80.0%
400 78.3%
80.0%
300

75.0%
200

100 70.0%

0 65.0%
All Patients Balance Seeker Willful Endurer Priority Juggler Self Achiever Directiion Taker
Direction Taker

Total Responses Green Responses Red Respnses

Responses % Green Responses

PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER 30

 PSYCHOGRAPHIC SEGMENT DISTRIBUTION
AMONG 315 CHF DISCHARGES

Balance Seeker
3%
Willful
Endurer
14% Direction Taker
Priority Juggler 37%
15%

Self Achiever
31%

For additional information on this case study, please download the FierceMarkets whitepaper,
Breakthroughs in Patient Engagement and Behavior Change: Reducing Hospital Readmissions and
Promoting Prevention of Cardiovascular Events.

31 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER

 ABOUT c2b SOLUTIONS

c2b solutions helps organizations succeed in
a dynamic healthcare environment,
leveraging consumer insights to achieve
superior results in the marketplace. c2b
solutions works with clients to deeply
understand the healthcare consumer and to
commercialize these insights through
business building innovations.
The experts at c2b solutions have extensive
experience in the healthcare industry, with
more than 50 years’ experience at Procter &
Gamble leading pharmaceutical and
Over-The-Counter medicine brands,
developing “Gold Standard” consumer
segmentation models and working with C-Suite
Executives, marketing & sales teams in
applying consumer insights to business strategy
and patient engagement efforts. For more
information, visit www.c2bsolutions.com.

Copyright 2017; All data and content property of c2b solutions, LLC

c2bsolutions.com

32 PSYCHOGRAPHIC SEGMENTATION AND THE HEALTHCARE CONSUMER