Find out how Strategy& works with payor, provider, and life sciences clients seeking to become leaders in the consumerization of healthcare.

Consumerization — the acknowledgment of the growing role of consumers and the need to develop strategies and market offerings that fulfill their needs and preferences and fully engage them in an end-to-end customer experience — is becoming an imperative in healthcare for payors, hospitals and health systems, and life sciences companies.

Once considered the domain of consumer product companies, consumerization has spread to service companies in banking, insurance, and now, healthcare, as advances in technology and easy access to quality and cost data have empowered consumers.

Market forces in healthcare, including years of double-digit increases in the cost of care, the inability of employers to pay the ever-growing bill for employee medical benefits, and of course, healthcare reform, are driving a transformation among healthcare consumers.

Far from being the traditionally-passive recipients of care that was prescribed and financed by others, consumers are being called upon to take a greater hand in managing and paying for their own health. In response, they are quickly becoming better informed, more discriminating on price and quality, and increasingly willing to walk away from poor service.

As in other industries before it, the rise of consumerism is likely to precipitate a sea change in how business is conducted in every sector of the healthcare industry. The industry, which has been focused on its institutional stakeholders — insurers, employers, and hospitals — will shift to a new basis, in which health plans, care delivery, and even administrative services are reoriented to focus on individuals and families.

Significant change will be required to thrive in a consumer-centric environment, and the winning players will be those insurers, hospitals, physician networks, pharmaceutical and other health care companies that can successfully apply a deep, nuanced understanding of consumers to the development of new business models, capabilities, and offerings.

We are already seeing some healthcare players embrace consumerization. Health plans are creating websites that connect their members with care providers and enable them to better monitor and manage their own health. Providers are shifting from opaque, volume based, fee-for-service models to alternatives including fixed price episodic bundles, which are transparent to patients.

Pharmaceutical companies are offering patients discounts on prescription refills to raise treatment adherence levels. As ideas such as these multiply and spread, consumerization will produce more personalized experiences at every customer touch point in healthcare, and by fully focusing on and engaging the consumer, the long-sought promise of improved outcomes and reduced costs will be realized.

PwC’s Strategy& strongly believes that consumerism is a revolutionary force that will fundamentally alter the status quo in the health industry. Revolutionary times are always difficult to navigate and fraught with risk, but they are also exciting and rich with opportunity.

We work with our clients as they seek to understand all the implications of this new world and become leaders in the consumerization of healthcare.


Putting an I in Healthcare
The days of the disengaged health consumer are numbered. Consumerization will transform healthcare systems, involving individuals as never before...

How we can help you

  • Payor
  • Health systems and other providers
  • Life sciences

The rise of consumerism in the health insurance sector is already underway. Large groups are shifting coverage decisions and management to their members, and insurance exchanges are stimulating growth in the retail segment of the market. A new surge of individual insurance buyers will force ever greater attention on the needs of members as opposed to employers.

In the coming years, as the basis for the health insurance sector is transformed, leading payors will pursue consumerization by shifting their focus from business as usual to the development of new business models, capabilities, and offerings that will rival sophisticated consumer product companies, such as Apple and Proctor & Gamble.

PwC’s Strategy& works with payors in the design and execution of consumer-centric strategies to not only win share in the fast-growing retail markets, but also support the cost reduction and outcome improvement necessary for a vibrant, sustainable healthcare industry. We recognize the difficulty of undertaking such fundamentally transformative and cross-functional change. Our teams have the deep experience and expertise in every key aspect of the insurance value chain and care delivery spectrum, the development of consumer capabilities, and the planning and implementation of large-scale change management that is needed to successfully achieve it. Service offerings include:

  • End-to-end transformations help payors design and implement consumer-centric strategies, operating models, and capabilities, including current state assessment, strategy formulation, and prioritized implementation plans.
  • Consumer-centric operating model and customer experience services assist payors as they design operating models and tailor end-to-end experiences that enable the identification and enhancement of consumer touch points at every point, starting with the path to purchase and extending throughout the member relationship.
  • Consumer-driven care delivery and engagement services support payors as they seek to surface behavioral insights and leverage them to craft member interactions and interventions that can help members better manage their own care and improve cost and care outcomes.
  • Consumer-driven product innovation services provide a detailed understanding of member-level market demographics, customer segmentation, lifetime customer valuation, purchase drivers, and price sensitivities. These services yield the deep consumer insights needed to produce compelling offerings that can attract and retain target members, and aid in the development of the consumer capabilities essential to building more profitable portfolios over time.

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The rise of consumerism is adding to the already considerable challenges facing care providers of every kind. In addition to grappling with increased demand, the rising cost of care, and the need to improve outcomes, hospitals and health systems, physician groups, and service providers alike are being called upon to become more patient-centric in every aspect of their performance.

As out-of-pocket costs continue to rise, consumers are demanding more transparency in the price and quality of care. They also expect services and products that are tailored to their wants and needs, and are demanding customer service that is comparable to the high levels of service that they receive in the most consumer-friendly industries.

PwC’s Strategy& works with care providers to create the strategies needed to succeed in an environment in which clinical integration, cost control, and consumerization are inextricably linked together in ways that are transforming the very basis of competition.

Our dedicated global health practice brings the foresight, knowledge, and deep industry and organizational expertise needed to identify and assist in the development of patient-centered business models, capabilities, and product and service portfolios that can lower costs, generate better outcomes, and deliver more compelling patient experiences. It will take nothing less to compete and prosper in increasingly consumer-centric healthcare markets. Service offerings include:

  • Consumer-driven product innovation services assist our clients in the development of healthcare bundles that bring together all of the care, coverage, and support required by a specific treatment or procedure into an integrated solution and compelling patient experience.
  • Consumer-driven care delivery and engagement services support our clients as they seek to optimize care delivery, expand into non-traditional channels, such as retail clinics and pharmacies, and provide consumers with more personalized and lower cost care.

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As out-of-pocket costs continue to rise, consumers are ever more sensitive to the value and price of health products, and are increasingly opting for generic and discount brands when they cannot discern a clear advantage to buying premium brands. Life sciences companies are pursuing consumerization in order to better focus on and respond to the needs of these new, financially-minded healthcare consumers.

PwC’s Strategy& assists pharmaceutical, biotech, medical devices, and diagnostics companies to develop the business models, capabilities, and product portfolios that will enable them to more efficiently and effectively compete in consumer-centric markets. The capabilities-driven strategies that we work with our clients to develop identify and capture new opportunities for growth by fostering consumer engagement. Built upon a foundation of successful assignments for life science companies, their customers, and their regulators, the breadth and depth of our experience and expertise in the sector is unparalleled. Service offerings include:

  • Direct-to-patient services assist our clients as they work to enhance their existing channels through the development and seamless integration of patient-centric tools, such as eHealth, DocFinder, and adherence and compliance applications.
  • Patient-centric value-beyond-the-pill services enable our clients to complement their traditional products offerings with value-added services designed to improve patient adherence, compliance, and outcomes.
  • Consumer-centric medical management transformation services assist our clients to simultaneously decrease costs and capture the full potential of their product from lower hospital admissions and disintermediation power.
  • Consumer product goods enabled growth services enable our clients to understand and generate desired consumer behaviors using analytical tools and best practices derived from the consumer product goods industry.
  • Patient advocacy association focused partnership services support our clients as they seek to foster cooperation and build relationships with patient associations in their quest to deliver value to consumers and other stakeholders.

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