US Healthcare Consumer Insights and Engagement Survey: PwC

The healthcare transformation continues, propelled by cutting-edge technology and rising patient expectations. PwC’s 2024 US Healthcare Consumer Insights and Engagement Survey delves into this complex interplay of factors, from ongoing consumer concerns over affordability and access to consumers’ adoption of tech-enabled healthcare and trust in the healthcare system.

The healthcare lottery: 28, 50, 65, 80

Four findings from the survey capture healthcare cost and navigation problems still in need of solutions as well as opportunities to help educate and engage consumers in preventive health and provide the care options they prefer:

28%

of consumers skip, delay or stop care because they can’t afford it, a number that rises higher among Gen Z (39%) and millennials (33%).

50%

of consumers ages 55-64 prefer a doctor visit over virtual visits compared to 34% of those 25-34.

65%

of consumers don’t seek care until it’s urgent.

80%

of consumers ages 18-34 are willing to use generative artificial intelligence (GenAI) in healthcare compared to less than 60% of consumers over age 55.

Old problems need new solutions.

Healthcare isn’t affordable for many. No surprise? That’s a problem.

If the news that healthcare isn’t affordable for many consumers isn’t a surprise, that’s a problem — and one that needs new solutions. The differences in consumer responses among generations, and among all consumers’ ability to pay for healthcare, are striking. We know the medical cost trend is rising to its highest level in years, not good news for the consumers who can’t afford their healthcare and medications. Now is the time for payers, providers and pharma to ramp up every cost management strategy and remain relentless in the mission to make healthcare and medications more affordable.

It's also the time to proactively help consumers estimate the cost of their care as well as compare costs for tests and procedures and choose sites of quality care that come at a lower cost. As well, let patients know about all the help that may be available to them, such as patient assistance programs that can provide financial assistance or free or discounted medications.

In sickness but not in health: 65% don’t seek care until it’s urgent

For years, the industry has worked to shift consumer attitudes and behaviors from seeking sick care to preventing chronic illness in efforts to help keep people healthier and ratchet down the spiraling costs of healthcare. Yet 65% of consumers say they don’t seek healthcare until it’s urgent.

Gen Z (39%) and millennials (33%) are far more likely to postpone care than baby boomers (18%), perhaps because the older generation has more chronic illness or is more accustomed to interacting with the healthcare system.

The opportunity field remains wide open for payers, providers and pharma to engage with consumers through targeted health education and outreach to members and patients — encouraging and incentivizing them to seek preventive care before they become sick.

Gen Z and those who can’t afford healthcare struggle most to navigate the system

Among Gen Z, 46% find it difficult or very difficult to know where to go when they need healthcare. Meanwhile, 30% of all consumers who say healthcare costs strain their finances don’t know where to go for healthcare.

It’s important for the industry to continue to simplify healthcare processes and to build health ecosystems around the patients who need extra support for their social, medical and behavioral services needs along with traditional medical care.

Consumers, especially those under 35, warm up to healthcare technology — within limits

Consumers are increasingly warming up to online tools powered by GenAI for routine tasks like making appointments, viewing test results and refilling prescriptions. The generational divide is prevalent though, with 80% of consumers ages 18-34 willing to use GenAI compared to less than 60% of consumers over age 55. One in five consumers is ready to use GenAI as a doctor’s assistant, while enthusiasm among other consumers is tempered by worries about data privacy and the quality of care.

An in-person doctor visit is still the preferred communication method over virtual care for most consumers, but there are broad differences by generation: 50% of consumers ages 55-64 prefer a doctor visit over a virtual visit compared to 34% of those 25-34.

The insights reinforce the importance of explaining and offering trustworthy and convenient digital, virtual and other care options that can suit consumers’ busy lives — and to understand and act on the differences among consumers’ comfort levels for digital and virtual care. It’s also the time to confirm that safeguards are in place to protect consumer data and that the use of responsible AI is standard practice.

Are doctors losing relevance among some generations?

Doctors continue to hold a strong trust advantage as the primary source of health information among all consumers. However, trust in doctors swings widely among generations, ranging from 40% among ages 18-24 compared to 84% among consumers 65 and older. A growing number of younger consumers are turning to technology as their first stop when they have health questions. This digital shift signals a future where traditional providers may need to engage differently with patients or risk becoming less relevant as a trusted information source among younger patients.

What the insights tell us: There is no typical healthcare consumer, and Gen Z is in the house

Consumers experience the healthcare system differently according to generation, health status and their ability to pay for their healthcare. Gen Z is now the largest generation in the world, defined by the US Census as those born between 1997 and 2012 — and these digital natives have their own preferences, questions and needs.

Our survey insights are a rallying cry to the industry to continually deepen personal connections with consumers in the digital age. Getting closer to consumers, treating them as individuals with specific needs and making healthcare more affordable and easy to use are all critical in creating a healthcare system that can work for all consumers.

Healthcare consumer themes emerge

Distinct consumer themes emerged as our survey delved into health behaviors, digital adoption, affordability and value, loyalty and trust, and barriers to healthcare navigation. Success hinges on understanding nuanced consumer needs to deliver effective, accessible and patient-centered care. Read more about what more than 2,000 consumers told us.

Digital and virtual adoption: consumers cautiously clicking

The days when digital healthcare meant only a Google search and WebMD are fading fast. Today's health-savvy consumers are increasingly using digital tools, even if they’re doing so with a measure of caution.

About half (51%) of consumers are clicking and tapping their way through healthcare plans and provider information. The digital tools they use most often enable them to view test results and book appointments online.

The industry's challenge is to deliver high-tech solutions that also provide the human touch.

An in-person doctor visit or phone call is still the preferred communication method for most people, but there are differences by generation. For example, 50% of consumers ages 55-64 prefer a doctor visit over virtual visits compared to 34% of those 25-34. Virtual care is becoming a go-to among some for follow-ups and preventive care, with three in 10 virtual visitors using it for mental health or prescription management. But not everyone is on board: Four in 10 consumers are still hesitant about virtual visits. Among the uninsured, none had virtual visits in the last 12 months.

Artificial intelligence (AI) is making its way into healthcare. Consumers appear open to letting AI handle a range of routine tasks such as scheduling appointments, refilling medications and updating contact details. While one in five consumers is ready to use GenAI as a doctor’s assistant, others are more reluctant — especially older generations.

Considering how many consumers still prefer human interaction through in-person doctor visits over virtual care, the industry's challenge is to deliver high-tech solutions that can also provide the human touch.

Why this matters

You can help consumers become more comfortable with digital health care by improving the digital patient experience.

All stakeholders: Digital solutions can help create better care outcomes, but delivering a unified digital healthcare experience can be challenging when organizations are integrating an assortment of digital solutions provided by a variety of vendors. When done poorly, it can feel like a disjointed patchwork for consumers to sift through to find care, schedule appointments, complete forms and make payments. Managing a health condition and medications, communicating with care teams and accessing telehealth or digital therapeutics — it can get complicated for consumers. Data should flow seamlessly across different vendor solutions and internal systems. Inconsistent or siloed data can hinder the effectiveness of AI algorithms, leading to wrong conclusions and unsatisfying patient experiences.

Back to healthcare consumer themes

Affordability and value: the financial divide

Affordability of healthcare varies among consumers. Four in 10 consumers find their healthcare costs manageable but couldn’t afford to pay more, three in 10 struggle with current costs, and three in 10 could afford to pay more.

This financial divide is reshaping care decisions. Those who can manage costs are more likely to be in good health, to understand their coverage and to be satisfied with digital services. In contrast, financially strained consumers often deal with serious health issues, struggle to maneuver through the system and face uncertainty about their insurance coverage.

These disparities have consequences: 28% of consumers say they have delayed, skipped or stopped treatment due to costs, with younger generations feeling the pinch more acutely. Gen Z (39%) and millennials (33%) are far more likely to postpone care than baby boomers (18%). More than a third (35%) of women say they struggle to find time to see a doctor. The stakes are even higher for those with health issues significantly impacting their quality of life — 44% of this vulnerable group have put off care due to financial constraints, potentially exacerbating their conditions.

Consumers also want to improve their overall patient experience through simplification of the healthcare maze and shorter appointment waiting times.

As costs rise, so does the need for a healthcare system that can balance affordability with the personalized care consumers crave.

Less than a third of consumers say they would be likely or very likely to spend extra on what might be considered "healthcare luxuries," which tracks with those who say they could afford to pay more for their healthcare. Personalized services such as blood testing and priority access to clinicians top their wish lists. One in four are willing to pay more for tailored nutritional and workout advice. Sixty-one percent of consumers aged 45 to 54 would be more likely to pay for genetic testing to understand their risk of hereditary diseases and tailored nutritional advice such as weekly meal plans and advice on vitamins and supplements.

This trend suggests that for those consumers who can afford it, healthcare is about curating a bespoke wellness experience.

When it comes to prescriptions, eight in 10 consumers have taken medication in the past year, with specialty treatment users more likely to struggle with payments. While one in three (more likely to be millennials) have brand preferences, those with serious conditions often feel less control over their treatment. In fact, 61% of consumers with health issues that significantly restrict their quality of life have difficulty managing the costs of their medication, compared to 44% of consumers overall.

As costs rise, so does the need for a healthcare system that can balance affordability with the personalized care consumers crave. The challenge? Those struggling financially also find it harder to manage the healthcare system and engage with digital health tools.

Why this matters

It’s time to meet affordability head-on through total cost of care management.

Health plans and pharma: Take a holistic approach, focusing on reducing wasteful spending, leading to transformative changes in the marketplace such as new pharmacy benefit management models, integration of medical and pharmacy benefits, enhanced transparency and member navigation. Delve into next generation capabilities including investing in AI or machine learning to proactively help identify wasteful spending and address operational inefficiencies. Smaller plans should look to external vendors or work with other like-minded health plans to build competitive total cost of care management capabilities.

Providers: Educate members about making choices in obtaining healthcare services. Reduce unnecessary spending by adhering to evidence-based guidelines and understand the impact on economics from increased total cost of care management efforts. Providers can also continue to participate in value-based care arrangements that often reward them for reducing wasteful spending.

Employers: Use transparency and better reporting to understand the outcomes and effectiveness of your health plans’ cost of care management efforts. Employer demand for better value in their health benefits is incentivizing health plans to demonstrate outcomes such as independent validation from their vendors.

Back to healthcare consumer themes

Trust and loyalty: a shifting landscape

Providers are testing various new channels to engage and build trust with today's consumers. For the time being, doctors — the traditional stalwarts of health information — command the most trust. But for how long? A growing number of younger consumers are turning to technology as their first stop when they have health questions. This digital shift signals a future where traditional providers may need to adapt or risk becoming less relevant as a trusted information source. Our research shows that for routine healthcare needs, convenience is the primary factor for many consumers when choosing a provider, with location and accessibility being key considerations. But patients with more complex health issues prioritize specialized expertise over convenience.

Most consumers say their most trusted source of health information is their doctor, followed by, in rank order: an internet search engine, the pharmacy, close family and friends and their health insurance plan.

The role of pharmacies has grown from medication dispensaries of years ago to trusted information sources. Sixty percent of consumers place their trust in pharmacies, which are expanding their offerings, even stepping into areas like blood tests and X-rays, traditionally the domain of clinics and hospitals.

Yet despite patient assistance programs and other measures introduced by pharmaceutical manufacturers and medtech companies to improve trust, only 6 percent of consumers turn to pharma or medtech as a most trusted source of information.

The payers, providers and pharma organizations who can blend accessibility with personalized care can break down barriers and win the loyalty of today’s healthcare consumers.

Meanwhile, tech company giants continue to make inroads into wellness and preventive care. Along with large retail brands, they are earning consumer trust in healthcare — a sign that the delivery model may be on the verge of a major transformation.

If success for healthcare providers lies in striking the right balance between traditional expertise and the convenience and innovation that modern consumers expect, a similar lesson holds true for payers. When selecting a health plan, consumers 55 to 64 years old are more likely to place importance on the network of healthcare providers, while 18- to 24-year-olds place more importance on flexibility of the plan and additional benefits.

Why this matters

You have the power to build trust and loyalty by offering consumers convenience, personalization, advocacy and transparency.

Health plans, providers: Use customer attraction and retention strategies to help deliver personalized and convenient healthcare tailored to individual needs. These core capabilities include new care delivery models that can meet consumers where they want to access care while keeping administrative costs low; “digital front doors” for members and patients to access care solutions and resolve basic account management and payment tasks in one place; advanced analytics including AI and GenAI to aggregate customer insights, understand their preferred engagement channels, anticipate their needs and help the entire care team create a unified experience that can ultimately reduce costs — meaning that savings can be passed on to members.

Health plans, providers, pharma: Become more transparent to earn consumer trust. Data protection is paramount for consumers. Being more transparent about corporate data policies may be one of the easiest ways to earn consumer trust. Being more transparent may also become table stakes in the new world of personalization that’s being turbocharged by the growing tide of companies sharing data with other firms. Consumers remain wary of how their information is being used and whether it can be accessed by hackers. Being open about how data is stored, used and sold may help a company preempt misinformation about their privacy policies and procedures during a crisis.

Strive to deliver a consistently excellent consumer experience, regardless of channel, to gain loyalty.

Back to healthcare consumer themes

Navigating care: an obstacle course for some

Care navigation appears to be an obstacle course for some. Seven in 10 consumers say they have no trouble making appointments or understanding what’s covered by their insurance. Yet, for others, the system is still an obstacle course. Consumers who can’t afford the cost of their healthcare find the healthcare system difficult to manage.

When seeking care, half (51%) prefer the familiar: in-person visits to their regular doctors. But those struggling with healthcare costs are nearly twice as likely to end up in emergency rooms compared to those who can afford their care. Younger consumers and those with fewer health concerns tend to opt for the convenience of walk-in clinics.

In fact, two-thirds of consumers say they put off visiting a doctor until it’s urgent. This signals a continued need for targeted preventive health education from health plans, providers and employers. And with nearly half of Gen Z saying they don’t know where to go for healthcare, payers and providers have an untapped opportunity to better engage and guide this young cohort.

Meanwhile, 45% of all consumers say they opt first for a DIY approach to health, preferring to manage their health on their own rather than seeing a doctor. Women are more likely than consumers overall to delay doctor visits, largely due to time constraints and the demands of caring for others.

This trend underscores a critical insight. Personalization in healthcare is about offering convenience and speed that fits seamlessly into busy lives. Digital health solutions could be the key to unlocking a new level of personalized care.

Two-thirds of consumers say they put off visiting a doctor until it’s urgent. This signals a continued need for targeted preventive health education. And with nearly half of Gen Z saying they don’t know where to go for healthcare, payers and providers have an untapped opportunity to guide this young cohort.

Why this matters

Consumers and patients need you to redouble your education and outreach efforts and knock down barriers to care.

Health plans, providers, pharma: Continue to educate consumers about healthy, proactive prevention and lifestyle choices and support for their health and well-being, targeting messages to reach consumers at the right time and through the right channel. Organizations should begin with a customer strategy to determine the needs of each segment and then consistently engage customers in every interaction across products, services, solutions and brand messaging. Increase efforts to help Gen Z understand their healthcare options, beginning with where to access care, and expand outreach to women who may be sacrificing care as they balance other demands on their time. For those consumers who face more barriers to healthcare, create community ecosystems around patients and coordinate their social, medical and behavioral services along with traditional medical care. A large university health system, for example, has successfully brought together community health workers, community clinics, large retailer wearable device companies and cloud-based health management applications to help provide diabetes management to vulnerable, chronically ill populations.

Employers: Continue to offer healthy lifestyle programs and wellness education to employees and look for all opportunities that can boost employee engagement in your programs. The workforce of the future will house four generations, and understanding employees’ distinct generational preferences and needs will be essential in delivering tailored programs and targeted communications.

Back to healthcare consumer themes

Consumers have spoken. It’s up to the industry to listen and respond.

Consumers have spoken. It’s up to the industry to listen and respond to these fresh consumer insights, and PwC can help. We’re launching a new series of articles in the coming weeks that will outline the steps payers, providers and pharma can take right now to rewrite the future of healthcare in real-time, reshaping services and redefining care delivery.

Success for health plans, providers and pharma hinges on understanding nuanced consumer needs to deliver effective, accessible and patient-centered care.

About the survey

PwC conducted an online quantitative survey and captured insights from US consumers on their attitudes and opinions towards the healthcare system. Fieldwork was conducted April 20-May 4. A nationally representative sample of 2,036 US consumers with quotas by age (18+), gender and region, insured and uninsured was achieved. Topics included digital adoption, affordability, value, trust, loyalty and barriers to use of healthcare.