The Centers for Medicare/Medicaid Services project that between 2015 and 2022, the growth rate of consumers entering the Affordable Care Act (ACA) health care system will be 6.2%. While the stat will whet insurer appetites, there is little data available to describe this consumer segment—not only in medical terms, but in lifestyle terms. So instead of seeking everyone in this group in aggregate, health insurers would be better served by first gaining a foundational understanding of the uninsured consumer.
UNDERSTANDING THE POTENTIAL RISKS
Potential risk is a key issue when it comes to assessing the uninsured market, and risk can come in many forms, ranging from chronic conditions to unhealthy attitudes and behaviors. At a foundational level, two measures can give some basic insight: the number of chronic issues a person has and self-reported health status.
Chronic conditions can be used as a measure of inherent risk. Individuals can’t always control if they’re afflicted by a disease, and sometimes they’re born with them. There are, however, behavioral actions they can take to maintain/improve health and wellness, including physical activity. And when we look across insured, previously uninsured and uninsured consumers, we see a positive relationship between health status and the number of physical activities.
As one might expect, there appears to be a negative relationship between the mean number of chronic conditions that consumers report and health status. Uninsured consumers, however, seem to report slightly fewer conditions than insured consumers do. Although the difference is typically marginal, the pattern occurs across all levels of the health status measure.
To get a deeper, more complete view of the uninsured consumer, Nielsen Health Track pulls data from U.S. household into one of 66 segments. When we roll up this data by specific segments, like life stage (a combination of measures based on age, affluence and presence of children within a household), we get a much more precise picture of the uninsured consumer.
For health insurers, the solution to better understanding the opportunity is to better understand the consumer—and the associated risk. And to do that, the key is to examine an array of factors and characteristics about the uninsured rather than looking at them as a homogenous group.