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The Power and Promise of Healthcare Segmentation / Blogs / Perficient


The saying “one size fits all,” absolutely does not apply to the healthcare industry. Consumers are flat out demanding a more tailored approach to their health care.

To provide this type of more personalized and effective care and services, healthcare organizations (HCOs) need to take concentrated efforts to understand the diverse needs and preferences of their consumers. As reported in Global Research Health Network, this includes:

  • Identifying who the patients are and what beliefs, affinities and requirements shape their decision-making
  • Determining who to target, how to talk with them and how to best tailor communication strategies to resonate with them
  • Uncovering where to find these consumers and the drivers of their current behavior

That is where the value of healthcare segmentation comes into play.

What is Healthcare Segmentation?

Healthcare segmentation has emerged as a powerful tool for healthcare providers, payers, and other stakeholders to tailor their services and interventions. It is a strategic approach of dividing a population or target audience into distinct groups or “segments” based on certain characteristics, such as demographics, health behaviors, medical history, or other relevant factors.

Segmentation allows healthcare professionals, organizations, and marketers to gain valuable insights into their consumers’ behavior, preferences, and health care needs, and enables them to tailor their strategies, interventions, and communications to specific groups, thereby improving the efficiency and effectiveness of health care delivery.

Healthcare segmentation involves categorizing the population into distinct groups based on various characteristics. These categories can vary depending on the specific objectives of the segmentation strategy and the available data.

There are five common categories of healthcare segmentation:

  • Demographic: age, gender, race, income, education, and occupation.
  • Geographic: geographical location, such as region, country, state, city, or rural vs. urban areas
  • Behavioral: health behaviors, lifestyle choices, motivation, interaction with technology, and adherence to medical recommendations
  • Psychographic: attitudes, values, and interests and behaviors
  • Clinical: medical conditions, severity of illness, treatment responses and other clinical factors

These categories are often used in combination to create more comprehensive and nuanced consumer profiles, enabling HCOs to better understand their consumer populations and design targeted interventions and strategies to improve outcomes and satisfaction.

Unleashing the Value of Healthcare Segmentation

Healthcare segmentation offers immense value in the modern healthcare landscape. Through segmentation, HCOs can facilitate personalized care delivery, efficient resource allocation, improved engagement, targeted interventions, and better health outcomes. By tailoring health care services to specific consumer segments, HCOs can enhance satisfaction, optimize health care delivery, and drive overall system efficiency. Moreover, healthcare segmentation plays a crucial role in promoting health equity, reducing disparities, and fostering innovation in care delivery ******.

Let’s dig in.

Tailored Interventions

  • With advancements in medical technology and genomics, there is a growing emphasis on personalized medicine. Segmentation enables HCOs to identify subgroups of patients with similar characteristics or health profiles, allowing for more targeted communications, treatments and interventions that are tailored to individual needs and preferences.

Resource Optimization

  • In an era of limited resources and rising healthcare costs, optimizing resource allocation is critical for HCOs. By understanding the unique needs of different segments, HCOs can identify high-risk patients who require intensive interventions or resources, allowing for more efficient and effective allocation of resources and prioritizing and optimizing the distribution of health care services and cost savings.

Improved Patient Outcomes

  • Tailoring healthcare strategies to specific segments can lead to better health outcomes. Personalized interventions are more likely to resonate with individuals, encouraging continual engagement, positive behavior change and better health management and adherence to recommended treatments.

Enhanced Patient Experience

  • Consumers today are more empowered and informed than ever before, and they expect personalized experiences across all aspects of their health care journey. When health care services are tailored to individual needs, consumers are more likely to have a positive experience. This, in turn, can contribute to increased satisfaction, engagement and loyalty.

Health Equity

  • Understanding the unique needs and barriers faced by underserved or marginalized communities, HCOs can use segmentation to identify disparities in healthcare access, utilization, and outcomes among different population groups and develop targeted strategies to improve health equity and reduce disparities in health care delivery.

Data-Driven Decision

  • By leveraging data analytics and segmentation techniques, HCOs can make more informed decisions about resource allocation, service delivery, quality improvement initiatives, and strategic planning by analyzing trends and patterns of their populations.

Ultimately, by harnessing the power of segmentation, HCOs can strive towards the goal of delivering consumer-centered care and services, value-based care that meets the diverse needs of individuals and communities.

Challenges To Healthcare Segmentation

While healthcare segmentation offers numerous benefits, there are also challenges associated with implementing and effectively utilizing segmentation strategies. Some key challenges include:

Data Quality and Availability

  • Data may be fragmented across different systems, inconsistent, or incomplete, making it difficult to develop accurate and comprehensive consumer profiles.

Privacy and Compliance Concerns

  • HCOs must navigate complex privacy regulations, when collecting, storing, and analyzing patient data for segmentation purposes. Ensuring compliance with privacy laws while leveraging data for segmentation can be challenging and requires robust data governance and security measures.

Integration of Data Sources

  • Harmonize data from disparate sources, such as electronic health records (EHRs), claims data, surveys, and social determinants of health (SDOH) to create a unified view of the patient population for segmentation purposes can be a struggle in creating a unified view of the consumer.

Analytical Complexity

  • Analyzing large volumes of data to identify meaningful consumer segments requires advanced analytical tools and expertise and most HCOs lack the necessary analytical capabilities or resources to conduct sophisticated segmentation analyses effectively.

Accuracy and Validity

  • Developing accurate and valid consumer segments requires careful consideration of segmentation criteria and methodologies. Challenges related to the selection of appropriate segmentation variables, sample sizes, statistical techniques, and validation methods may arise.

Patient Engagement and Trust

  • Implementing segmentation strategies may raise concerns among patients about privacy, fairness and discrimination, and the use of personal data. Therefore, HCOs must communicate transparently with consumers about the purpose and benefits of segmentation to build trust and ensure engagement in segmentation initiatives.

Resource Constraints

  • Segmentation initiatives may require significant investments in technology, infrastructure, resources, and training. Those HCOs with limited resources may struggle to allocate sufficient resources to segmentation efforts or prioritize them over competing priorities.

Forging a Clear Path Forward

Healthcare segmentation holds immense value within the industry. By tailoring interventions to specific groups, healthcare providers can deliver more effective and efficient care, ultimately reducing costs and improving overall health management. However, challenges such as data privacy concerns, the need for sophisticated analytics, and potential inequalities in care must be addressed to fully realize these benefits.

As health care continues to evolve, the next frontier for segmentation lies in leveraging advanced technologies like AI and big data analytics to refine and expand segmentation strategies, ensuring that all patient groups receive the most precise and equitable care possible.

Have questions? We help the largest HCOs navigate intense technological and regulatory requirements, control costs, and delight patients and members. Perficient has been trusted by the 10 largest health systems and 10 largest health insurers to deliver transformative results. Contact us today, and let’s discuss your specific needs and goals.





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