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Health care & millennials

Millennials Defined

Millennials — The millennial generation — those born between 1982 and 2000 (currently ages 16 to 34) — now number an estimated 83.1 million. They have surpassed the Baby Boomer generation (ages 52 to 70), previously the largest, according to the U.S. Census Bureau.

The connected, tech-savvy millennial generation already is influencing every aspect of health care — from the cost structure to the way providers deliver services, including changes in the way doctors perform operations, the way manufacturers roll out devices to make do-it-your-self diagnosis easier and the way insurers court potential customers.

Obamacare: The Invicibility Factor

Many millennials are burdened with big student loans. That debt load — along with the feelings of invincibility that go along with being young — have made many millennials who are not covered by employer health plans reluctant to sign up for insurance plans offered through the federal Affordable Care Act — Obamacare.

Data from healthcare.gov indicate that people ages 18 to 34 made up only 28% of Obamacare enrollees as of March 2015. Experts say millennials are making choices based on a narrow cost-benefit analysis. Faced with choosing between fines and a smorgasbord of insurance choices, many are simply choosing to remain uninsured. “Millennials feel young and healthy and are skeptical about spending on health insurance,” says Ceci Connolly, managing director of Price water house Cooper’s Health Research Institute. “If they aren’t making a big salary, it’s hard to convince them to shell out several hundred dollars a month for health coverage they don’t think they are going to need. It’s a hard sell.”

Meanwhile, however, the financial structure of Obamacare makes enrolling young adults pivotal because this age group tends to have low anticipated medical costs; their premiums, while low, serve collectively to subsidize the health care costs of their elders.

When it comes to their health, millennials ...

  • Take a broad, holistic approach. They are interested in broader notions of wellness than just traditional health care or "sick care."
    "Serving these consumers will involve alternative medicine, promoting healthier lifestyles, exercise, diet and mindfulness. They want more than just 'what's my health insurance policy?' " says Ceci Connolly, managing director of the Health Research Institute.
  • Are concerned about their appearance. More than half of millennials (55%) report their motivation for participating in corporate wellness programs is "to look good," according to a survey of 2,700 U.S. employees and their dependents by Aon Hewitt and the National Business Group on Health and The Futures Co.
  • Like to use technology. More than other demographic groups, millennials are likely to use technology as a complement to their fitness routines, employing health apps and wearables to track their steps, monitor their heart rate or find the healthiest foods, according to Pew Research Center.
  • Want results, fast. Many millennials "have fitness ADD. They get bored quickly and don't stick to anything. Knowing it took a year or more to put weight on, they want it off in 30 days. The immediacy they are used to with text messages has carried over to their health and fitness," says Matt Pack, owner of Primal Fit Miami, a personal training facility in Miami Shores.

Convenience

71% - In a survey by HIT Consultant (a health care technology website), 71% of millennials said they would be interested in a doctor/provider giving them a mobile app on their smartphone or tablet for preventive care, to review health records and to schedule appointments. Embracing the trend, patients who are seen in the UF Health network at Gainesville or Jacksonville hospitals and UF Health Physicians clinics in Gainesville and Jacksonville receive access to a website and app that allows them to see their test results, request prescription refills, communicate with providers and manage appointments.

Research

In studying health care trends, PNC Healthcare found millennials also make health care decisions by shopping online for doctors, using online diagnostic tools and researching treatment options on the internet. Nearly 50% of millennials use online reviews such as Yelp or Health grades when shopping for a health care provider, compared to 40% of Baby Boomers and 28% of seniors, PNC found.

Say 'Ahhhh' to the App

When Sarah Crilley's throat was so raw she could barely swallow, she called her doctor. As she described her symptoms, she took out her iPhone and took a picture of her throat. With a few taps on the screen, Crilley sent the photo to her doctor miles away in his office. "It was so convenient," she says. "I had a prescription a few hours later."

Tech-savvy and cost-conscious millennials such as 25-yearold Crilley are driving big changes in health care delivery. Many no longer want or need much face-to-face interaction with a physician. They want convenience, and they use technology to get it. "They want mobile apps and digital tools that will help them manage their health and wellness, and they want them at the touch of a finger," says Ceci Connolly, managing director of the Health Research Institute.

One such health app is CellScope's Oto, which combines an app with an attachment that lets you turn your iPhone into an otoscope, the instrument physicians use to look into theear. The attachment allows young parents to capture, on video, an examination of their children's ears and send it to a physician.

Along with apps, experts say social media will play an increasing role in health care. Baptist Health South, for example, tries to engage the community with a mobile app people can use to find the closest emergency rooms and shortest wait times using their cellphones. It also uses Twitter, Facebook, YouTube, Pinterest, FourSquare, Instagram and LinkedIn. Members and patients also are using social media to communicate with insurance companies and providers. The Health Research Institute said physicians who want to engage the millennial generation are going to have to learn to use social media and allow millennials to contact them digitally.

Jean Hippert, senior vice president of PNC Healthcare, says the insurers and health care providers who adapt sooner rather than later to the preferences of this young, technology-driven generation will survive and thrive.

Eye on the Bottom Line

For Jimmy Sinis, a 30-year-old Miami designer/manager, being a marathon runner pays off. Not only is Sinis exercising, his hobby allows him to get the points he needs to reach the gold level and earn a discount on his employer-sponsored health insurance. “It’s an incentive to be active,” he says.

Sinis says millennials like the idea of receiving an insurance discount for being young, healthy and in good shape. They are participating in company wellness programs and even wearing company-issued fitness tracking devices to keep their insurance costs at a minimum.

A survey by FAIR Health found that the cost of health insurance was a top concern for millennials, unlike members of older generations who tended to select insurance plans based on whether their preferred doctor was included in the network.

The survey found cost-conscious millennials are choosing health plans with high deductibles, banking on their ability to stay healthy and cure themselves with over-the-counter medicine. Sinis’ deductible is $2,000 — “which makes you think twice about going to the doctor,” he says.

Insurers realize they have their work cut out for them in marketing to millennials, who are the largest generation in the U.S. and will grow to dominate the market in the years to come.

Florida Blue says it has recognized that millennials are savvy shoppers. “Many of our educational seminars and community outreach events are aimed at helping millennials understand health insurance and the Affordable Care Act and why it’s important to have insurance and get regular check-ups even for those who are young and healthy,” says Doug Bartel, director of public affairs for Florida Blue.

Bartel says many millennials are comfortable shopping for insurance online, using apps and mobile websites, but Florida Blue also finds some millennials want to speak face-to- face with an adviser — one reason the company has opened 21 retail centers across the state.

Costs: Searching for Deals

If reading your medical bill gets easier and medical costs more reasonable, you will have millennials to thank in part. Millennials are twice as likely as the general population to challenge the cost of their medical care and search for better deals, according to a Price water house Coopers report called “Money Matters: Billing and Payment for a New Health Economy.”

Having grown up comparison-shopping on the internet, 19% of 1,000 consumers ages 25 to 34 said they had asked for a discount on medical care, compared with just 8% of the general population. Millennials also revealed they are nearly twice as likely as the general population to ask for cheaper treatment options and to seek help from providers to pay for costly medical bills, according to the PwC report.

With an eye to the future, more hospitals are working on simplifying the way they bill patients. They are embracing online and mobile bill payments and creating online tools for patients to get estimates — all things that are important to millennials, the PwC report found.

19% Percentage of 1,000 consumers ages 25 to 34 surveyed who have asked for a discount on medical care

8% Percentage of the general population that asked for discounts

Plan Options

Under the Affordable Care Act, young adults are allowed to stay on their parents’ health insurance plans until they turn 26. And that’s what many are doing, according to a report by ADP Research Institute. Of employees under age 26 who are eligible for health insurance at work, only 44% took it. However, as they got older, their coverage changed. Three-quarters of eligible employees ages 26 to 39 enrolled in an employer health plan, the survey found.

Billing

According to “Money matters: Billing and Payment for a New Health Economy,” a new report from PwC’s Health Research Institute, millennials want to use mobile and computer technologies to quickly review their bills and pay them — in the same way they pay electric or cable bills or shop for products online. Unfortunately, they are finding U.S. health care lags other industries when it comes to digital payments and payment communications.

Campus Trends: More Services, Different Problems

Decades ago most colleges and universities maintained health centers to treat the sick and injured. Today, student health centers have to meet the demands of a generation that expects a full range of services.

On an ordinary day in Gainesville, students stream into the Student Health Care Center at the University of Florida. They may be coming to get a flu shot or to get an antibiotic for a urinary tract infection. They may be coming to be seen for a scooter injury, for a sports injury or to be screened or treated for sexually transmitted diseases.

Guy Nicolette, director of the UF Student Health Center, says the increase in students who are active in intramural or weekend sports has led to more injuries and more staffing of sports medicine professionals at university health centers. Instead of just using X-rays when students come in, the university also uses ultrasound more often to evaluate bone, joint and muscle injuries, Nicolette says. “The students want us to use the latest technology.”

Mental Health

From 2008 to 2013, Florida universities reported their enrollments grew by 13%, but their counseling centers saw a 48% increase in the number of clients and a 67% jump in therapy sessions. The most common complaints were depression, anxiety and academic-related stress.

According to a survey by the American College Health Association, one in six college students nationally has been diagnosed with or treated for anxiety within the last year, which has surpassed depression as the most common mental health diagnosis among college students.

In response to understaffing, the State University System’s board of governors has made a $20-million request to improve staffing at counseling centers and police departments.

STDs

Nationwide, nearly half of the 20 million new sexually transmitted diseases (STDs) diagnosed each year are among people ages 15 to 24. Guy Nicolette, director of the UF Student Health Center, says the university has responded to the nationwide concern and launched a free Get Yourself Tested Initiative through the Alachua County Health Department for students who don’t have any STD symptoms. “We fill all the time slots every week,” he says.

Wellness as a Recruitment Tool

How do you transition your company’s workforce into one that attracts millennials?

Smart City Telecom in Lake Buena Vista discovered that a corporate wellness program is one way. Three years ago, the company, which provides telecom services to Walt Disney World Resort and Celebration, opened an on-site fitness facility, where it also offers weekly yoga classes. In addition, the company brought in a personal fitness consultant to work one-on-one with its employees at no cost to them. The company also has a team that trains for 5k runs during lunch. “We have just under 100 employees and about 65% participation in our Get Fit program,” says Tracie Wilczynski, human resources director at Smart City Telecom.

The majority of the company’s employees are long-tenured, with more than half over age 50. “People are retiring, and there’s a natural succession going on,” Wilczynski says. She has found the wellness programs help recruit millennials. “From an HR perspective, our robust fitness program is definitely a key selling point,” she says.

Marketing to Millennials

Tech-Savvy Patients

When millennials come for a consultation with Dr. Carlos Lavernia, a Miami orthopedic surgeon and director of the Center for Advanced Orthopedics at Larkin Hospital, he sees a pattern. “They want to know if you’re using technology to make an operation safer and better.”

Lavernia, whose specialty includes hip and knee replacements, uses MAKOplasty, a robotic arm that allows for more accurate implant placement, shorter hospital stays, quicker rehabilitation and a smaller scar.

In February, Lavernia will offer patients full knee replacements using a more advanced roboticassisted surgery he helped develop with millennials in mind. Where doctors are performing roboticassisted surgery with imaging as their guide, the new procedure will allow surgeons to use 3-D technology to achieve a new level of precision. “It will change the face of knee replacement,” he says.

While most of Lavernia’s patients are older, he finds an increasing demand from the younger set. “Millennials have started to exercise a lot earlier, and they do not always do proper training. A lot of them are hurting themselves,” he says.

Like Lavernia, sports medicine physician Jason Pirozzolo, with Orlando Hand Surgery Associates, understands how important using the latest medical techniques is to his young patients. He also realizes the significance of using digital marketing to reach millennials.

Pirozzolo, 38, who is on the board of governors of the Florida Medical Association, uses a combination of platforms to reach potential young patients — Facebook, Twitter and YouTube, for example. Pirozzolo’s practice also uses a “geo fence” to track publicly posted social media conversations and lure business. For example, if someone in downtown Orlando sends a tweet saying his shoulder hurts, Pirozzolo uses a program that sends a reply: “If you need help with your shoulder, give us a call, we have an opening today.”

Because his specialty is sports medicine, Pirozzolo says that embracing technology is critical to attract younger, athletic patients. “Most physicians are acknowledging that marketing on social media is where health care is going. But there’s a difference between acknowledging it and making that change.”