Do you know your Customers: The Power of Personas and Segmentation in Healthcare Strategy

In today's fast-paced healthcare environment specially for Medicare Advantage, knowing your customers isn't just a luxury—it's a necessity. Whether you’re working with healthcare providers, insurers, or retail health services, understanding your audience on a deeper level drives better engagement, care outcomes, and business growth.

Two key tactics for truly knowing your customers are personas and segmentation. By combining these approaches, healthcare organizations can tailor their strategies to meet the diverse needs of their patient populations and deliver more personalized care. In this article, we’ll dive into the importance of each and discuss actionable tactics you can use in your healthcare strategy.

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What Are Personas and Why Do They Matter?

Personas are fictional representations of your ideal customers or patient groups. They’re created by analyzing data and insights into your target audience's behaviors, motivations, pain points, and needs. By giving a "face" and a story to your target audience, personas allow you to think more empathetically and strategically about how to serve them.

Tactics to Build Strong Personas:

1. Conduct Qualitative Research: Start by conducting interviews and surveys with your patients or healthcare consumers. Ask about their health concerns, how they access care, and the factors that influence their healthcare decisions. Conduct atleast 30 interviews to find patterns in goals, motivations and behaviors and additional interviews for outliers.
2. Leverage Data Analytics: Use data from Electronic Health Records (EHRs), claims data, or customer service interactions to identify patterns in patient behavior and demographics. A customer data platform enables to view the member as a whole and drive Personas/ Segmentation as a whole
3. Identify Key Demographic Segments: Focus on age, income, education, and other socio-economic factors like Social Vulnerability Index. In healthcare, different demographics often require distinct care models.
4. Map Out Patient Journeys: Understand the typical patient’s journey in their healthcare experience. From initial symptoms to diagnosis, treatment, and follow-up care, each step offers insight into how you can improve services.
5. Use Emotional Drivers: Don’t forget the emotional and psychological aspects of healthcare. Fear, hope, and trust play significant roles in how patients interact with healthcare systems.

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Example: A health insurance company might create personas for individuals nearing retirement, focusing on their concerns about Medicare, rising healthcare costs, and managing chronic conditions.

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What is Segmentation and How Does It Complement Personas?

While personas offer a detailed snapshot of individual customer types, segmentation breaks down your entire customer base into distinct groups based on shared characteristics. Segmentation ensures that your healthcare offerings, marketing, and engagement efforts are targeted at the right groups.

Tactics for Effective Segmentation:

1. Demographic Segmentation: Divide your audience by factors such as age, gender, income level, and education. In healthcare, age often determines the types of services a patient needs. For instance, Millennials may prioritize wellness and preventive care, while older adults might focus on managing chronic diseases.
2. Behavioral Segmentation: Segment your audience based on their behaviors, such as how frequently they seek care, whether they use telemedicine, or their level of engagement in preventive health measures.
3. Geographic Segmentation: Understanding where your customers live can help you identify regional health challenges. For example, urban populations may need more access to mental health services, while rural areas may focus on telemedicine solutions.
4. Psychographic Segmentation: Group customers based on their lifestyle, values, or attitudes toward healthcare. For example, some patients are proactive about their health, while others are more reactive and only seek care when absolutely necessary.
5. Health Status Segmentation: In healthcare, grouping customers by health status (e.g., chronic illness, wellness-focused, at-risk) is essential for delivering the right care at the right time.
6. Experience Segmentation: Grouping customers based on experiences they had or not had with Health plan driven by their call patterns, website usage patterns, submission of grievances or complaints, digital behaviors

1. Benefits Utilization Segmentation: segmenting customers based on how they utilize their benefits for e.g. Supplemental benefits aka Dental, Vision, Over the counter benefit, out of pocket costs, Pharmacy utilization, primary care visits, specialist visits, Ancillary visits and Institutional visits.

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Example: A retail health clinic might segment customers into those seeking acute care for minor illnesses versus those looking for long-term health management, such as weight loss or smoking cessation programs.

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Bringing Personas and Segmentation Together

By combining personas with segmentation, healthcare organizations can create highly targeted strategies that resonate with specific patient groups while still addressing the broader market. Here’s how you can implement both:

1. Persona-Driven Marketing Campaigns: Tailor messaging, content, and outreach for each persona. For example, a healthcare provider might create separate campaigns for young parents focused on pediatric care and seniors managing chronic conditions.
2. Customizing Care Pathways: Use segmentation to create specialized care pathways for different patient groups. For instance, you could design one pathway for high-risk patients who need more frequent monitoring and another for low-risk patients who prefer telemedicine.
3. Service Line Optimization: By understanding which segments are most profitable or in need of more attention, you can optimize services. For example, segmenting your patients by chronic disease can help direct resources toward more intensive management programs.
4. Personalized Digital Health Experiences: Use personas to guide your digital health initiatives. You might develop a user-friendly app for tech-savvy younger patients and provide a different experience, such as phone support or in-person visits, for older, less tech-inclined segments.
5. Personalized experience of N=1: Build personalized experience by creating a one member view which integrates the data across different member attributes and created personalized experiences for the specific member based on the context of their life journey.

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Conclusion

In the healthcare industry, knowing your customers is key to driving meaningful engagement and delivering better care outcomes. By leveraging the power of personas and segmentation, you can better understand your diverse patient base, develop more tailored services, and build stronger relationships with your customers.

As healthcare continues to evolve, organizations that prioritize a customer-centric approach will not only meet patient needs but also differentiate themselves in an increasingly competitive market specially in Medicare Advantage. Understanding and acting on the unique needs of your patient segments and personas is the foundation for a winning healthcare strategy.