▪ research for your brand’s health klein & partners Another Kitchen Sink Survey from Klein & Partners: What consumers think about a plethora of healthcare topics… Presented by: Rob Klein, President Klein & Partners 4th Quarter, 2013 Disclaimer: Please feel free to use these charts in any of your presentations; just cite Klein & Partners as the source of the information.

▪ research for your brand’s health klein & partners INTRODUCTION Page 1

▪ research for your brand’s health klein & partners Background  The purpose of this nationwide quantitative survey was to understand consumers’ current thinking on a wide range of healthcare-related topics, including: Methodology  A national online survey was conducted among 401 heads of household, 21 or older who are most responsible for healthcare decisions for the household. The interviewing was conducted from November 15-26, The sample frame used was Research Now’s online consumer panel. The final data set was weighted by geography, age, education, income, and ethnicity.  The total sample size of 401 yields a sample error of +/-4% at the 90% Confidence Level (CL). For example, if this study were repeated 100 times, in 90 times out of that 100 (i.e., 90% confidence level) we would find a total sample statistic of 50% to fall within 46% and 54%.  Significant differences are called out in the charts. Colors and bolding are used to highlight interesting patterns and/or findings. Introduction Reactions to health reform Reactions to healthy living incentives Tax exempt perceptions Primary care physician Reactions to credit card request Smart phone Communications preferences Interest in new information sources Factors influencing health plan choice What healthcare can learn from other industry brands Transparency/Price shopping Getting care in these economic times Page 2

▪ research for your brand’s health klein & partners SO WHAT DID WE LEARN? Page 3

▪ research for your brand’s health klein & partners REACTIONS TO HEALTH REFORM Page 4

▪ research for your brand’s health klein & partners Q1: What do you think will get better or worse for you personally under healthcare reform? Page 5

▪ research for your brand’s health klein & partners Page 6 Q2: How confident do you feel in understanding what your health insurance options are under health reform? Significantly fewer year olds are confident!

▪ research for your brand’s health klein & partners Page 7 Q3: Now that the health insurance exchanges are up and running have you gone online or called to check out what your health plan options are through these exchanges? Remember this was asked in mid-November of last year. Goes up significantly with age: 82% among those 65+

▪ research for your brand’s health klein & partners Page 8 Q4: If you were offered a financial incentive to change a certain aspect of your lifestyle (e.g., stop smoking, lose weight, exercise, etc.), how likely would you be to change that behavior or lifestyle? Q5: And which of the following incentives would you be most interested in receiving for your healthy lifestyle choices? Assume each of these options would have a similar financial ‘value’. 63%

▪ research for your brand’s health klein & partners Page 9 Q6: Do you currently participate in a structured wellness program (i.e., a program provided by an employer, hospital, insurer, gym, etc.)? Q7a: Who is sponsoring this structured wellness program? Q7b:From which of the following would you most likely sign-up for a structured wellness program if they offered it? Who sponsors the program? Employer – 42% Health plan – 33% Fitness club – 14% Hospital – 7% Who sponsors the program? Employer – 42% Health plan – 33% Fitness club – 14% Hospital – 7% Where most likely sign up for program? Fitness club – 33% Health plan – 18% Employer – 10% Doctor – 8% Hospital – 2% Not interested (mostly seniors) – 15% Not sure – 14% Where most likely sign up for program? Fitness club – 33% Health plan – 18% Employer – 10% Doctor – 8% Hospital – 2% Not interested (mostly seniors) – 15% Not sure – 14%

▪ research for your brand’s health klein & partners Page 10 Q8: When you think about your personal health and wellness, what would motivate you most to buy and act healthy?  More likely year olds  More likely seniors  More likely in the South

▪ research for your brand’s health klein & partners Page 11 Q9: How often during the week do you take a minute walk? Q9a: What keeps you from walking minutes every day?  Especially women  Especially those  Especially seniors  Especially higher socio-economic status

▪ research for your brand’s health klein & partners Page 12 Q10: If your employer offered all employees a wellness program that was structured and provided incentives for healthy choices, what would your initial reaction be? Especially those , college educated, and Hispanics

▪ research for your brand’s health klein & partners Page 13 Q11: Are you familiar with what a ‘charityathon’ is at a workplace? Q12:How likely would you be to participate in one of these charityathons through your employer? Especially those and college educated Especially those , <$45k income, and Hispanics

▪ research for your brand’s health klein & partners Page 14 Q13: Next how well do each of the following statements describe your employer? *Note: Among the 78% reportedly working outside the home.

▪ research for your brand’s health klein & partners TAX EXEMPT STATUS Page 15

▪ research for your brand’s health klein & partners Q14a: Do you support or oppose the idea of hospitals being tax-exempt organizations? Q14b: Do you support or oppose hospitals being exempt from paying state and local taxes? Note: Question worded slightly differently and half sampled to determine if adults would react differently Support of tax-exemption Page 16 Oppose Not sure Support

▪ research for your brand’s health klein & partners Q15a/b: Many local communities and states are looking for ways to increase revenue to meet rising demands for services/to close budget gaps. One way that has been proposed is to treat local hospitals just like any other business in the community and charge them property tax and sales tax. Do you think this is a good idea or a bad idea? Charging hospitals property and sales tax Page 17 Bad idea Not sure Good idea

▪ research for your brand’s health klein & partners Q16: Do you think (your local) hospitals give away enough of these free services to earn that tax-exempt status? Q17: Do you think (your local) hospitals have enough uncollected bills which they write-off to earn that tax-exempt status? Page 18 Support tends to come more from seniors and those without college educations

▪ research for your brand’s health klein & partners Views on hospitals Q18: Do you agree or disagree with the following statements? Strongly disagree Somewhat disagree Not sure Somewhat agree Strongly agree Page 19 The classic ‘Catch-22’

▪ research for your brand’s health klein & partners PRIMARY CARE PHYSICIAN Page 20

▪ research for your brand’s health klein & partners Q19: Do you have a primary care or personal physician? Q20: Have you ever gone online to a social networking site and shared your experiences about a doctor or a hospital you recently visited? Primary Care Doctor ZAGAT Page 21 Primary care physician Nearly unchanged from past waves, more than eight in ten (82%) adults have a primary care physician. But it’s only 69% among those under 45. Going online to rate a doctor or hospital has doubled in the past few years: 6% in % in % in % in 2013 (especially 21-44, <$45k income) Going online to rate a doctor or hospital has doubled in the past few years: 6% in % in % in % in 2013 (especially 21-44, <$45k income)

▪ research for your brand’s health klein & partners Q21: For each of the following statements about your doctor’s office please check how much you agree or disagree. Page 22  Not as much among  Especially among year olds are feeling most disengaged with their PCP.

▪ research for your brand’s health klein & partners Page 23 Waiting in the doctor’s office – ’30 minutes and I’m gone’ Q22: On average, how long would you say you typically wait to see the doctor from the time you arrive t the doctor’s office for an appointment? Q23: And what is your maximum acceptable wait time to see the doctor once you arrive at the doctor’s office? Q24: Have you ever left a doctor’s appointment because the wait was getting too long and you couldn’t wait any longer? Q25: And how long did you wait before you left? Q26: How long would the wait have to be before you would leave and reschedule your appointment? 16 minutes Average wait time 21 minutes Maximum acceptable wait time (average) 16 minutes Average wait time 21 minutes Maximum acceptable wait time (average) 30% have left the doctor’s office because the wait was too long 29 minutes and they left 28 minutes and would leave 30% have left the doctor’s office because the wait was too long 29 minutes and they left 28 minutes and would leave People will wait longer than they say

▪ research for your brand’s health klein & partners Page 24 Q27: Have you heard of a ‘concierge medical practice’ where you pay a primary care doctor an annual fee (typically $3,000-$5,000) and then you have priority access to that doctor in person, via , or on the phone whenever you need any type of care and there is no additional cost to you? Familiarity goes up significantly with age.

▪ research for your brand’s health klein & partners REACTIONS TO CREDIT CARD/HSA DEBIT CARD NUMBER REQUEST Airlines do it… hotels do it… why can’t doctors’ offices do it? Page 25

▪ research for your brand’s health klein & partners Page 26 Providing credit card or HSA debit number to doctor’s office year olds are much more trusting Q28:How would you feel if when you called to make an appointment at your doctor’s office that they asked for your credit card or your HSA debit card number (like when you make a hotel or airline reservation)? Q29: What reservations do you have about giving your credit card or HSA debit card information to your physician’s office when you call to make an appointment? Q30: If your physician’s office asked you for your credit card or HSA debit card information at the time of appointment, how would this make you feel about your doctor? What reservations do you have? “Anyone could put any charge on the card. Just not fair.” “I am not sure what charges would be put on there, risk of mistakes.” “Do not like giving info by phone.” “Care should be covered by health insurance.” “I don’t trust them.” “Don't want to have to deal with identity theft.” “Do not want my personal credit card information out there.” “Don't like giving personal info over the phone.” “I feel uncomfortable with it, because they can steal my information.” “Prefer to pay when I’m done.” “Would not like to give up my personal freedom over an act that seems like a convenience for them.” “If something comes up and I am unable to make the appointment will they deduct.” “It is new and doesn't feel comfortable.” How would this make you feel about your doctor? “Uncomfortable.” “Leery, insulted.” “No different.” “I would change doctors.” “I would feel they were only worried about money.” “It’s smart business these days.” “I would think they don't trust me.” “I'd have a low opinion of him.” “I'm not sure. Doesn't seem like that big of a deal though.” “It would make me feel like just a 'number' - not a patient the doctor should care about.” “It would not change how I feel about my Dr. but it would change how I feel about the medical organization.”

▪ research for your brand’s health klein & partners Trusting your doctor’s office with credit card/HSA debit card information Don’t trust at all Don’t have card Not sure Somewhat trust Completely trust Q31: Do you trust your physician’s office with your credit card information? How about your HSA debit card information? Page 27 Because this is what is getting stolen!

▪ research for your brand’s health klein & partners Page 28 Q32: If your doctor’s office asked for a credit card or HSA debit card number on the phone at the time of you making your appointment but also offered to let you pay for your co-pay by cash, check, or credit card/HSA debit card at the time of the visit, what do you think you would most likely do? W A I T !

▪ research for your brand’s health klein & partners SMART PHONES ‘Can you hear me now?’ Page 29

▪ research for your brand’s health klein & partners Q33: Have you used a smart phone or any phone that can access the internet to go online and do any of the following…? Page 30 Any of these uses is significantly higher among year olds.

▪ research for your brand’s health klein & partners Page 31 Q34: If a health plan you were part of offered a mobile app for your smart phone, which of the following features, if any, would you MOST LIKELY USE? (Asked of those who have a smart phone) Any of these uses is significantly higher among year olds. EMR is now an expectation not a cool differentiator.

▪ research for your brand’s health klein & partners COMMUNICATON METHODS Page 32

▪ research for your brand’s health klein & partners Q35a: Which of the following communication methods have you used to communicate with your primary care physician? Page 33

▪ research for your brand’s health klein & partners Q35b: Which of the following communication methods have you used to communicate with your hospital? Page 34

▪ research for your brand’s health klein & partners Q35c: Which of the following communication methods have you used to communicate with your health insurance company? Page 35

▪ research for your brand’s health klein & partners Page 36 Q36: In the past year, have you visited and/or ‘Liked’ a health plan or hospital Facebook page? How much are we spending on having a Facebook page? Facebook visitors are almost entirely year olds

▪ research for your brand’s health klein & partners INTEREST IN NEW INFORMATION SOURCES Page 37

▪ research for your brand’s health klein & partners Page 38 Q37: Which of the following healthcare topics would you be very interested in learning about? Women are more interested in: articles on women’s health, articles personalized to your own health status, clinical information about specific health conditions, and articles on emotional issues. Those are more interested in articles on: lifestyle advice, women’s health, healthcare reform and how it will impact their family, and emotional issues.

▪ research for your brand’s health klein & partners Page 39 Q40: Have you purchased the US News & World Report ‘Best Hospitals’ publication that came out recently? Readership is tied strongly to college education and age (i.e., higher among year olds).

▪ research for your brand’s health klein & partners Q39: Now, if you were looking for information on hospital quality to compare different hospitals before you made a decision on which hospital to choose, which of the following sources of quality information, if either, would you more likely find useful in your decision-making? Page 40

▪ research for your brand’s health klein & partners CHOOSING A HEALTH PLAN Page 41

▪ research for your brand’s health klein & partners Q38a-c: And if you were choosing a health plan and you wanted to gather information about which health plan you should choose, which of the following sources of information: Page 42 W-O-M, the insurer’s website, employers, and physicians are the primary sources of health plan decision-making information. But when you add all forms of ‘online search’ that becomes the largest combined source of health plan information.

▪ research for your brand’s health klein & partners SEARCHING OUT THE BEST SERVICE What can we learn from other industry brands? Page 43

▪ research for your brand’s health klein & partners Page 44 Q41: If {hospitals/health plans} could learn about customer service from companies in other industries, which of the following well- known brands do you feel {hospitals/health plans} could learn the most from in terms of how they treat their customers?

▪ research for your brand’s health klein & partners Disney “They seem to always treat their customers with respect & kindness.” “They bend over back wards for their customers to get the best experience.” “Everything is clean. Very customer focused. Wants everyone to leave happy.” “Honesty, consistency, use of plain language, no government involvement.” Amazon “Always responsive and helpful without long delays. Always have customer service as a priority and good communication.” “Amazon does a good job of communicating with it's customers and they follow-up with allowing customers to post reviews about their experience(s).” “Organized and easy access to your info.” “They are direct and straight shooters with a rating system afterwards.” Southwest  “Are very consumer oriented even when it impacts their bottom line negatively.”  “How to provide consistent quality service at a cheap price.”  “Excellent customer service!”  “Southwest usually goes the extra mile for it's customer service.” Walgreens “I like being able to speak directly with a pharmacist & also open 24 hours if you need medication.” “They are very friendly and knowledgeable.” “At Walgreens I had an issue about purchasing some antibiotics. And the pharmacist actually took time to call the doctor for a different drug that works the same but it was a whole lot cheaper than the doctor prescribed me.” Page 45 What hospitals/health plans can learn from brands – selected verbatims Ritz Carlton “Because they do their best to get the job done with as little trouble as possible to the customer. The Ritz is an excellent example of what true customer service should be.” “THEY COULD TREAT PEOPLE WITH MORE RESPECT AND UNDERSTAND THAT WE ARE PAYING A LOT OF MONEY FOR HEALTH CARE EVEN WHEN WE DONT USE IT AS MUCH AS WE PAY FOR IT AND NO ONE WANTS AN ATTITUDE WHEN THE INSURANCE COMPANY MESSES UP YOUR INFORMATION AND YOU HAVE TO SPEND HOURS TRYING TO FIX IT.” Apple Stores “In person you are always greeted promptly. They offer online scheduling for help. All their associates are friendly and knowledgeable. They can communicate in layman's terms. Generally you get the impression that they want to help.” “Keep it simple. Make use of your information intuitive, approachable to the lay customer, personalized and responsive to my needs. Apple Stores characterizes all of these things to me.” Nordstrom  “Focus is on experience and belief in their service and products and they stand by them both.”  “The customer is treated with respect and they value the customers’ business. The customer is always right attitude.” AT&T “It's a family oriented environment...you have to market what you have... Health plans need to be flexible to allow choices... just like a rate plan with AT&T.” Home Depot “At our Home Depot we are asked immediately what we need help with. Then we are shown exactly where to find what we need. If we are not sure what we need we can explain what we are trying to do then advice is given how we can do it.” “Knowledgeable staff, ready and willing to help.” Q41a: What do you think {hospitals/health plans} could learn from {RESTORE Q41 RESPONSE} regarding how they treat customers?

▪ research for your brand’s health klein & partners Page 46 Q42a: When you think of your current relationship with your health insurance company, check one of the relationship styles below that best describes your current relationship, good or bad, with your health insurer. Q42b: Next, check one of the relationship styles below that best describes how you wish your relationship was with your health insurance company (i.e., your Preferred Relationship). Current vs. preferred relationship with health insurance company People want a relationship not a transaction.

▪ research for your brand’s health klein & partners PRICE SHOPPING Page 47

▪ research for your brand’s health klein & partners 4 th Qtr th Qtr th Qtr th Qtr th Qtr th Qtr 2013 Households that have contacted a healthcare organization to ask the price for a specific visit, test, treatment, or surgery 33%32% 22%28%24% Chose the least expensive provider for one of these healthcare cases 36%41%31% 33%24% % of the total patient market  12%13%10%7%9%6% Price check in aisle five! Q43: Within the past year, did you or did a member of your immediate household contact any healthcare organization, hospitals, or physician offices to ask about the price for a specific visit, test, treatment, or surgery? IF YES… Q44: How did you check on pricing? Q45: What type of health service did you ask about pricing for? Q46: Did you end up choosing the least expensive provider? Called: 2010/ % % Called: 2010/ % % Page 48

▪ research for your brand’s health klein & partners HEALTH INSURANCE AND GETTING CARE Page 49

▪ research for your brand’s health klein & partners Page 50 Q47: What type of health insurance, if any, do you have currently or have recently purchased that will go into effect in January? Remember we interviewed in December

▪ research for your brand’s health klein & partners Q48: Have you experienced a significant financial hardship in the past year due to medical bills? Page 51 Especially women (21%) and those (24%).

▪ research for your brand’s health klein & partners Q49: In the past year have you had to delay or avoid seeking any healthcare services because you couldn’t afford the cost due to a change in your employment and/or health benefits? Q50: What healthcare services have you delayed? In 2013, 29% of adults had to delay or avoid seeking healthcare services because they could not afford it due to a change in benefits or employment. (30% in 2012 and 26% in 2011) In 2013, 29% of adults had to delay or avoid seeking healthcare services because they could not afford it due to a change in benefits or employment. (30% in 2012 and 26% in 2011) Page 52

▪ research for your brand’s health klein & partners APPENDIX Page 53

▪ research for your brand’s health klein & partners Demographic profile Female53% Ethnicity Caucasian African American Hispanic Asian 62% Age Median age 45% Median household income$51,000 Education Level Up to high school Some college College grad (undergrad) Graduate degree 15% Generally think of yourself as… Strongly Republican Moderately Republican Independent, lean Republican Independent Independent, lean Democrat Moderately Democrat Strongly Democrat Other Not sure 8% Page 54

▪ research for your brand’s health klein & partners Additional information If you would like additional information regarding this study, please contact: Rob Klein President Klein & Partners Morningside Rd. Orland Park, IL [630] Page 55