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Author: Evelyn Tee

Vice President

Health Equity: The Kx Research Approach and Case Study

Posted on by Evelyn Tee

Health Equity:

The Kx Research Approach and Case Study

Health Equity in Advanced Treatments

How does health equity impact advanced treatments?

Advanced healthcare treatments require patients to pass through multiple specialists or undergo significant surgical procedures. As a result, health inequities are especially salient for patients to receive adequate and timely care. Specifically, in multi-step referral processes, patients move from one specialist to another, and receive a plethora of tests at each step. With the added inequities tied to determinants of health, like access, race, socio-economic status, education, and environment, the patient journey for advanced treatments can go from complicated to unnavigable.

Research on understanding the patient journey is the first step in identifying solutions for such inequities and is a necessary element of any health equity initiative.

How do you begin health equity research and initiatives?

For companies looking to kick off health equity initiatives, start with defining a patient pathway. Doing so will help identify where general points of friction occur and set a “baseline” from which underserved peoples’ experiences may vary.

A typical patient journey goes from initial detection of disease to referrals to specialists to discussions of treatment options to the ultimate treatment a patient receives. At each point of the patient journey, patients may experience multiple inequities, layering on top of each other creating significant friction. For most diseases requiring advanced treatment (e.g., surgery, infusion treatments), patients go through four key stages, from initial identification and education to confirmation and treatment.

Even in the most efficient and straightforward cases, going through the standard care pathway to reach a specialist may take months and involve at least three different diagnostic assessments.

In the following case study, Kx explores how to conduct health equity research in advanced treatments, like surgery or biologic usage, specifically focusing on challenges faced by Black patients.

Kx Case Study: Health Equity Research Identifying Barriers to Care for Black Patients Receiving Advanced Treatments

Define the Patient Journey

In disease management, a condition may first be detected by a general practitioner (GP), who then refers the patient to a specialist. Depending on the diagnostic testing and treatment types, patients may then go through multiple other specialists before receiving an advanced treatment. These patient journeys are often complex, and serve as a baseline for understanding patient challenges in obtaining treatment.

To start, Kx defined the process that all patients typically go through, regardless of race, when receiving advanced treatments, starting with initial ID and education.

Pinpoint Provider-Identified Challenges

After exploring the patient journey in advanced treatments, Kx identified four categories of stakeholders who interact with patients:

For the highest and most immediate impact, Kx focused research on specialists (core specialists, treatment administrators, and physician extenders & staff). To tease out unconscious biases, the Kx team designed interview questions to ask not only about a practitioner’s self-identified habits, but also trends they noticed among their peers. Furthermore, with the inclusion of relevant physician extenders, Kx was able to understand challenges from multiple perspectives.

Kx found physicians are highly aware of logistical challenges related to race. Physicians noted in their practice, Black patients have been disproportionately impacted by these barriers. For example, physicians noted the work-up and test requirements prior to surgery, such as dental examinations, can cause unnecessary delay for patients needing treatment. Also, lifestyle factors like poor diet and lack of exercise may lead to comorbidities, like diabetes, that further complicate results.

Additionally, diagnostic testing is often needed for the diagnosis and long-term follow up of patients on the pathway to advanced treatment. However, comorbidities (e.g., diabetes and hypertension), which are more prevalent among Black patients, can skew diagnostic measuring and symptom identification. In the case of advanced cardiological treatments, such comorbidities have specific and direct impacts on diagnostic echocardiograms, which are used to identify disease and assess severity.

Physicians struggled to self-identify challenges in recognizing patients’ disease understanding and prioritization of their healthcare. Specialists and relevant extenders acknowledge the process-oriented limitations of short patient interactions and long wait times but advocated for their own techniques and bedside manner. Many physicians also acknowledged generalized trends in their patient populations. Specifically, 1 out of 4 physicians interviewed mentioned observations related to Black patients and lower socioeconomic status that drive initial preconceived notions.

Understand the Patient Perspective

The next step of Kx’s research process focuses on gathering perspectives from patients. In the case of non-emergent cardiac surgeries, Black patients highlighted a number of challenges centering around social determinants of health which disproportionately impact Black patients in the US.

Through conversations with patients at different points of the advanced treatment pathway, it is evident these social determinants of health not only serve as predictors for individual challenges frequently faced by Black patients, but also impact the entirety of the experience. During patient interviews, Kx was able to identify, pinpoint, and aggregate the most frequent occurrence of challenges, whether during initial detection, follow-up, referral, or treatment.

Combining it with Epidemiological Evidence

Ultimately, after understanding patient and provider perspectives, Kx was able to combine findings with epidemiological evidence about patient flow-through by race and identify where patients were facing the most significant burdens.

Moving Forward

As more advanced treatments enter the US market, healthcare access and equity for Black patients become increasingly significant. The administrative requirements and time leading up to life-changing treatments can create obstacles and delay treatment for underserved or marginalized populations. However, healthcare providers and medical manufacturers that focus on the patient pathway to lower barriers to treatment can increase penetration of novel treatments and grow their eligible patient populations.

 

How Kx Can Help

With our expertise, Kx Advisors can guide your team in addressing health equities and targeting underpenetrated patient populations. Our experts will analyze the patient pathway to treatment, identify obstacles, and create a strategy to operationalize a health equity initiative. To learn more about how Kx can support your Health Equity initiatives, contact Evelyn Tee at evelyn.tee@kxadvisors.com.

Contact Our Team Today

References
  1. Ostchega Y, Fryar CD, Nwankwo T, Nguyen DT. Hypertension prevalence among adults aged 18 and over: United States, 2017–2018. NCHS Data Brief, no 364. Hyattsville, MD: National Center for Health Statistics. 2020.
  2. Stierman B, Afful J, Carroll MD, Chen TC, Davy O, Fink S, et al. National Health and Nutrition Examination Survey 2017–March 2020 prepandemic data files— Development of files and prevalence estimates for selected health outcomes. National Health Statistics Reports; no 158. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: https://dx.doi.org/10.15620/cdc:106273..
  3. Garg S, de Lemos JA, Matulevicius SA, et al. Association of concentric left ventricular hypertrophy with subsequent change in left ventricular end-diastolic volume. Circulation: Heart Failure. 2017;10(8). doi:10.1161/circheartfailure.117.003959
  4. Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2021. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2021.
  5. Poverty rate by race/ethnicity. KFF. https://www.kff.org/other/state-indicator/poverty-rate-by-raceethnicity/currentTimeframe=0&sortModel=%7B%22colId%22%3A%22Location%22%2C%22sort%22%3A%22asc%22%7D. Published October 28, 2022. Accessed April 10, 2023.
  6. Lopez C, Kim B, Sacks K. Milken Institute; 2022. https://milkeninstitute.org/sites/default/files/2022-05/Health_Literacy_United_States_Final_Report.pdf. Accessed April 10, 2023.

Using the Patient Journey to Understand Health Equity Challenges

Posted on by Evelyn Tee

Health Equity: Overview of Health Systems and Patient Pathway

Unequal healthcare access among different groups leads to less preventative care, and more urgent and intensive procedures. Such disparities in access currently cost the US healthcare system approximately $320 B annually and is projected to grow to as much as $1 trillion annually in 2040[1]. In economically and socially disadvantaged communities, patients face barriers that impact their ability to receive necessary and equal care.

For life sciences companies, inequities lead to patients receiving inadequate or delayed care, and in its worst form, causes patients to miss treatment opportunities that utilize their products.

Life science companies can begin to tackle some of the drivers and determinants of health equity by using a patient-centric approach, as patients’ primary point of interaction with the healthcare system is through their providers. A closer examination of those interactions can reveal how manufacturers and medical technology companies can create initiatives to support greater equity. Examining the patient pathway can reveal specific moments when inequities “add-up” causing significant treatment drop out.

Solutions to equity barriers are not static – companies need to set themselves on a continuous path to improvement. The place to start is understanding what drives friction between patients and their own healthcare and focusing on the patient-provider interaction to identify solutions and expand their presence in underserved markets.

Barriers Arise During Patient-Provider Interactions

In order to maximize patient access and health outcomes for life science companies and manufacturers, the patient-provider interaction is key to understanding barriers to treatment. Acute analysis of these barriers is the first step to understanding where life science teams have the most influence on health equity and patient treatment access.

  1. Barriers limiting patient-provider interaction Before a patient walks into a doctor’s office, they may already face structural and socio-economic challenges impacting their interaction with the physician and their ability to follow a treatment plan. Such barriers include a lack of insurance, lack of transportation resources, and lack of availability. For example, Black Americans were 3x more likely to report loss of health insurance during the pandemic compared to white respondents. Structural and socioeconomic challenges also drive additional comorbidities, such as obesity and hypertension[2], which may limit treatment options.
  2. Patient perspectives and hesitancies during provider interaction When treating patients, providers interact with patient groups with differing attitudes towards the healthcare system, their diagnoses, and treatment options. For example, Black patients are more likely to mistrust the healthcare system due to long-standing racial inequalities. A nationwide poll by The Undefeated and the Kaiser Family Foundation found 7 out of 10 Black Americans say they’re treated unfairly by the healthcare system and 55% percent say they distrust it[3]. Lower trust among patients can lead to slower and less vigilant follow-up, and potentially patient drop-off from treatment. Patient groups also have varying awareness and understanding of their diagnosis due to education levels, and a patient’s perspective on the severity of a disease can be a major driver for urgency and vigilance with treatment follow-up
  3. Provider biases and pre-conceived notions Finally, physicians can also be impacted by racial bias, impacting the delivery of healthcare to racial minorities. Studies testing implicit association among physicians have found low to moderate levels of bias against racial minorities[4], and a public health study found 32% of Black Americans have reported being discriminated against when receiving healthcare treatment[5]. Although this bias may be unintentional, implicit bias from physicians negatively impacts patient behavior. A Journal of Family Practice study found patients who felt racial discrimination in a healthcare setting were less likely to follow physician recommendations and more likely to delay care[6]. Although many healthcare curriculums have developed to increase understanding of race-based impacts, negative impacts of bias on patient outcomes remain.

Health Equity Barriers to Patient Care

How can Kx Support Your Health Equity initiatives?

Research in Health Equity can be challenging. Understanding how to create a more equitable environment, and how to support underserved populations requires a nuanced and detailed approach to research supporting such initiatives. Kx Advisors helps clients frame research challenges using the patient pathway to understand where and how health equity initiatives should be targeted. To learn more about how Kx can support your Health Equity initiatives, contact Evelyn Tee at evelyn.tee@kxadvisors.com to learn more.

 

Contact Our Team Today

 

[1] McKinsey COVID-19 Consumer Survey as of June 8, 2020
[2] Akil L, Ahmad HA. Effects of socioeconomic factors on obesity rates in four southern states and Colorado. Ethn Dis. 2011;21(1):58-62.
[3] Common Wealth Fund: Medical mistrusts among Black Americans
[4] Sabin J, Nosek BA, Greenwald A, Rivara FP. Physicians’ implicit and explicit attitudes about race by MD race, ethnicity, and gender. J Health Care Poor Underserved. 2009;20(3):896-913. doi:10.1353/hpu.0.0185
[5] NPR/Robert Wood Johnson Foundation/Harvard T.H. Chan School of Public Health, “Discrimination in America: Experiences and views of African Americans,” 2017, Figure 1.
[6] Blanchard J, Lurie N. R-E-S-P-E-C-T: patient reports of disrespect in the healthcare setting and its impact on care. J Fam Pract. 2004;53(9):721–30.

Six Considerations to Evolve Your Capital Equipment Pricing Strategy

Posted on by Evelyn Tee

Six Considerations to Evolve Your Capital Equipment Pricing Strategy  

Capital Equipment Pricing Models  

As the world of capital equipment changes rapidly, manufacturers must find innovative ways to stay competitive. With new technology and enhancements, such as software upgrades and digital and connectivity solutions, as a crucial part of the value proposition of capital equipment, manufacturers can offer alternative pricing solutions to provide greater customer customization. Flexible pricing is especially pertinent for higher–value equipment on the market, such as AI-assisted imaging equipment, robotically–assisted surgical equipment, and advanced monitoring equipment. With the shift in procedures from hospitals to smaller office-based labs and ambulatory surgical centers, manufacturers can also capture new business opportunities with these alternative models.  

New Pricing Models for Capital Equipment  

The traditional pricing models offered three options: an upfront purchase with each component sold separately, a consumable upcharge model, or a leasing model. A combination of new technology and more customized pricing improves a manufacturer’s value proposition. With new pricing models, manufacturers can boost revenues, increase penetration, and build long-term relationships with clients by offering greater flexibility.  

These new models include:   

  • Risk-based or outcomes-based model: Risk-sharing pricing strategies factor in a cost savings component from any operational efficiencies gained and clinical outcomes achieved in this model 
  • Recurring revenue stream model: Instead of the traditional transfer of ownership model, manufacturers offer a subscription with a recurring fee. The purchaser or user is granted access to a set number of capital equipment devices for the subscription period. This fee may or may not include unlimited usage in the number of consumables 
  • Patient usage pricing model: Based on patient usage, manufacturers can offer a per-patient fee for the equipment over a period of time with this model 
  • Enterprise–level model: This model bundles the customer‘s capital equipment needs across entire care units and multiple hospitals within the network. The bundle would normally include both equipment and services components. Payment schedules could be yearly or bi-yearly

Six Considerations for Identifying the Right Pricing Model  

With so many pricing models emerging, it can be challenging to identify the right one for your product offerings. As your organization moves towards a new pricing model, like the ones above, there are six key considerations to keep in mind to identify the most effective model for your team: 

  1. Set clear objectives: With an identified goal, your organization can better evaluate the potential models. Objectives can include increasing revenue, expanding the adoption rate, smoothing revenue, maximizing profit, and expanding account use of a suite of products and services. For example, if a manufacturer’s goal is to increase the use of a full suite of products, the recurring revenue stream model may be a better fit for their goal 
  2. Identify the value drivers of your product:  Drivers, such as clinical efficacy, payment model, ROI, and the strength of existing relationships, impact pricing and the manufacturer’s ability to customize the pricing model  
  3. Determine the decision-maker: Sometimes the end-user who makes the purchase decision is different from the purchaser who chooses the pricing model. Broadly, there are three types of capital equipment buyers: economic, clinical, and operational. The economic buyer’s sole focus is to improve their organization’s profit. In contrast, the clinical buyer is more focused on the clinical value of the product offerings, like patient outcomes or improved patient experience. Operational buyers typically focus on other factors such as department workflow, device integration with key clinical systems, or maintenance and uptime. Knowing the levels of influence and priorities for each buyer type will help determines which pricing model to offer. If the buying decision is more committee-based, the pricing model will need to consider all stakeholder needs  
  4. Consider the impact on clients’ budgets: Pricing structure might impact where a client categorizes a purchase (i.e., capital expenses or operational expenses). Often capital expenses will fall under the hospital’s capital budget while operational expenses fall under the department’s budget, which may sway some clinicians towards a capital expense model  
  5. Understand clients’ financial health: Innovative recurring pricing models might be a better fit for clients working under capital restraints. This consideration is crucial overseas, especially in countries where COVID-19 has ravaged hospitals, which would seek to reduce the upfront cost of purchasing capital equipment  
  6. Establish benchmarking metrics: This consideration is the most important for risk-based or outcomes-based pricing, as identifying the equipment’s impact on patient outcomes or operational efficiencies dictates price. These metrics could include hospital readmission rates or the number of adverse events related to the equipment. When determining these benchmarks manufacturers must ensure they are measurable and that clients have the right infrastructure system in place to measure them 

How Kx Can Help You  

With our expertise in pricing strategy, Kx Advisors can guide your team through developing an optimized capital equipment business model. Our team of healthcare experts will help you evaluate your base, identify your customer segments, effectively appeal to your ideal customer, and position your organization for long-term success.  

Contact Our Team Today

How Understanding Cognitive Bias Can Drive Patient Volumes

Posted on by Evelyn Tee

How Understanding Cognitive Bias Can Drive Patient Volumes

Understanding Patient and Healthcare Provider Behavior 

We all strive to make rational choices. But as humans, we are prone to bias and misjudgment. In the medical field, cognitive biases can have a profound impact on both patients and healthcare providers. Kx frequently conducts studies to uncover cognitive biases in referral pathways, including specialist referrals for more advanced therapies or interventions.

By pinpointing these biases, our team helps specialty drug and medical device clients focus their marketing and education efforts and increase market penetration within their eligible patient population. 

Common Dilemmas

Often specialists do not refer patients for treatment quickly enough or at all. These delays in or lack of treatment not only allow the patient’s condition to deteriorate, but also prevent the drug and device companies from fully reaching their addressable patient population. In our recent studies, Kx found that cognitive biases exist at each stage of the referral process.

Cognitive bias map of specialist referral pathway
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The Kx Solution

When guiding healthcare organizations by improving their specialist referral pathway, the Kx team runs an in-depth qualitative analysis speaking with specialists to understand critical attitudes, behaviors, and beliefs across the population of relevant doctors. Key differences within demographic segments (e.g., age, specialty, practice type) and behavioral segments (e.g., willingness to refer, referral choice) help identify drivers of attitudes and potential solutions for changing these behaviors. 

Uncovering Cognitive Bias to Reach the Addressable Patient Population  

Kx developed the following key findings to drive the patients through the specialist referral pathway:

  1. Awareness that symptom recognition is often the most significant barrier in the referral process and education to combat the issue. Early in the referral process, during the diagnosis phase, cognitive biases result in the specialist not probing consistently, missing symptoms by not asking the right questions, or simply not asking enough clarifying questions. Incorrectly identifying patients’ health status based on outward appearance or insufficiently probing symptoms can result in critical underdiagnoses or undertreatment.
  2. A clear path to referral, particularly one with a singular point of contact, can help referring physicians feel more at ease. Successful drug and device companies reduce friction in referral pathways by helping referring physicians establish clear points of contact across hospitals, specialists, and surgical teams. Elucidating a single point of contact cuts down on ambiguity and removes an obstacle for referring providers.
  3. Direct relationships between the referring specialists and the treatment teams (surgery team) build comfort and encourage referrals.
  4. When creating tools for doctors, simplicity and ease of use are key factors. Biases exist among doctors to simplify complex thought processes. Though tools, like decision guides for complex cases, can be extremely beneficial, they must be simple and easy to understand and use to overcome biases and help physicians better identify which patients need further treatment.

How Kx Can Help

Our healthcare experts can guide you by adjusting various aspects of our corporate strategy, including your referral pathway, with insights from market research. Cognitive bias is built into our research methodology, enabling your team to overcome any we find and fulfill more referrals. As data-driven decision-makers, we design research using both traditional factors and behavioral science to pinpoint process improvement and qualitative analysis opportunities. 

 

Contact Our Team Today

Kx’s Four-Step Customer Segmentation Process

Posted on by Evelyn Tee

Kx’s Four-Step Customer Segmentation Process

How To Level Up Your Customer Segmentation Strategy: Behavioral Segmentation  

Kx‘s customer segmentation delves deeper than any traditional segmentation by looking at underlying behavioral and attitudinal factors that can replace the standard identifiers. Your team can improve your process by expanding on the factors you include in your segmentation beyond demographics and traditional commercial indicators. Below are some of the behavioral segmentation variables your team can include:  

  • Attitudes: These variables influence customers’ perception of products and their receptiveness to trying out a new product  
  • Roles and  level of influence: Customers’ roles can impact drivers of purchase or use, and prioritizations of these drivers, based on different roles/responsibilities and experiences of the user/purchasers    
  • Experience and situational context: Analyzing these factors can showcase different unmet needs based on the type of user and provide context into what healthcare companies can do to drive increased adoption/purchase

Customer Segmentation Graphic

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Developing Customer Segments With Sales Teams In Mind 

While customer segments are a vital marketing tool, focusing on behavioral segmentation allows your sales team to provide a more personalized experience. Throughout this process, marketing teams must ensure that each segment is:  

  • Specific: the segments are mutually exclusive and collectively exhaustive, and each customer can only fit in one segment  
  • Meaningful: apparent differences exist among segments, and these differences are significant drivers of behavior and preferences  
  • Actionable: markers for different segments support easy identification and targeting for therapy development teams  

Creating digestible segments specifically for the sales funnel empowers the sales team to better secure business. 

Kx‘s Four–Step Approach For Segment Profiles 

Our experts uniquely leverage these variables to identify accounts that give the biggest share of wallet. Kx conducts the segmentation through three steps: 

  1. Determine segmentation goals: Kx works with organizations on clarifying their goals and mapping their segments to match these goals, including identifying the segments that are most likely to drive profit and have the most significant lifetime value  
  2. Identify the markers for distinct segments : Defining key demographics is critical for the success of the segmentation process as it dictates the approach of any go-to-market strategy. Our experts start with traditional indicators and slowly work through the in-depth behavioral indicators, identifying the deep and nuanced permutations within the target base
  3. Develop and quantify segment profiles or archetypes: When Kx works with organizations on customer segmentation, our team builds out the different segment profiles, or “archetypes“ of customers. Our team performs in-depth qualitative research to understand the drivers of high product affinity within each segment, giving your sales team insights they need to message to their targets effectively. After setting the boundaries, quantifying each segment’s size allows your team to gauge which segments are the highest value for your team, and provide the most significant growth opportunities. To do so, we conduct quant research and K-clustering to identify combinations of variables that statistically show segments 
  4. Implementation: Perhaps the most challenging aspect of the implementation process is where the tie between marketing and sales matters most. The cardinal implementation rule for marketing teams is that all archetypes rolled out must be unique. With that in mind, the fewer archetypes, the better the sales team’s result as they can customize their approach and connect more effectively with their targets. Our team is skilled at designing tailored strategies for implementation and can support your team through the procedure 

How Kx Can Help 

With product planning and launch strategy expertise, Kx Advisors can guide your team through customer segmentation and targeting. Our team of healthcare experts will help you evaluate your base, identify your customer segments, effectively appeal to your ideal customer, and position your organization for long-term success.  

Contact Our Team Today

3 Questions To Ask For Launch Planning During COVID-19

Posted on by Evelyn Tee

What Product Managers Must Do To Launch Successfully In This Pandemic

Launching Healthcare Products In Uncertain Times  

For many pharmaceuticals and medical device companies, the spread of COVID-19 has no doubt disrupted upcoming product launches. As prescribers treat and patients seek care in this highly variable environment, the landscape for a product launch looks different than just a few weeks ago. This crisis hampers months to years of planning, and we see a unique set of questions posed to product management leaders.  

What You Can Do Today – A Launch Planning Framework  

As the COVID-19 virus continues to spread, many companies must adjust different components of their upcoming launches. How do product managers decide what to adjust in their launch, how it impacts them, and where to go from here? Our experts created this framework to guide you through three critical questions for agile launch planning during this pandemic.   

Launch Planning Framework For Product Managers During COVID-19
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Moving Forward During COVID-19 

The uncertainty triggered by COVID-19 highlights the healthcare industry’s need for adaptability in pharmaceutical and medical device launches. Leveraging this framework, product managers can anticipate and meet any future challenges to launches due to COVID-19 or other rapidly-evolving events. Acting now can diminish any negative impact on your launch.  

Kx Advisors, Experts In Launching   

Are you planning a product launch that could be impacted by COVID-19? Kx Advisors can help. With launch planning expertise, our team of healthcare specialists will guide your team in identifying issues quickly and adapting your plans for whatever comes next. Our rapid assessments will build on this framework, examine market data, and evaluate your options to guide you through the crisis. Our tailored approach will empower your team to launch your product effectively. 

 

Contact Our Team Today