Gaps in the healthcare landscape

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Healthcare must be accessible, affordable and equitable

See why

Healthcare must be accessible, 
affordable and equitable

Individuals need partnerships 
with their providers

Few are getting what they 
need from healthcare

Let's learn from those who
use healthcare the most

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Healthcare must be accessible, affordable and equitable

In all the markets we surveyed, attitudes around accessibility, cost and fairness play a huge role in shaping views about the healthcare system. When asked what they want from future healthcare encounters, individual respondents told us they want but are not 
always receiving:

  • Preventive care that’s accessible for everyone
  • Greater coordination of care between providers
  • Transparent billing practices
  • Easier appointment scheduling
  • Seamless access to medical records and histories

Other than in Sweden, the percentage of people in every country who said “I feel like the healthcare system doesn’t care about people like me” increased between 2022 and 2023. This perception comes with a cost: Three-quarters of individuals in every country except Japan said they put off care because accessing it is so frustrating.

On a more encouraging note, we saw an increase in the number of individuals in the U.S. and Germany who are motivated to care for their mental health. And more than 50% of individuals in the U.S., U.K. and China said connected health tools could help them prevent illness and maintain better health. What’s more, healthcare providers and individuals are aligned on the importance of preventive care and agree that it will play a critical role in improving the healthcare experience.

Improving preventive care is still a priority for all

Healthcare consumers

Healthcare providers

U.S.

U.K.

Germany

Sweden

China

Japan

84%

76%

Source: ZS Future of Health Survey 

Q. “Please read each of the following and rate how important they are in terms of improving the overall healthcare experience.” Base: 9,500 healthcare consumers and 1,055 PCPs; U.S.=4,000; 552. China=2,000; 101. U.K.=1,000; 100. Germany=1,000; 101. Japan=1,000; 101. Sweden=500; 100.

Healthcare must be accessible, 
affordable and equitable

Individuals need partnerships 
with their providers

Few are getting what they 
need from healthcare

Let's learn from those who
use healthcare the most

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Few are getting what they need from healthcare

Healthcare consumers aren’t having the patient experiences they want and need. Across markets, people said it’s difficult to make appointments, diagnoses take too long, care is unaffordable and their overall health is suffering. About one in four individuals said they avoid care due to hassles, with younger people in all markets being more likely to avoid care due to hassles or cost. And in the U.S., Hispanic and Black individuals are more likely to avoid care due to hassle, cost and a fear of unexpected healthcare bills.

In the U.S., individuals who prefer alternative sites of care such as urgent care or telehealth are more likely to be younger and say the healthcare system doesn’t care about people like them. Moving forward, these channels may be an effective way to engage with groups who don’t feel well served by traditional sites of care. Retailers such as Costco, Walmart and Amazon have already responded to these trends by expanding their healthcare offerings.

US consumers trust retailers to act in their best health interests more than healthcare companies

66%

Retailers (Walmart, CVS, etc.)

Medical device manufacturers 

Health insurance companies 

Pharma companies 

56%

54%

51%

Source: ZS Future of Health Survey
Q. Adult public: “How much do you trust each of the following people or stakeholders to act in your best interests when it comes to your health?” Base: 4,000 adults; U.S.=4,000.

Healthcare must be accessible, 
affordable and equitable

Individuals need partnerships 
with their providers

Few are getting what they 
need from healthcare

Let's learn from those who
use healthcare the most

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Individuals need partnerships with their providers

While individuals are actively owning their healthcare journeys, they still want their healthcare providers to be “partners,” a relationship defined as one in which patients and physicians develop treatment plans together. But across markets, the number of respondents who want a partnership exceeds the number of those who say they have one.

People who are happier with their healthcare—or those who believe the system cares about people like them—are more likely to perceive their healthcare providers as partners. This sense of partnership is particularly important for people with chronic health issues. For example, U.S. respondents with obesity and cardiovascular disease want a higher degree of partnership with their providers than they’re currently getting.

Consumer attitudes about healthy lifestyles and their desire for better preventive health could be an opportunity for healthcare providers to become the partner their patients are seeking. In every country we studied, individuals said “lifestyle choices,” which include drinking, smoking and exercising, are top factors influencing their health. This suggests many individuals could use a trusted coach or partner to empower them to make changes that will positively affect their health.

More consumers want partnerships with healthcare providers than have them

Want a partnership

Currently have one

U.S.

U.K.

Germany

Sweden

China

Japan

49%

40%

Source: ZS Future of Health Survey 

Q. Adult public: “Which of the following most closely describes how you currently manage your health?” Base: 9,500 adults; U.S.=4,000; U.K.=1,000; China=2,000; 
Japan=1,000; Germany=1,000; Sweden=500. 

Healthcare must be accessible, 
affordable and equitable

Individuals need partnerships 
with their providers

Few are getting what they 
need from healthcare

Let's learn from those who
use healthcare the most

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Let’s learn from those who use healthcare the most

In our survey, some of the keenest healthcare insights came from individuals with chronic conditions, including autoimmune disease, cancer, cardiovascular disease, respiratory disease or obesity.

Individuals in the U.S. with chronic conditions were more likely to have mixed emotions about their healthcare interactions, including feeling more “cared for” and “grateful,” but also more “overwhelmed” and “alone.” In addition, they were much more likely to have a practitioner they consider to be “their doctor,” which could explain why they feel more cared for. People with chronic conditions were more likely to feel negatively about the healthcare system in general, especially if they have conditions that trigger biases, such as obesity, substance abuse disorders or neuro and psych conditions.

While patients with cancer and cardiovascular disease tend to have more positive emotions toward the system, we found that their providers were out of sync. For example, 64% of oncologists think their patients feel cared for after a visit, while 46% of cancer patients report this. This is generally in line with the trend among healthcare providers to overestimate how positive their patients feel about interactions.

Healthcare consumers aren’t having the experiences their providers think they are

2x

2x

PCPs are twice as likely to say their patients feel
 "cared for" or "grateful" than their patients actually feel.

Cardiology care in the US highlights the patient experience gap  

Of U.S. cardiologists think their patients 
feel frustrated after an interaction 

Of U.S. cardiology patients feel

frustrated after an interaction 

Source: ZS Future of Health Survey

Q. Adult public: “Please take a moment to think about your recent healthcare interactions. Overall, how does interacting with the current healthcare system make you feel? Select all that apply.” Base: 9,500 adults; U.S.=4,000; U.K.=1,000; China=2,000; Japan=1,000; Germany=1,000; Sweden=500.

Q. Physicians: “Please take a moment to think about your recent patient interactions. Overall, how do you think your patients feel after seeing you? Select all that apply.” Base: 1,055 PCPs; U.S.=552. U.K.=100; Germany=101; Sweden=100; China=101; Japan=101. 304 specialists; cardiologists=103; oncologists=101; neurologists=100.

Solutions to bridge the gaps

Healthcare systems across the globe are experiencing big challenges. But that doesn’t mean healthcare’s players can’t be part of a solution. Medtech companies, pharma companies, health plans and provider networks can make incremental improvements wherever they operate. Here’s where to start.

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No one group can build the future of healthcare 

See why

No one group can build the
future of healthcare

Chronic health crises can 
drive digital health adoption

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Physician confidence in AI 
starts with trust

No one group can build the future of healthcare

Solving healthcare’s problems won’t be quick or easy. The industry’s thorniest problems, from healthcare access to health equity, will require collaboration from every healthcare stakeholder, as well as governments, according to our respondents.

One clear starting point is health equity partnerships, or alliances between organizations focused on addressing the root causes of health disparities for underserved populations. Under these partnerships, pharma companies, health plans or provider organizations typically cooperate with community-based organizations, nongovernmental organizations, patient advocacy groups, government agencies, tech and digital health companies, among others, to solve very targeted, specific problems. For example, a payer aiming to reduce atrial-fibrillation-related cardiac events among Black men in the Washington, D.C., metro area might work with local community centers to help identify men who would benefit from cardiology screenings. The payer could also partner with Uber Health to ensure prospective patients have transportation to their screenings. While health equity partnerships can start narrow in scope and scale, successful ones can be replicated, repeated and scaled across other regions and markets.

There’s also a role for government in solving health equity challenges, of course. More than three-quarters of individuals in the U.S., U.K., Sweden, Germany and Japan agreed governments should shift funding toward preventing diseases to reduce health disparities.

What to do next?

Advance health equity through partnerships and other strategies.

Healthcare consumers believe governments should invest in preventive care to reduce health disparities   

Sweden

U.K.

Japan

Germany

U.S.

84%

85%

76%

86%

84%

Source: ZS Future of Health Survey     
Q. Healthcare consumers: “How much do you agree or disagree with each of the following statements?” Base: 7,500 healthcare consumers; U.S.=4,000; U.K.=1,000; Germany=1,000; Japan=1,000; Sweden=500.     

No one group can build the
future of healthcare

Chronic health crises can 
drive digital health adoption

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Physician confidence in AI 
starts with trust

Physician confidence in AI starts with trust

As the population ages and healthcare worker shortages persist, AI has the potential to alleviate stress on the healthcare system by taking on tasks that: 

  • Reduce administrative burden
  • Quicken the pace of diagnoses
  • Automate billing and coding
  • Triage patients

But for AI to make a difference, providers have to use it and trust it—and our survey finds many don’t. They’re understandably concerned about AI’s safety and accuracy, following reports of algorithms perpetuating racial bias or failing to detect sepsis accurately. It’s no secret that large language models like ChatGPT don’t always offer accurate information.

But there are three things, in ZS’s view, that developers of AI tools can focus on to earn physician trust. They are to rely on:

  • Usable, representative data: Federated learning can be used to train analytical models to solve biased data sets and alleviate privacy issues. Data consortia can eliminate variations in data security, patient privacy and interoperability.
  • Trustworthy design: AI tools must be deployed responsibly, competently and transparently. 
  • Seamless, scalable applications: AI tools should integrate seamlessly into workflows providers already use.

Designing AI around the highest guidelines, such as the European Union’s AI Act, will help ensure that AI solutions are transparent and will deliver the kind of consistent, safe results essential to gaining physician trust.

What to do next?

Scale the value in healthcare with AI.

PCPs across countries believe AI will play the largest role in delivering quality healthcare in similar areas

U.S.

Germany

Sweden

China

Japan

U.K.

Top 3 areas for AI

Optimizing time required for administrative tasks

Supporting improved patient education

Accelerating diagnosis

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Source: ZS Future of Health Survey
China’s top and second benefit tied with the same number of responses.  

Q. PCPs: “From the following, please select the top three areas where you think artificial intelligence (AI) will have the largest role in delivering quality healthcare to your patients. Please select your top three.” Base: 1,055 PCPs; U.S.=552. U.K.=100; Germany=101; Sweden=100; China=101; Japan=101.

No one group can build the
future of healthcare

Chronic health crises can 
drive digital health adoption

1

3

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Physician confidence in AI 
starts with trust

Chronic health crises can drive digital health adoption

Individuals and providers are interested in connected health tools, but barriers to adoption remain, including low reimbursement rates, difficulty obtaining patient consent and data overwhelm. In this year’s survey, we only saw modest increases in connected health use among consumers in the U.S., Germany and Japan.

How can providers and individuals use digital health tools to their full potential? We believe mental health care and obesity are two therapy areas that could present the adoption moment digital health has been waiting for:

  • Both conditions can be treated almost entirely virtually. While bloodwork or diagnostics may occasionally be needed, prescribers don’t need face-to-face visits to provide refills or support.
  • Long-term management of both conditions are expensive for the patient, especially anyone who’s taking a GLP-1 for obesity not covered by their insurance.
  • When accompanied with lifestyle changes and cognitive behavioral therapy, common pharma treatments for obesity and mental health become infinitely more effective.

For connected health to achieve even wider adoption, however, individuals and providers must bridge the gaps between them, as each thinks the other is reluctant to adopt digital health tools. Germany, Japan and the U.K. stood out as examples of countries where high percentages of healthcare consumers and healthcare providers pointed to the other’s reluctance to use connected health tools as a barrier to adoption.

What to do next?

 Explore digital health’s expanding horizons.

Healthcare providers and consumers perceive each other as reluctant to adopt connected health tools  

Healthcare consumers who think providers are reluctant to adopt  

Healthcare providers who think 
consumers are reluctant to adopt  

Germany

Japan

U.K.

77%

59%

Source: ZS Future of Health Survey 

Q. “To what extent do you agree or disagree that each of the following are potential barriers to connected health adoption?" Base: Germany=1,000 adults; 101 PCPs; Japan=1,000 adults; 101 PCPs; U.K.=1,000 adults; 100 PCPs.

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