Five Groups Inside 9,960 Unscreened Residents: Segmenting a Lung Cancer Screening Market by Need, Coverage and How People Reach Care
Student Name
American College of Education
HLTH5673: Marketing for Healthcare Professionals
Module 2 Assignment
Instructor Name
July 10, 2028
Why Segment
The market analysis in Module 1 showed that the composite 180-bed hospital's lung cancer screening program faces a small competitive market, about 730 residents screened by other providers, and a much larger unscreened one: about 9,960 residents who meet national criteria and were not screened by anyone last year. Treating those 9,960 people as one audience would produce a message and a channel that fit none of them well. A 72-year-old former smoker who sees a primary care physician every three months, a 53-year-old current smoker without a regular clinician and a 51-year-old who does not know the criteria changed in 2021 need different things.
The segmentation uses three variables, as the module brief suggests. Need captures smoking status and whether the person knows they are eligible. Coverage captures insurance: Medicare, commercial, Medicaid or none. Access captures whether the person has a regular source of primary care and the practical barriers to reaching the hospital, such as distance and transportation. Segmenting by age alone would group people with nothing in common except a birthday.
Data Sources and Their Limits
The segments are estimated from three sources: the patient registries of the eight primary care practices affiliated with the hospital, which cover about 60 percent of eligible-age residents; state survey data on smoking, insurance and usual source of care for the two counties; and census data on vehicle access by ZIP code. Each has limits. Registries list smoking status for most patients but record a usable pack-year history for fewer than half. That problem is not unique to this hospital. Modin et al. (2017), comparing electronic records with histories taken in shared decision-making conversations at a Seattle screening program, found that the record disagreed with the conversation for 96 percent of patients and underreported pack-years for 85 percent, by a median of 29 pack-years. Segment sizes are therefore estimates, and the program should expect the electronic record to undercount eligible patients rather than overcount them.
The Five Segments
Segment 1, connected but not asked, about 4,100 residents or 41 percent. Mostly former smokers aged 65 to 80, covered by Medicare, and seen by a primary care clinician at least once in the last twelve months. They know the hospital and have no cost barrier, since Medicare covers screening with no cost sharing when criteria are met. Their main barrier is that no one has raised screening with them, often because their charts lack a pack-year history. Segment 2, current smokers who avoid the subject, about 2,600 or 26 percent. Aged 50 to 64, commercial or Medicaid coverage, many with irregular primary care. Their main barriers are fear of the result and stigma. Carter-Harris (2015) found that perceived lung cancer stigma was associated with delay in seeking care for symptoms, with shame, social isolation and smoking-related stigma each correlated with delay.
Segment 3, newly eligible and unaware, about 1,700 or 17 percent. Aged 50 to 54 or with 20 to 29 pack-years, eligible only since the 2021 criteria. More are women than in other segments, consistent with the task force's point that loosening the age and pack-year limits mainly brings in women and Black adults (US Preventive Services Task Force et al., 2021). Most have commercial insurance and a primary care clinician who may still apply the older criteria. Segment 4, rural and hard to reach, about 1,100 or 11 percent. Residents of the eastern ZIP codes, more often on Medicaid, a quarter without a regular clinician and many without reliable transportation, living 25 to 40 miles from the hospital. Segment 5, uninsured or without any care, about 460 or 5 percent. Mostly aged 50 to 64, uninsured or between coverage, with no regular clinician.
Evaluating the Segments
Segments are useful only if they are large enough to matter, identifiable, reachable and likely to respond. Segment 1 scores highest on every criterion: it is large, it can be identified through the affiliated practices' registries once pack-year histories are recorded, it is reachable through physicians it already trusts and it has no cost barrier. A reasonable effort, prompting clinicians and simplifying the decision visit, might screen 15 percent of it, about 615 people in a year. Segment 3 is also identifiable and reachable through primary care and, once aware, is likely to respond; 10 percent would be about 170 screenings.
Segment 2 is large but harder. Current smokers are identifiable in the registries, but messages that feel judgmental may deepen avoidance, and the right approach may pair screening with support to quit rather than lead with screening. A realistic first-year yield is perhaps 5 percent, about 130 screenings. Segment 4 needs a different model entirely, such as screening days with transportation or a partnership with a rural clinic, with higher cost per screening. Segment 5 depends first on connecting people to coverage and a clinician, which the hospital's financial counselors and the county's community health center can help with, but screening yield in the first year will be small.
What Each Segment Needs
The segments differ in what would move them, and those differences will shape every later module. Segment 1 needs a prompt from someone it trusts, most often its own physician, and a process that does not add a separate visit; the message it needs to hear is simple: you qualify, it is covered and it takes fifteen minutes. Segment 3 needs to learn that the rules changed, which means reaching both residents and their clinicians, since a clinician applying the old thresholds will talk an eligible patient out of screening without meaning to. Segment 2 needs reassurance before information. Its members are more likely to respond to a message that avoids blame and presents screening as something that finds problems early, when they are most treatable, than to one that leads with smoking.
Segment 4 needs the service brought closer or transport to it, and a trusted local messenger, such as the rural clinic's own staff. Segment 5 needs coverage and a clinician first. For every segment, the program will need a way to take an accurate pack-year history, since the records will undercount eligibility; a short, plain-language eligibility check, completed by a nurse or medical assistant or by the patient online, will serve all five.
Choosing the Targets
The program will target Segment 1 and Segment 3 first, because together they could produce about 785 additional screenings in a year, more than doubling the program, through channels the hospital already controls. Segment 2 will be a secondary target, approached through the hospital's tobacco treatment program and clinicians rather than mass messaging. Segments 4 and 5 will be addressed through partnerships in the second year, with their own measures, so that the program does not quietly neglect the residents with the greatest barriers. The next module develops a position for the program aimed at the primary targets, set against the alternative they are most likely to choose, which for most of them is not screening at all. The competitor for a 72-year-old former smoker is not another hospital; it is the absence of anyone asking.
References
Carter-Harris, L. (2015). Lung cancer stigma as a barrier to medical help-seeking behavior: Practice implications. Journal of the American Association of Nurse Practitioners, 27(5), 240-245. https://doi.org/10.1002/2327-6924.12227
Modin, H. E., Fathi, J. T., Gilbert, C. R., Wilshire, C. L., Wilson, A. K., Aye, R. W., Farivar, A. S., Louie, B. E., Vallières, E., & Gorden, J. A. (2017). Pack-year cigarette smoking history for determination of lung cancer screening eligibility: Comparison of the electronic medical record versus a shared decision-making conversation. Annals of the American Thoracic Society, 14(8), 1320-1325. https://doi.org/10.1513/AnnalsATS.201612-984OC
US Preventive Services Task Force, Krist, A. H., Davidson, K. W., Mangione, C. M., Barry, M. J., Cabana, M., Caughey, A. B., Davis, E. M., Donahue, K. E., Doubeni, C. A., Kubik, M., Landefeld, C. S., Li, L., Ogedegbe, G., Owens, D. K., Pbert, L., Silverstein, M., Stevermer, J., Tseng, C.-W., & Wong, J. B. (2021). Screening for lung cancer: US Preventive Services Task Force recommendation statement. JAMA, 325(10), 962-970. https://doi.org/10.1001/jama.2021.1117
How this HLTH 5673 Module 2 example is structured
HLTH 5673 Module 2 typically segments that population by need, coverage and how care is reached; your classroom's instructions decide the variables and the number of segments. This example states its segmentation variables and data sources first, then describes each segment with its size, profile and main barrier. A section evaluates the segments against standard criteria, including how reachable and responsive each is, and the paper ends by choosing target segments for the positioning work in the next module.
HLTH5673 Module 2 questions, answered
What does HLTH5673 Module 2 usually ask for?
HLTH5673 Module 2 typically asks students to segment the market for a health care service into groups that differ in needs and in how they can be reached. Many sections expect segments to be sized, profiled and evaluated before targets are chosen. Your classroom's instructions decide the variables and the number of segments.
Which variables work best for segmenting a health care market?
Variables tied to why people do or do not use the service work best, such as need or clinical status, insurance coverage and access to care. Demographics alone often group people with different barriers together.
How do I choose target segments?
Evaluate each segment on size, whether it can be identified and reached, likely response and cost to reach. Estimate the realistic yield from each, choose the segments that offer the most results for the effort first and plan separately for segments with greater barriers so they are not ignored.
Write yours, or have the desk draft it
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