Home Health Insurance What do Consumers Want in a Health Insurance Plan?

Someone asked me recently, “What are consumers looking for in a health plan or an insurance company?” I quipped a simple answer: convenient, comprehensive, affordable healthcare. In truth, a more accurate and current response is not nearly as clear-cut. To reasonably answer that question, we must consider an industry that is shifting its messages, becoming increasingly fractured and consumer-centric, and disrupted by big data and technology.

Identify the consumer. Is he or she a prospect or a member? A company employee, millennial, senior citizen, Medicaid recipient, Hispanic, or none of the above? Is your consumer in good health or in need of daily care? Is their primary language English? Is he or she visually or hearing impaired? Put simply, consumers are not all the same, and the health information they are looking for is rooted in their culture, life stage, circumstances, and health state. More than ever, health shoppers are asking “How does this relate to me? And what am I going to get out of it?” That said, consumers are also looking for validation from others like themselves, which means peer-to-peer social sites and testimonials will play a larger role in the healthcare choices they make.

One common thread for all consumers, regardless of their ethnic, demographic or socioeconomic background is that they are being asked to pick up more of the healthcare costs that were previously paid by their employers or government programs. Over the next few years, the average American consumer will be on the hook to pay a greater share through increased premiums, deductibles, copays, and coinsurance. In response, users are starting to educate themselves and are looking for greater value when shopping for health insurance and overall care.

Share data to provide value. Just a few years ago, insurance companies had no incentive to offer more than basic plan information, and consumers had no real need to compare benefits, quality of care, or costs. Nor did they have any reason to share their personal data. Because of the Affordable Care Act and the corresponding ‘retailization’ of the health insurance marketplace, prospective members want more information, not only about plans, but about quality rankings (hospitals, doctors, and providers), wellness programs, drug interactions, peers on social communities, and even new research studies. Members are looking for data to measure drug availability and interactions, quality of care, and to calculate costs and claims. Ultimately, consumers want to understand what they’re actually paying for in their health plans. They are also willing to share more of their personal information if it leads to better healthcare for themselves and their families.

Offer information and services in accessible, multiple formats. The rise in available healthcare data has paralleled technology innovations in recent years. This is good news for insurance companies as they can now reach and engage consumers in new ways. It’s also a positive trend for consumers, especially younger and more tech-savvy audiences, who expect information will be available 24/7 in every consumable channel including—but not limited to—personalized  web sites, provider tools, cost calculators, mobile apps, and even wearable health devices. In addition, customers also expect information to be easily accessible to them regardless of age, disability or language barriers; if not directly online, then through monitored phone, chat, or other customer service request channels.

A challenge for insurers will be balancing the cost of delivering the data and developing tools to meet consumer demands, while at the same time staying within regulatory requirements, particularly around privacy and security. Partnerships with other health organizations, technology companies, and even the government will be essential to meeting these expectations.

As the post-ACA cycle of disruption and innovation in the healthcare marketplace continues, consumers will be looking for insurance companies to provide personalized experiences, more information transparency to drive decisions, and readily available, consumer friendly  tools to drive engagement and retention. In 2015 and beyond, consumers will continue to gain greater control over their healthcare options. Insurance companies will need to listen to consumers and deliver on their expectations in order to evolve and thrive.

1 reply to this post
  1. Some consumers would love to see the insurance agent in person. But some would prefer to consult an agent online, while some would prefer to communicate through email. Thus, as a reputable insurance company, it is best for them to figure out which they way the customer prefer to interact with them and provide them the way that they want.

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