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Despite choice limits, they outperform more traditional insurers


Accenture’s research indicates that consumers trust information about their health up to 46 percent more often with provider-led insurers than traditional insurers.

Offering insurance is fertile ground for hospital systems that may want to build upon the relationship they have with patients, and offer an enhanced level of care and convenience. This is why increasing numbers of hospital systems (e.g., providers) are becoming health insurers. These healthcare hybrids are emerging as strong contenders in the health insurance marketplace.

Provider-led insurers are such strong contenders because they are built on a foundation of trust. According to Accenture research, a consumer’s trust in his or her doctor is the leading indicator of trust for a health insurer.1

1Regression analysis of the 2012 Accenture Healthcare Consumer Survey


The shift to a consumer-oriented health insurance market offers the opportunity for new provider-led insurance entrants to quickly gain market share and build on past performance. By focusing on innovation, price transparency, and being easy to do business with, providers can outperform traditional, established insurers across the end–to-end consumer experience.

To explore this concept, Accenture conducted an online survey of 3,209 healthcare consumers over 18 years of age in the United States. Consumers included Medicare, Medicaid, Group (Defined Benefit and Defined Contribution), Individual (purchased directly through Insurer and purchased through Broker), Uninsured Consumers (subsidy eligible and non-subsidy individuals) and small group decision makers.

The survey was conducted in June of 2012. The analysis included advanced analytics to draw insights as well as healthcare consumer needs-based segments that transcend traditional market/product segments.


Accenture’s advanced analytics indicates that innovation, price transparency and being easy to do business with are the top three factors driving brand loyalty in health insurance.

Provider-led insurers are taking the lead in these three areas to garner consumer loyalty and create brand advocates:

  1. Innovation. Members of provider-led insurers are twice as likely to indicate that their insurer is innovative, compared to regional Blues and Commercial payers (77 percent of members who think you’re innovative will promote their health insurance brand).

  2. Knowing cost. Provider-led insurers’ members are up to 50 percent more satisfied with knowing their cost of care in advance of seeking treatment (74 percent of members who know cost of care in advance will promote their health insurance brand).

  3. Business ease. Consumers also find provider-led insurers up to 35 percent easier to do business with than Blues and Commercials (72 percent of members who think you’re easy to do business with will promote the brand).


Some healthcare providers are better positioned than others to make it in the health insurance market. Those that have built a recognized, trusted brand are well positioned to transfer that brand recognition and trust to the insurance market. A relentless focus on the consumer experience will be critical to successful retention and acquisition of members.

Provider-led insurers should apply their ability to cater to patient needs on the clinical side, to satisfy consumer needs on the insurance side. This level of care will create a differentiated experience, but also a seamless experience that enhances consumer satisfaction and advocacy across the consumer lifecycle.

Products must also be differentiated. For example, provider-led health insurers should actively work to create products and services that are perceived as innovative, easy to use and accessible to their consumers. Analytics can help drive such differentiation.

Provider-led insurers have a wealth of insurance and care delivery data that enables them to better predict and anticipate consumer behaviors. In response, they can deliver tailored products and services that best meet consumer needs.