Rising healthcare costs sparked health plans and employers to use higher deductibles to transfer responsibility to individual consumers for making optimal shopping decisions about healthcare and coverage. The notion was that consumers would be more likely to seek out the right care at the right price if they were to bear the financial burden of paying more for services. However, consumers have become frustrated because they perceive that most health plans aren’t providing the necessary information and support to make it easy to find the best care at the lowest price.1 Health plans are now paying a price: significantly lower consumer loyalty and satisfaction.

Impact on loyalty

There is a proliferation of high deductible health plans (HDHPs), as well as general growth in average deductibles across the spectrum of insurance products:

Consumers with high deductibles are significantly less likely to promote their health plan’s brand or remain loyal if they are not given the information and support they need to make informed decisions about cost and services. Group insurance consumers with higher deductibles have a Net Promoter Score® (NPS®)4 of -24, compared to 5 for consumers with lower deductibles.5 Furthermore, these consumers are 44 percent less likely than those with lower deductibles to say they’ll “definitely” stay with their plan.6

Deductible differences

Consumers with higher deductibles (more than $2,400) are less likely to agree that their insurers are helping them understand cost and coverage, compared to consumers with lower deductibles (less than $1,200) – See Figure 1. Consumers with higher deductibles are dissatisfied with the information about cost and coverage that insurers provide, and they don’t know how to properly navigate the system.

Interestingly, consumers with high health insurance deductibles have a better understanding of how to navigate the healthcare system—59 percent are expert or proficient in health literacy compared to just 45 percent of lower deductible consumers7—yet they struggle to understand their options or how they can save money on care.

Give them what they want

Health plans must begin to provide true healthcare transparency, using an experience-led approach to change consumer behavior—otherwise membership will seriously suffer. Here’s how:

Understand what makes consumers tick. Health plans can take an experience-led approach to changing consumer behavior by understanding the motivation behind it. For instance, the Fogg Behavior Model (FBM)8 suggests that three elements must converge at the same time for a behavior to occur: motivation, ability and trigger. When it comes to transparency, health plans can use FBM as a guide to identify what prevents members from engaging in desired behaviors.

Make tools usable. Develop convenient, accessible and intuitive tools that allow consumers to access information in the way they want. Tools should be designed for the channel, whether online, mobile or call center.

Get personal and relevant. Next-generation transparency solutions will use artificial intelligence (AI) to proactively engage consumers9 with real-time personalization providing the information consumers need, when they need it, through their preferred channels.

Design differently. Products should be clear and intuitive, designed around consumer needs.

Widen the circle. Extend transparency offerings and experiences to the provider setting with shared incentives for engaging consumers in discussion of the price of healthcare service options.

Capture consumerism

Health plans work hard to provide the products, programs and services that consumers are looking for, but one thing is missing: relevant information about the cost and availability of those offerings. The technology and the tools are there to make it easier for consumers. Now is the time to create transparent experiences that meet consumers’ needs and surpass their expectations.

1 Accenture 2017 Consumer Experience Payer Benchmark Survey

2 National Business Group on Health’s 2018 Large Employer Health Care Strategy and Plan Design Survey

3 Kaiser Family Foundation, 2017 Employer Health Benefits Survey, September 2017

4 Net Promoter, Net Promoter System, Net Promoter Score, NPS and the NPS-related emoticons are registered trademarks of Bain & Company, Inc., Fred Reichheld and Satmetrix Systems, Inc

5,6,7 Accenture 2017 Consumer Experience Payer Benchmark Survey

8 Dr. BJ Fogg, What causes behavior change?

9 Accenture, The Intelligent Payer: A Survival Guide, 2018

RELATED: The intelligent payer: A survival guide

Jean-Pierre Stephan

Managing Director – Payer Front Office Lead

Loren McCaghy

Director – Consumer Engagement and Product Insight​​

Michael Brombach

Senior Manager – Strategy


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