Health Plans, Members and COVID-19: New Research Reveals Consumer Sentiment and Behavior

In the midst of fielding our annual benchmark survey to take a pulse on consumer sentiment related to health care transparency tools, COVID-19 turned our country on its head. We realized that a “2020” report of any sort, without a view into the pandemic, would be woefully incomplete. So, a few weeks ago, we surveyed 505 U.S. residents to learn about their experience as health plan members during COVID-19. In advance of our full report, which will be released in the coming weeks, I’d like to share some of the ways members have been impacted.

Delayed care and what it means for 2020 and beyond

Study after study is showing clear data that people are delaying medical care – care that ranges from preventive check-ups to cancer treatment and dental visits to elective surgeries. Hospitals are also reporting fewer strokes and heart attack patients are presenting in emergency rooms. In our survey, 56% of respondents say they’ve delayed health care visits due to the outbreak of COVID-19. Of those who’ve delayed, the reasons are as follows:

  • 53% say they are following their state’s stay at home orders
  • 43% say they are scared to enter a medical facility due to the potential spread of COVID-19
  • 39% say the care they need is not currently being offered by their health care provider/facility due to COVID-19
  • 8% say they can no longer afford the care

As of today, all states are easing restrictions and working toward getting people back in for non-COVID-related medical care. However, while stay at home orders loosen and the availability of care gradually increases, people’s fear of getting COVID-19 isn’t going to dissipate. We asked people how likely they are to seek medical care once the restrictions ease and here’s what they said:

  • Two-thirds are likely to seek the health care they’ve delayed after COVID-19 restrictions ease up (67%).
  • Half of those consumers will wait 1-3 months to receive health care (52%) once restrictions ease, while nearly one-quarter are likely to wait 4-6 months (21%).

Actuaries at health plans are facing an unprecedented situation as they work to assess what this will mean for the financial health of their organizations. In the short term, fewer claims are being paid due to delayed care, which can create immediate MLR impact. But at some point, that delayed care is likely to become a massive wave of claims as people feel more comfortable seeking in-person care. One topic of conversation we’re having with our clients right now is identifying ways to guide members to quality, cost-effective locations as they begin the process of searching for care again. Sharing out-of-pocket cost estimates while members compare providers online is one such strategy as is using incentive programs to reward members financially for choosing cost-effective care.

Consumers aren’t thrilled with their health plans’ response

From our vantage point, health plans across the country have stepped up to support members and providers during the pandemic. We asked respondents in our study a few questions on the topic, including, “How effective was the U.S. health care system and government in handling the crisis?” We found that people believe the health care system is responding to the COVID-19 outbreak better than the government. More than half believe the health care system is responding well (60%), while less than half say the same about the government (43%).

However, when we asked how has COVID-19 changed Americans’ perceptions of health insurance in the U.S., more than half of our respondents said they view health insurance more negatively than they did before the COVID-19 outbreak (59%).

What’s driving these negative attitudes is undoubtedly complicated. While health insurance has long been an industry that’s low on the list of ‘trusted’ businesses, research we completed earlier this spring found that trust increased, from 46% in 2019 to 52% in 2020. However, that trust is waning as consumers encounter challenges accessing care or getting reimbursed for care, and they may not be aware of plans’ efforts to support members.

In our survey, 41% of respondents reported that their health plan has not communicated to them about its COVID-19 plans and coverage. This large percentage highlights the importance of not only proactive communication about crises but also the importance of communicating through channels that meet your members where they are – email, snail mail, text messages, in-app messaging or even robo-calls. While press releases and website homepage updates may reach some individuals, direct outreach that’s as personal as possible will have the highest likelihood of getting through to members.

How COVID-19 will change health care

The increased usage of virtual care or telehealth has been widely reported and discussed as a result of COVID-19. What remains to be seen is if this mode of care continues its widespread use once the pandemic eases. Are people using telehealth because it’s the only option, or now that they’ve tried it once, will they prefer it to the care they once had? We asked our respondents how they expect to interact with the digital tools and resources from their health plan as a result of COVID-19 and they reported:

  • 52% say they’re more likely to use their health plan’s telehealth/virtual care services
  • 48% say they’re more likely to use online appointment scheduling through their health plan
  • 44% are more likely to use their health plan’s online chat

There is an opportunity for health plans to change the dynamic of trust with members during this time—as well as activate members to use cost-effective online resources and increase ongoing use of those resources. Providing members with what they want is part of it. Communicating with them about what’s available is just as important.

The impact COVID-19 will have on the future of health care is uncertain, from the care delays mentioned above to changes to the way consumers interact with their health plan and the health care system generally. We discussed these findings as part of an AHIP webinar on June 22. You can watch the replay from the event here.