What Members Want from Health Plans in 2021
Based on our 2021 consumer research, it’s clear that health plan members want more from their health plans, including accurate information on out-of-pocket costs (83%) and more control over their health care costs (67%). Consumers also say they want guidance from their health plan, with 48% saying they want more help understanding and navigating healthcare options and 70% stating that they would be interested in their health plan guiding them through the process of finding a provider.
These findings are very encouraging for price transparency and consumer engagement. They also mean many health plans have some work to do to meet the changing demands of their members. Based on these findings, we’ve put together three suggestions to help plans deliver more information to members as they navigate their healthcare needs.
Suggestion #1: Bulk up your plan portal
It’s no secret that health plan members expect more and more from their digital experiences, thanks to the interactions they have with other consumer industries. So how can health plans build out their plan portals to deliver more of what members want? We asked respondents about the capabilities they want their health plans to offer and here are what tops the list:
- Sharing what my out-of-pocket costs will be before I get care
- Showing my medical history
- Displaying information relevant to my remaining deductible
- Showing my current providers
- Showing recommended care/preventative care tasks
- Making healthcare savings recommendations based on my personal claims data/medical history
Suggestion #2: Provide a better provider profile
Our survey showed that 30% of consumers look at their health plan website first when seeking out a new doctor. This is more than any other source, including good ‘ole Dr. Google. Our survey asked about which traits or details about a provider are most important to members as they research care.
Here are the top 10 details health plan members look for in a provider profile:
- Whether the doctor is in-network
- Expertise in my condition
- Distance from home or work
- Appointment availability
- Years of experience/in practice
- Quality ratings/scores
- Cost of service/care
- Experience with patients like me
- Reviews from other patients
- Preferred treatment approaches
Suggestion #3: Help members learn where they can save on care
Even with insurance, 25% of respondents in this year’s survey said that they have avoided getting healthcare due to a lack of information on costs. Providing accurate cost information is central to what we do at HealthSparq – and what the government is now mandating for both hospitals and health plans – for good reason: people want and need this information to make informed choices.
Beyond just providing costs, health plans are being asked to provide more guidance for members through recommendations and insights that ensure members understand where and how they can save on care. Navigating healthcare is complicated, and health plans should be working to get their members get through it as easily as possible. Below are two areas where members would specifically like additional guidance on managing their healthcare spending:
- 1 in 3 would like their health plan to provide healthcare savings recommendations based on their personal claims data/medical history
- 7 in 10 would like to know ways to save on care when planning a major surgery along with the cost
Interested in even more findings? Take a look through the full report!