KEY TAKEAWAYS
  • The high – and rising – cost of healthcare has prompted the rise of new models of health insurance.
  • Whether new health insurers organize health insurance around new technologies, medical expertise, or cost transparency, their ultimate success will be determined by their ability to push patients towards healthful lifestyles.

Healthcare insurance evokes very strong feelings for most U.S. consumers. Not surprisingly, a U.S. survey indicates that the vast majority (87%) would like to receive high-quality healthcare at a lower cost than is currently available. The priority is on comprehensive benefits, with particular emphasis on coverage for prescription drug, preventative care, and emergency care. Furthermore, a survey by Troubadour Research and Consulting reveals that most consumers would exchange personal information and even biometric data in return for lower-cost products.

Consumers’ current view of health insurers is noticeably dim. A Consumer Reports survey finds that a large majority believe that insurers are profiting excessively from a broken system. They want greater transparency and overwhelmingly support hospitals and insurers to provide accurate, upfront cost estimates to help them weigh health decisions. Yet, a majority of respondents would accept out-of-pocket health expense below a threshold of about $2,500.

Bankrate.com offers further evidence that out-of-pocket expense is often not the primary issue for consumers. Its survey shows that Americans are split in their preference for low out-of-pocket expenses vs. lower premiums. Of those surveyed, 36% would chose a plan offering lower deductibles and copays, but with higher monthly premiums, but 44% would chose the opposite option.

Overall, consumer sentiments seem to suggest that the stage is set for AI-powered health insurance products that can leverage patient and provider data to provide broad coverage and steer consumers to value-for-money providers. Upfront price transparency and low (although, not necessarily zero) out-of-pocket expenses would also be important considerations.

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