Consumers are becoming more educated about choosing their own health plans. They will drive market demand by choosing plans that are tailored to their lifestyles as opposed to plans that fit into a matrix of benefits offered by organizations.


The re-engineering of the US healthcare system is gaining momentum and consumers are driving the most fundamental changes. This “new health economy,” will be designed by the consumer and for the consumer with the use of a vast array of new technologies, including mobile applications and social media networks. As consumers become more educated about their healthcare needs, they will look to tailor their healthcare plans to suit their personal requirements. According to Sam Ho, executive vice president and chief medical officer of UnitedHealthcare and chair of the board of directors of the eHealth Initiative, “the restructuring under way is radical and the implications for health information technology are equally profound.” Health insurers must now learn to navigate this brave new world lest they fall behind.

Until recently, specialists have designed healthcare plans with a business-to-business mindset. The focus has been on the collective—and captive—audience. Individual consumers have had to find a way to fit into pre-existing plans with little choice and no say in how such plans are laid out. However, new technologies are shifting consumer expectations. Individuals are now keen to access a retail shopping model—much like that employed by Amazon and other Internet giants—to meet their specific healthcare needs. And much like in the retail markets, customers can walk away if they have a negative experience or if they feel their needs aren’t being met.

These new expectations are leading consumers to choose health insurers that have a customer-oriented focus. Giving consumers the opportunity to personalize plans to individual tastes will push competition in the health market to resemble competition in traditional retail markets. Personalization is ultimately expected to lead to better plans and lower costs, as with any other commodity. The benefits to both consumer and provider are clear.

Being able to understand the consumer and his or her specific needs is also necessary for health insurers to humanize the healthcare purchasing experience. According to a 2014 survey by eHealth Initiative, healthcare organizations recognize the importance of different types and sources of electronic data to analyze healthcare use and patient needs but many have not committed to the use of such data because of costs and staffing concerns. In addition, the survey shows that analytic capabilities and practices vary significantly across healthcare organizations.

Health insurers need to integrate a customer model with quality data and patient-engagement strategies to generate a positive overall customer experience. A portal that can engage customers will improve the purchasing experience and build consumer loyalty. Having the ability to take greater control over their healthcare options will create a better experience for consumers and providers should see positive changes to cost structures. As Charles Darwin stated when developing his theory of natural selection, “It is not the strongest or the most intelligent who will survive, but those who can best manage change.”

As consumers start to make their own health insurance decisions, health insurers will need to listen and tailor their plans in order to survive in the consumer marketplace. Is your health insurer listening to you?

This post was authored by Mark Nathan, CEO.