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Health Insurance and Trust

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What You Need to Know

  • Patients who trusted their health plans might be more interested in hearing about wellness.
  • Primary care physicians would have an easier time steering patients away from the emergency room.
  • People who need mental health care would be more likely to get it.

The fundamentals of the health care insurance industry are shifting post-pandemic. How the industry responds to consumers’ new expectations and changing needs could unlock huge value for the health insurance ecosystem.

The future of health care insurance depends on exploring new models of doing business, something the industry has been slow to embrace. Proactively reinventing their business models helps insurers get closer to consumers, as many show willingness to consider alternative distribution channels.

In the near term, business models that capitalize on the benefits digital technology can bring for insurers while meeting a changing set of consumer demands will help insurers not only to remain relevant but also to grow. This shift could also help create trust and encourage a more intimate relationship between consumers and insurers.

Here are four steps the insurers you and your clients are working with should take.

1. Embrace alternate care models.

As people return to their “normal” levels of health care consumption after months of uncertainty, they’re more conscious of and willing to be proactive about their options for preventive care and holistic wellness. While insurance has always rewarded consumers who actively seek preventive care, employers and insurers alike can do more to connect people with the resources they need (and provide the coverage to do so).

For example, many consumers have often defaulted to using the hospital, specifically the emergency room, as their go-to for receiving treatment. In a primary care physician-led model, patients are in more frequent communication with their primary care physicians and will work with them to find the right place for treatment (often not the hospital).

With the primary care physician’s guidance, patients will feel more confident to embrace procedures and therapies administered outside of surgery centers. This not only saves the patient (and the insurer) money but by encouraging a stronger relationship between the primary care physician and the patient, could lead to better health outcomes — rather than waiting until the condition is so bad that the patient needs hospital care.

2. Customize patient care with technology.

Additionally, there are untold opportunities to customize health care based on information patients can easily collect (and may already have) outside the office visit. Designing a health care plan that integrates modern, ubiquitous, patient-friendly technology can make health care feel more accessible to patients.

Wearable technology like smartwatches, medical wellness apps, and other off-the-shelf, consumer-friendly devices allow patients and possibly physicians to track and monitor health outside of visits. When coupled with education and understanding, patients have a better appreciation of their data and they can feel empowered to decide when to contact a physician for care.

Even in their most basic use, the data these watches and apps collect can serve as a useful data point for providers. While no technology is perfect, having a patient bring these data points can help the provider discover patterns the patient might not think to reveal if they were only answering the physician’s questions.

3. Treat mind and body.

The rapid transition we made as a society during the first months of the pandemic quickly highlighted the need for mental health care and healthy coping mechanisms. Many carriers responded by increasing access to mental health care, such as allowing patients to see therapists virtually; however, carriers have begun to lift these allowances now that many providers are reopening.

The future of health care will depend on treating both mind and body. Consumers who sought mental health treatment in the past year will expect to be able to do so at their convenience and with the same level of coverage. Now that more people are willing to accept mental health treatment, it’s on carriers and providers to encourage the trend with the goal of treating the patient holistically.

As with wearables, technology can help to fill in gaps here as well. There are myriad apps available to support patients’ health and wellness outside the office, covering topics such as therapy, meditation, meal tracking, fitness and more. Of course, not all apps will meet the medical community’s standards, but if providers can vet these apps for legitimacy they can provide patients with additional tools to take control of their health.

4. Encourage positive outcomes through insurance plan design.

For brokers and employers to add value to their health care offerings, they need to take a holistic, best-of-breed approach to build the best package possible. Flexible plan design is key when thinking ahead to health care consumers’ future needs. Large carriers may be slow to embrace change — or may even work backwards — but brokers and employers can work together to build a plan to bridge the gap between insurers and consumers.


Terry Rowinski (Photo: HPS)Terry Rowinski is president of Health Payment Systems Inc., a health care payments company.