With health insurance premiums increasing among public and private payers and ACA subsidies no longer in effect, new research suggests Americans are receptive to alternative insurers. A survey by health care technology company Softheon found that 74% of U.S. adults would likely choose a plan from a local hospital or health system if it cost about the same as other options.
Softheon's research (based on 1,000 online survey responses from U.S. adults ages 25 and older) suggests room for expansion of provider-sponsored plans from hospitals or health systems for consumers seeking alternatives to traditional models. Among respondents, interest in provider-led plans was highest among parents with children under 18 and individuals who are self-employed. More than 80% of each group said they would likely choose a local health system plan at comparable pricing.
"Health insurance decisions are becoming increasingly difficult for many," said Eugene Sayan, Softheon's founder and CEO. "Millions have experienced ACA premium subsidies expiring, and private insurance holders are likely to see premium increases this year, if they haven't already. This is prompting consumers and even employers to reconsider how they engage with health coverage. More people want their insurance and their doctors working together. That expectation creates opportunities for health systems that can deliver a provider-aligned model of integrated care and coverage."
Survey highlights
The survey revealed a split in trust depending on the specific insurance function. For example, respondents favored provider-sponsored health plans for understanding their health needs (53%) and acting in members' best interests (54%). Traditional national insurers, meanwhile, maintained an edge in such operational areas as providing clear coverage information (54%) and processing approvals quickly (56%).
Notably, neither type of insurer achieved more than 60% trust in any category, indicating that strong performance in a few key areas could allow any plan — including provider-sponsored plans — to differentiate and compete effectively, according to Softheon officials.
Survey respondents also identified several persistent problems with their current health insurance. These include high costs (47%), confusion about what is covered (34%), and poor communication between insurance companies and health care providers (23%).
When asked what benefits they would expect from a plan in which doctors and insurance are part of the same organization, the top responses included better communication between doctors and insurance (59%), faster approvals for care (50%), and anticipated lower overall costs (38%).
"When you have people coming in to get care, you need mechanisms to ensure they have the right insurance and programs in place," Sayan said. "Tighter integration between providers and payers can help manage those dynamics and drive better outcomes."
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