What Members Want from Health Plans in 2021 - Kyruus Health (2024)

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:

  1. Sharing what my out-of-pocket costs will be before I get care
  2. Showing my medical history
  3. Displaying information relevant to my remaining deductible
  4. Showing my current providers
  5. Showing recommended care/preventative care tasks
  6. 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:

  1. Whether the doctor is in-network
  2. Expertise in my condition
  3. Distance from home or work
  4. Appointment availability
  5. Years of experience/in practice
  6. Quality ratings/scores
  7. Cost of service/care
  8. Experience with patients like me
  9. Reviews from other patients
  10. 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!

What Members Want from Health Plans in 2021 - Kyruus Health (2024)

FAQs

What Members Want from Health Plans in 2021 - Kyruus Health? ›

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%).

What do consumers want from health insurance? ›

Consumers are most concerned about costs of coverage, technical competence, the information and communication provided by physicians, coordination of care, and access.

What are the 2 most common health insurance plans? ›

Before choosing a health insurance policy for yourself, your family, or your employees, you must know what types are available. Some popular health insurance policy options are: Preferred provider organization (PPO) plans. Health maintenance organization (HMO) plans.

What does Kyruus health do? ›

Kyruus Connect for Providers

Our suite of solutions helps health systems connect, organize, and harness their data—and take it further with APIs that power interconnected experiences for patients, providers, and partners across the care ecosystem.

What is the best US health plan? ›

Compare the Best Health Insurance Providers
CompanyAvailability
Blue Cross Blue Shield Best Overall36 states
Kaiser Permanente Highest Quality Plans8 states and the District of Columbia
Oscar Best Health Management Programs18 states
Aetna CVS Health Best for Same-Day Care12 states

What do people want most in health insurance? ›

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%).

What do people want in healthcare? ›

The health care consumer landscape is changing. Engaged consumers desire greater levels of self-service, access to information, greater choice, and real-time interactions.

Why do doctors prefer PPO over HMO? ›

Doctors often prefer PPOs because they offer greater reimbursem*nt rates compared to HMOs and have less administrative paperwork. Is a PPO a good thing? For many, a PPO's flexibility and coverage make it a favorable choice, but it comes with higher premiums.

What is the best health insurance? ›

Summary: The Best Health Insurance Companies
COMPANYFORBES ADVISOR RATINGOUR EXPERT TAKE
Blue Cross Blue Shield5.0Best Provider Network
Kaiser Permanente5.0Best Quality
UnitedHealthcare4.6Best for Low Out-of-Pocket Costs
Sep 1, 2024

What are the 4 recommended type of insurance? ›

Most experts agree that life, health, long-term disability, and auto insurance are the four types of insurance you must have. Employer coverage is often the best option, but if that is unavailable, obtain quotes from several providers as many provide discounts if you purchase more than one type of coverage.

How long has Kyruus been in business? ›

Kyruus was founded in 2010.

How many employees are at Kyruus? ›

As of August 2024, Kyruus Health has approximately 391 employees across 4 continents, including North AmericaEuropeSouth America. Key team members include CTO, CSO: C. G.Chief Technology Officer: H. S. Chief People Officer: P. C. L.. Explore Kyruus Health's employee directory with LeadIQ.

Who is the number 1 health insurance in the US? ›

Best health insurance companies of 2024

Kaiser Permanente: Best health insurance. Blue Cross Blue Shield: Best health insurance for the self-employed. UnitedHealthcare: Best health insurance provider network. Aetna: Best health insurance for young adults.

Which health insurance company denies the most claims? ›

UnitedHealthcare is the worst insurance company for paying claims with about one-third of claims denied. Kaiser Permanente is the best large health insurance company for paying claims, denying only 7% of medical bills. Currently insured? It's free, simple and secure.

Who is number 1 in healthcare in the US? ›

Massachusetts, Hawaii, and New Hampshire top the 2023 State Scorecard rankings for health system performance, based on 58 measures of health care access, quality, use of services, costs, health disparities, reproductive care and women's health, and health outcomes.

What do consumers look for when buying insurance? ›

CR rates insurers based on member feedback on the cost of their premiums, the ease of processing claims, the quality of non-claim-related customer service, thoroughness of policy review, clarity of policy coverage, and proactive help and advice.

What are healthcare consumers looking for? ›

In addition to quality and affordability, convenience and personalization are key drivers of consumer choice and perception of their healthcare.

What customers want from insurance companies? ›

Insurance customers want to reduce risks in their lives and are willing to use risk-prevention services from insurers. This preference is most pronounced among millennials, affluent customers, urban customers, and families with children.

What do consumers value in healthcare? ›

Four out of five respondents said finding a provider who accepts their insurance is “very important” or “important.” About 70% said that a convenient location is important for finding a provider, with slightly more than half giving strong weight to good online ratings and reviews.

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