All Articles Healthcare The new health care consumer is here to stay


The new health care consumer is here to stay

Health plans that invest in decision support technology will connect and get consumers into the right plans for them.

6 min read


The new health care consumer is here to stay


It’s been a dynamic decade in health care, and all signs point to continued change. Among the biggest shifts has been the rise of the health care consumer. Health plans continue to reorient processes and products around savvier, more engaged members, but it’s a work in progress. To better understand the state of health care consumerism today, SmartBrief spoke with Connecture President and CEO Jeff Surges. Here — and in greater detail at AHIP Institute & Expo later this month — Surges discusses the roots of this trend and key steps health plans can take to empower consumers.

When the Affordable Care Act was implemented, consumerism was expected to be a major disruptive force. How did that disruption play out, if at all?

I think the ACA’s biggest impact – aside from increasing access to care for many people – was the spotlight it placed on a movement that was already underway: health care consumerism. With the rise of high-deductible health plans in the early 2000s, consumers began demanding more transparency around cost and quality in health care. At the same time, online retail giants like Amazon were shaping the way consumers purchased goods online, and consumers brought those experiences and expectations to health care.

Connecture President and CEO Jeff Surges

In the midst of these powerful forces, the ACA put the American health care consumer front and center. Today, health care consumerism continues to thrive, and people are still demanding the same two things that underpin the entire movement: transparency around data and the convenience of technology. The health insurance community has seen this play out in the proliferation of decision-support technology. Connecture recently completed a study that tracked consumer behavior from 2012 through 2017, and we saw 30% growth in the number of people who shopped online for health coverage with the help of decision-support tools. Those same people were four times more likely to find their best-fit plan than people who opted not to use these tools. It is clear that consumer-driven technology has made a positive impact.  

What do today’s consumers want and need from their health insurance?

Last year, Connecture surveyed more than 2,000 Americans to find out how people shop for health insurance. Not surprisingly, we saw that many find shopping for and enrolling in health insurance stressful and dissatisfying. In fact, 55% said they are frustrated they can’t afford any of the options available to them. And 51% said they don’t understand what certain plans would really cost them over a year. Ultimately, we advise consumers to consider more than just premium costs when they’re shopping for coverage, and ask themselves critical questions such as:

  • What is your realistic budget?
  • How frequently do you anticipate visiting your primary care doctor and specialists over the next year?
  • What prescription drugs are you using?

Honest responses to these questions will help people better identify the best-fit options for them and their families. Access to decision-support tools and online cost calculators to help answer these questions is critical, too. 

How should carriers enable consumerism, and what benefits could arise when they do so?

The online retail world continues to influence the health care industry, including health insurance. So far in 2018, we have seen retail giants like Walmart, CVS and Amazon make big waves with their proposals to merge with more traditional insurance players. This is an exciting convergence and a disruption our industry has been moving toward for decades.

If you are a carrier in the midst of this collective push toward consumerism, there are a number of ways you can enable it. First, invest in decision-support technology. According to our annual consumer survey, 87% of consumers prefer to shop and enroll in coverage on their own — but only 20% actually complete the process by themselves. What does this tell us? Shopping for health insurance online is not like shopping for shoes and airline tickets. It’s much more complex, and the health insurance industry must continue to help people become more informed, confident shoppers. Access to information is not necessarily the problem; understanding the information is. So, carriers should continue to leverage technology and intuitive platforms that walk consumers through decisions.

Second, leverage data and analytics to understand the entire consumer journey. The more you understand about your customers and the different ways they shop, the better you will be able to meet their needs.

Finally, make engagement part of your strategy year-round, not just during enrollment. Engage people on the topics that matter most to them. For example, we know rising prescription drug costs are a major concern for Americans. Carriers have a unique opportunity to leverage drug comparison technology and offer consumers a meaningful solution for curbing the costs of medications year-round.

What role will technology play in continued progress moving forward?

Technology will undoubtedly remain a hallmark of health care consumerism. I think we’ll see more advancements in decision-support technology and even artificial intelligence in the near future. I also think we’ll see a stronger emphasis on prescription drug transparency. Health insurance carriers and others in this space are uniquely positioned to help bring real solutions to the table if they leverage data and technology.

Consumers are embracing this type of innovation, too. Our surveys tell us 80% of people are willing to talk to their doctor about alternatives to their prescription medications. Decades ago, conversations like this did not happen, but today’s consumers are much more informed and empowered. Data from our online drug-price transparency tool DrugCompare shows that consumers conduct more than 38 million drug searches a year. What are they finding? That they can save, on average, $958 per drug­ search, which can result in $4 billion in potential annual savings for consumers and carriers. This is consumerism, and it’s fueled by technology.  

How has this unpredictable and dynamic environment reshaped Connecture’s mission and vision?

The health insurance industry is going through its own metamorphosis. We are not seeing rapid change, but there are incremental signs change is happening, and more is coming. I think it is perfectly healthy for an industry or even an organization to reinvent itself in response to new or ongoing demands from consumers and advancements in technology. In fact, we are renovating our company to more nimbly meet the demands of our customers by shifting from a public to a private organization. This was a huge decision for us and one we felt would better position Connecture, for new opportunities and to address the ever-changing commercial insurance space. And now – with a clear company vision, revamped product road maps, new executive team members and smarter processes around our data and research work – we feel stronger than ever. Our mission is to empower our customers with innovative technology that makes choosing health care coverage simpler. That is core to what we believe, and it is something that will make the entire industry, our clients and their health care consumers stronger.

Connecture works with payers, brokers and government agencies to create shopping, enrollment and engagement products that help people confidently enroll in the right health plan. Learn more at