Contributor: What’s Driving Consumers to Switch Away From Health Care Payers

The year 2024 is expected to be a year of growth for health care organizations, with 91% of health care organizations expecting some level of revenue surge as forecasted by Accenture’s Pulse of Change Index. However, to deliver on that growth and improve health care outcomes for members, health care payers need to focus on strengthening patient trust and loyalty.

Understanding Dissatisfaction and Factors Influencing Payer Switching

To understand how people select and switch between health care payers, Accenture surveyed 9700 insured consumers, revealing how payers perform across key satisfaction and loyalty touchpoints.

The research reveals that more than 50% of consumers who chose to switch payers did so because of negative experiences. In contrast, they are 3 times more likely to trust insurers that consistently deliver accurate information.

The findings also examine consumer sentiments towards their health insurers and assess their performance, identifying the key motivators influencing consumers to switch payers. Members tend to leave payers when inconsistent or inaccurate information is provided, as well as when they feel their questions are not answered. Unsurprisingly, poor or subpar customer service experiences and ineffective digital methods contribute to decisions to switch. While experience motivates many to switch payers, the importance of this factor also varies across generations, especially among Gen X (54%) and Millennial (60%) respondents who have higher expectations.

Meeting Consumer Needs

When it comes to reasons for choosing or retaining insurers, benefits and coverage are important considerations. However, the survey also indicates that access to quality care and payer experience takes precedence over price when consumers choose or renew plans.

Retention of members is also grounded in ease of use as 75% of people will definitely stay when they find their insurance very easy to use. When people perceive their insurance as somewhat easy to use, only 32% indicate a high probability to stay with their insurer. This shift in preference has more than double the effect on retention.

Consistent communication and providing accurate information are essential to facilitating this ease and are among the key factors that make insurance user-friendly across Medicare Advantage, individual, and group coverage types. This is further evident in how closely members’ access to information online is linked to their overall rating of payer ease, with 82% rating the overall plan as very easy to use when they can find information easily.

Loren McCaghy presents methods for payers to keep consumers on their plans | Image credit: Accenture

Fundamentals to Building Trust and Loyalty

1. Build a strong foundation – Health care payers need to evolve their capabilities to prioritize engagement and understanding. Doing so requires an operating model and integrated ecosystem that is experience-led and scalable.
2. Understand your customer – Meaningful customer insights are key for health care organizations to create life-centric experiences that reflect the needs of members as real people with complex and sometimes contradictory expectations and needs.
3. Focus on the connected journey – Addressing experiences across interactions is non-negotiable to build loyalty and trust. Creating an omnichannel experience that seamlessly powers the whole journey means linking individual experiences to each other and across channels.

As consumer expectations continue to evolve, health care payers need to meet demands for better accessibility, increased transparency, and a more human-centered experience. Consumer loyalty is cultivated by health organizations that prioritize empathy and improve access, experiences, and outcomes through trusted, personalized health journeys. By prioritizing experiences and personalizing services with new digital capabilities, payers can improve engagement and build the foundation of trust that is integral to retention and loyalty.