62% of young members use AI to choose a health plan

Commercial health payers are in the middle of a member trust problem, leaving 62% of younger members using AI, not care navigators, to choose a health plan, according to new Accenture data obtained via email.

This could cost payers to the tune of $3 billion in future member lifetime value, or the profit a payer could make throughout the payer-member relationship, over the next decade, the report authors said.

Member trust, on the whole, is dropping, with Accenture flagging a 10.5-percentage-point decline among Millennial and Gen Z members between 2023 and 2026. That means younger members aren't turning to their healthcare payers for plan information or healthcare guidance, according to Bracken Flynn, principal director in Accenture's Health industry.

"When members don't trust their health plan, they don't just disengage, they route around it," he said in a statement. "Our data shows that younger consumers aren't asking for less from their insurer. They want more."

Members say getting their needs met feels transactional, Accenture showed, with some younger members saying that complex healthcare access, limited price transparency and a lack of  guidance from their health plans are damaging their relationships with payers.

That's going to cost payers, Accenture added. Younger members are 50% less likely to stay with a health plan after encountering even one barrier, such as unpredictable pricing or unclear health guidance.

Members aren't settling for poor healthcare navigation. Instead, a new party has entered the chat: AI.

"[Members are] looking for a partner that helps them navigate care, understand costs, and make confident decisions," Flynn explained.

AI has proven to be that partner, with members starting to use the technology to help them select a health plan.

However, the answer is not simply for payers to install their own member-facing AI tools to redirect engagement. Members who don't trust their payers to begin with won't be receptive to their payers using AI, the Accenture data showed.

While 69% of younger members who trust their insurer said they are comfortable with the payer using AI to help them find a doctor, that figure is just 16% among those who don't trust their payer.

Instead, payers need to change course, transitioning from being the administrator of coverage into the orchestrator of overall member health.

"The insurers that earn that trust now will define what health coverage means for the next generation," according to Flynn.