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Public health insurance exchange enrollees

2016 Survey of US Health Care Consumers

Findings from Deloitte’s Survey of US Health Care Consumers shed light on how public health insurance exchange enrollees shop for coverage, their confidence in handling future health care costs, use of online services, and knowledge of costs. As health care consumers’ expectations continue to evolve, what does it mean for the future of the US health insurance industry?

Key findings from the report

A look at health insurance exchange enrollees

The public health insurance exchanges have been in operation for nearly three years. In Deloitte’s 2016 Survey of US Health Care Consumers, we sought to understand exchange consumers’ satisfaction with coverage, knowledge of costs, confidence in handling future health care costs, use of online services, and how they shop for coverage.

We found that:

  • Exchange respondents are as likely to say they are satisfied with their coverage as respondents with employer coverage. 
  • Many exchange consumers say they had no difficulty paying out-of-pocket (OOP) costs and more feel prepared to handle future health care costs than in 2015. 
  • More than twice as many exchange consumers report using online information sources to shop for a plan than the average consumer, including those with employer coverage. 
  • More exchange consumers say they understand their costs than consumers with employer coverage, and when they used their coverage, one-quarter of exchange enrollees says they had surprise OOP costs. 
  • Exchange enrollees who report having at least one chronic disease say they understand their coverage better than those who report no chronic disease. 
  • Many exchange consumers shop around for coverage and evaluate the total costs before making decisions, and they continue to be willing to accept network tradeoffs for lower payments. Also, brand matters: When deciding between coverage options, many exchange consumers start with brands they know and then look at total plan costs.

These findings suggest that people who obtain health insurance through the public health insurance exchanges continue to shop around for coverage. They are showing signs of increased confidence in coverage affordability and appear to be just as satisfied with their coverage as people with employer coverage. Exchange consumers’ focus on factors beyond cost and their demand for tools and technologies to support their shopping experience emphasize how important it can be for health plans to review consumer engagement techniques to enhance touchpoints. For health plans in this market, meeting these expectations today may lead to even more confident and satisfied customers in the future.

Health care consumers’ expectations for information and transparency are increasing, as is their interest in intuitive tools to access relevant information. Meeting these expectations should lead to increasingly more confident and satisfied customers in the future.

Explore insights from last year’s survey

Findings from the Deloitte Center for Health Solutions 2015 Survey of US Health Care Consumers suggest that public health insurance exchange (HIX) customers differ from those with other sources of insurance coverage. They are more cost-conscious, price-sensitive, and focused on finding a plan that offers good value and fit. By the time they enroll, HIX customers have a better understanding of plan benefits and costs than individuals with coverage through employers, Medicaid, or Medicare. They are inclined to compare plans, providers, and services on price but show interest in quality measures, too. These early signs suggest that HIX enrollees are becoming savvy, informed consumers who are geared to shop around not just for health insurance, but also for health care services and products.

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