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Health Insurance - US - August 2016

"While the ACA (Affordable Care Act) was passed in 2010, health insurance is still a hot topic of conversation. Insurance companies and consumers are each finding out the benefits and challenges of healthcare reform. Changing demographics, innovative technology, and new expectations are shifting the landscape, and the upcoming presidential election is adding to the uncertainty. Insurers need to be nimble in this market and use all the tools at their disposal if they expect to successfully compete."

-Robyn Kaiserman, Senior Financial Services Analyst

This report discusses the following key topics:

  • Costs are still a primary concern – and they are still rising 
  • Most consumers don’t understand the information their insurance company provides
  • How will the upcoming election affect the Affordable Care Act (ACA)?

This Report covers the state of the health insurance industry in America. Issues include the changing demographics of America, the effect of the ACA, and the impact technology is having and will continue to have on the industry.

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Table of contents

  1. Overview

    • What you need to know
      • Definition
      • Executive Summary

        • The issues
          • Costs are still a primary concern – and they are still rising
            • Figure 1: Top factors in choosing health insurance, June 2016
          • Most consumers don’t understand the information their insurance company provides
            • Figure 2: Easy to get and understand information, by generation, June 2016
          • How will the upcoming election affect the Affordable Care Act (ACA)?
            • Figure 3: Attitude toward ACA, by demographics, June 2016
          • The opportunities
            • Technology-based health insurers have an opening
              • Figure 4: Attitudes toward health insurance and health insurance providers, by age and gender, June 2016
            • Customer service improvements
              • Figure 5: Ease and preference of communication, by generation, June 2016
            • Incentives may help attract and retain customers
              • Figure 6: Interest in financial incentives, by gender and age, June 2016
            • What it means
            • The Market – What You Need to Know

              • Healthcare spending continues to rise
                • Growth in healthcare spending as a percentage of GDP has slowed
                  • Percentage of Americans who are uninsured is dropping
                    • Most have employment-based coverage
                      • The majority have medical and prescription coverage
                        • The aging of America
                          • Unemployment continues to be low
                            • The presidential election may affect the ACA
                            • Market Size and Forecast

                              • Healthcare spending continues to rise
                                • Figure 7: National health expenditures, selected years, 1960-2014
                              • Growth in healthcare spending as a percentage of GDP has slowed
                                • Figure 8: Healthcare spending as a percentage of GDP, selected years 1960-2014
                              • Percentage of Americans who are uninsured is dropping
                                • Figure 9: Percentage of Americans who are uninsured, 2004-14
                            • Market Breakdown

                              • Most have employment-based coverage
                                • Figure 10: Source of health insurance coverage for Americans with health insurance at least part of the year, 2014
                              • The majority have medical and prescription coverage
                                • Figure 11: Type of coverage owned, June 2016
                            • Market Factors

                              • The aging of America
                                • Figure 12: Percentage of total population, by age, selected years 2015-55
                                • Figure 13: Anthem direct mail ad, 2016
                              • Unemployment continues to be low
                                • Figure 14: US unemployment rate, May 2010 –May 2016
                              • The presidential election may affect the ACA
                              • Key Players – What You Need to Know

                                • Most are satisfied with their health insurance plan and provider
                                  • Wellness program partnerships
                                    • Health exchanges
                                      • Online tools to manage healthcare costs are floundering
                                        • Consolidation of the industry
                                          • The role of technology in health insurance
                                          • What’s Working?

                                            • Most are satisfied with their health insurance plan and provider
                                              • Figure 15: Attitudes toward health insurance plans and providers, June 2016
                                            • What would consumers change?
                                              • Wellness program partnerships
                                                • Figure 16: Interest in insurance savings opportunities, by generation, August 2015
                                            • What’s Struggling?

                                              • Health exchanges
                                                • Figure 17: Attitude toward need for health insurance, by gender and age June 2016
                                              • Online tools to manage healthcare costs are floundering
                                              • What’s Next?

                                                • Consolidation of the industry
                                                  • The role of technology in health insurance
                                                    • Zoom+PHI
                                                      • Clover Health
                                                        • Picwell
                                                          • The use of wearables is continuing to grow
                                                            • Figure 18: Ownership/intent to purchase any fitness tracker, by generation, September 2015
                                                        • The Consumer – What You Need to Know

                                                          • Employer-sponsored is most popular
                                                            • Parents more likely than non-parents to have private insurance
                                                              • Health insurers need to improve communication
                                                                • Young people are interested in incentives to manage their health
                                                                  • Cost is most important
                                                                    • Technology-based health insurers can benefit from desire to change
                                                                    • Health Insurance Ownership

                                                                      • Employer-sponsored is most popular
                                                                        • Figure 19: Health insurance ownership, June 2016
                                                                      • Hispanics and Blacks are least likely to have employer-sponsored health insurance
                                                                        • Figure 20: Health insurance ownership, by race and Hispanic origin, June 2016
                                                                      • Parents more likely than non-parents to have private insurance
                                                                        • Figure 21: Health insurance ownership, by parental status, June 2016
                                                                    • Type of Coverage Owned

                                                                      • Income affects coverage
                                                                        • Figure 22: Insurance coverage owned, by household income, June 2016
                                                                      • Parents buy a greater variety of coverage
                                                                        • Figure 23: Insurance coverage owned, by parental status, June 2016
                                                                    • Ease of Working with Health Insurance Carrier

                                                                      • Health insurers need to improve communication
                                                                        • Figure 24: Ease of getting information, by generation, June 2016
                                                                        • Figure 25: UnitedHealthcare email ad, 2016
                                                                      • Websites are important – and need to improve
                                                                        • Electronic communication better for parents
                                                                          • Figure 26: Communication preferences, by parental status, June 2016
                                                                        • Mobile apps are of more interest to Hispanics
                                                                          • Figure 27: Interest in mobile apps, by Hispanic origin, June 2016
                                                                        • Young people are interested in incentives to manage their health
                                                                          • Figure 28: Interest in managing health, by generation, June 2016
                                                                        • Most would like financial rewards
                                                                          • Figure 29: Believe health insurers should offer financial rewards, by generation, June 2016
                                                                        • High earners most likely to want financial rewards
                                                                          • Figure 30: Believe health insurers should offer financial rewards, by household income, June 2016
                                                                      • Important Factors in Choosing Health Insurance

                                                                        • Cost is most important
                                                                          • Figure 31: Most important factors in choosing a healthcare plan, by generation, June 2016
                                                                        • Copay amounts most important to Blacks
                                                                          • Figure 32: Most important factors in choosing a healthcare plan, by race and Hispanic origin, June 2016
                                                                        • Cost is top of mind for most
                                                                        • Attitudes toward Health Insurance and Providers

                                                                          • Parents are more positive about health insurers
                                                                            • Figure 33: Attitudes toward health insurance providers, by parental status, June 2016
                                                                          • Technology-based health insurers can benefit from desire to change
                                                                            • Figure 34: Interest in different health insurance plan, by gender and age, June 2016
                                                                          • Hispanics want technology and are interested in switching plans
                                                                            • Figure 35: Interest in different health insurance plan, by Hispanic origin, June 2016
                                                                          • Hispanics value health insurance more than do non-Hispanics
                                                                            • Figure 36: Attitudes toward health insurance, by Hispanic origin, June 2016
                                                                            • Figure 37: Anthem email ad, 2016
                                                                        • Knowledge of the ACA

                                                                          • No growth in understanding of the ACA
                                                                            • Figure 38: Awareness of ACA features, April 2014, June 2016
                                                                          • Consumer experience with the ACA
                                                                          • Appendix – CHAID Analysis

                                                                              • Figure 39: Interest in purchasing insurance from a technology-based company – CHAID – Tree output, June 2016
                                                                          • Appendix – Data Sources and Abbreviations

                                                                            • Data sources
                                                                              • Sales data
                                                                                • Consumer survey data
                                                                                  • Consumer qualitative research
                                                                                    • Direct marketing creative
                                                                                      • Abbreviations and terms
                                                                                        • Abbreviations
                                                                                          • Terms
                                                                                          • Appendix – Consumer

                                                                                              • Figure 40: Use of health monitoring devices for personal use, by demographics

                                                                                          Health Insurance - US - August 2016

                                                                                          US $3,995.00 (Excl.Tax)