HealthEdge 2025 Report: Consumers View Health Insurance More as Partner than Payer

HealthEdge's fifth annual Healthcare Consumer Report reveals evolving consumer attitudes toward health insurance, with 51% of respondents viewing their health plans as partners in care rather than solely payers of medical bills. This shift underscores the industry's movement towards greater member engagement, affordability, and transparency. Increased consumer demand for flexible coverage options through Medicare Advantage, ACA exchanges, and employer reimbursement is prompting payers to adopt retail-like experiences that foster stronger member relationships.

Digital engagement in healthcare is rising, with 78% of surveyed consumers reporting current or planned use of health plan mobile apps, up from 64% the previous year. Despite the growing role of artificial intelligence (AI) in healthcare, consumer adoption of AI tools remains limited, as 79% either have not used or are unaware of AI-powered features provided by their health plans. However, 64% express openness to utilizing AI applications such as chatbots and personalized cost-saving tools.

Consumer concerns about AI focus on quality, accuracy, privacy, and data security, with nearly one-third advocating for transparent communication regarding AI use to build trust. These insights highlight opportunities for health plans to enhance member experiences by integrating AI-enabled innovations that support personalized and proactive care services while addressing security and accuracy concerns.

Conducted among over 4,500 U.S. health plan members with diverse demographics and coverage types, the study emphasizes the increasing importance of technology and digital tools in shaping consumer expectations and satisfaction in the evolving health insurance landscape. HealthEdge, serving more than 110 million members across 48 states, aims to support payers in leveraging integrated administrative and care management platforms to improve service delivery and operational efficiency.