How can the U.S. have the world’s highest health care costs and only average health outcomes? It’s a question that’s plagued policymakers for decades. But most can agree that to fix it, incentives need to change. They need to align with the desired results.

Enter the consumer.

Until recently the consumer was absent. The employer paid the health insurer who in turn paid the providers. Because they had little skin in the game, consumers dutifully paid their deductibles and copays, and that was about it.

Now the center of gravity is shifting. Increasingly, employers (who continue to sponsor 90% of all private health insurance coverage¹) are leaving the decisions about coverage to their employees. They’re providing their people with a menu and a subsidy and directing them to public or private insurance exchanges. (One recent study predicts that by 2020, nine out of 10 workers will be getting their employer group coverage through an exchange.²)

Which means the consumers are the ones making the decisions about where the money is being invested. As Aetna CEO Mark Bertolini puts it, “They’ll come to the marketplace with their own money and either a subsidy from their employer or a subsidy from their government. And it doesn’t much matter – they’ll be spending their money.”³

Sound familiar? In the ’80s and ’90s employers got out of the pension business and increasingly offered 401(k) plans. Which meant their people needed to learn the fundamentals of investing – risk tolerance, asset allocation – the whole nine yards.

Today, health insurance is the new 401(k) – except more so. It can be harder to understand, and its impact is immediate. Get it wrong and you’ve got problems. To make the right choice, people will need access to the right information. This greater empowerment will require more education, engagement and guidance.

It’s all about the experience

It’s no surprise that in a recent survey of 46 national health plans (representing about 60% of the individual commercial market), the consumer experience was at the top of the priorities list.⁴

Included in the consumer experience are such things as consumer segmentation and analytics, so that each individual plan member gets the right information through the right medium at the right time. And more and more, that will demand mobile health (mHealth) solutions, which leverage the reach and penetration of mobile devices to deliver more personalized care. The result? Better health outcomes for the member, greater efficiencies and retention for the health plan.

As we’ve said before and continue to say, health care is going retail. The winners will be those who make consumer education and engagement a cornerstone of their strategy – and who simplify the complex for their newly empowered customers.

Are you looking to simplify the complex? It’s what we do. Let us know how we can help.

¹ © 2014 Kaiser Family Foundation (based on 2012 data)

² S&P Capital IQ, a division of McGraw-Hill

³ Forbes, February 24, 2014

⁴ Deloitte’s 2013 Health Plan Retail Capability Survey. © 2014 Deloitte Development LLC.