Executive Summary

In an effort to control healthcare costs, payers are working to encourage healthier behaviors and prevent chronic conditions through member wellness programs, consumer education, digital health offerings and other initiatives.

However, in most American households, it is not consumers in general, but women in particular, who are responsible for healthcare for themselves and their families. Through a nationally representative study of more than 3,000 women who manage their family’s healthcare, Willow Research examined their experiences navigating the healthcare system in the United States: what is working well for them, where there are difficulties, and what they need to keep themselves and their families healthy.

The research was conducted from January 2020 through August 2020, in the midst of the coronavirus pandemic, and reveals the challenges these women face as they try to navigate an often-confusing system during a period of crisis. Women tell us the help they want and need to keep their families afloat, both now and in the future.

Key Points:

In most American households, women are the ones who are responsible for healthcare for themselves and their families. From this study, we learned:

  • 46% feel “stressed out and frustrated” by the healthcare system.
  • 43% prioritize their family’s healthcare over their own.
  • 44% have made sacrifices in order to cover healthcare costs.
  • More than half of households (57%) have at least some difficulty paying for healthcare.
  • 72% say that healthcare costs are unpredictable.
  • 70% of women would find it helpful to have an app or program to tell them whether something would be covered and what their out-of-pocket costs would be before point of care.

How Providers Can Help

As we found in our recent study of payer executives,[1] payers are hard at work trying to address the cost problem in healthcare. In addition to leveraging their core capabilities in data analytics and fostering greater collaboration with providers, payers are also encouraging their members to be healthier through a range of wellness and educational initiatives and digital health tools.

However, the present study finds that, from the consumer perspective, the challenge of high healthcare costs has not been solved. Our study of women who are healthcare decision-makers for their family finds that their greatest challenges relate to managing healthcare costs and insurance coverage. In order to ease the difficulties that women have navigating the healthcare system, these women want help from payers in the three areas below.

  • Greater transparency around costs and coverage
  • Financial education around healthcare financial tools
  • Financial support for healthcare costs

Importantly, women are open to technological solutions to achieve greater cost transparency. Success in addressing these three needs would be welcomed across the board, but for the most precarious households, solutions aimed at greater transparency may not be sufficient. The aftermath of the pandemic is likely to leave even more in need of financial education and assistance.

Payer Edition: Head Above Water