Health insurers (HIs) face a tough road ahead to improve customer experience. As health insurance leaders balance cutting costs with the pressure for innovation in a rapidly evolving ecosystem, they must revisit their priorities to cocreate value and strengthen trust with members. To help guide health insurance leaders, our new report, The Seven Trends That Matter For US Health Insurers In 2025, explores the top seven trends for HIs in 2025, including:

  • Redefining the end-to-end member experience. The relationship with your customers starts before they buy, and each touchpoint is an opportunity to ensure salience, fit, and trust. To earn trust, HIs must still tackle the basics, proving their competence, dependability, and accountability.
  • Experimenting with benefits to address the affordability crisis. Affordability remains a top concern for key stakeholders including members, employers, and insurers. In response, employers are experimenting with new insurance and benefit models like Individual Coverage Health Reimbursement Arrangements (ICHRAs), Exclusive Provider Organizations (EPOs), and other plan arrangements that favor quality and cost savings. As plan options diversify, HIs must invest in more robust tools to help consumers navigate to the best plan fit.
  • Reinventing pharmacy benefit managers (PBMs). PBMs find themselves under the microscope as HIs and regulators alike seek to improve transparency and reduce medication costs for consumers. Optum Rx’s recent move to eliminate 10% of prior authorizations signals a shift toward a simpler medication approval process, improving efficiency and patient access. HIs must prioritize affordability, revamp new pharmacy service models, and cut the red tape to drive improved outcomes.

Ready to chart your course? Schedule a guidance session now to discuss how your organization can seize these opportunities. Forrester clients can also read the companion report on The Seven Trends That Matter For US Healthcare Providers In 2025 and watch our recent on-demand webinar that covers both perspectives.

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