The online response to the recent killing of UnitedHealthcare CEO Brian Thompson revealed long-brewing resentments against insurance companies. With their reputations so damaged, how can payers rebuild trust with American consumers?
To rebuild trust, payers must reestablish its foundation: credibility. Transparency in cost and quality is key to reestablishing credibility and ultimately trust. Insurers must be responsive to consumer needs, and they will need to embrace a new business model that aligns incentives around outcomes that matter to patients. Consumers need to be empowered with clear information to make informed decisions about their care.
As I wrote in a recent column, anger towards insurers and healthcare delivery organizations is growing as care gets more expensive and more complex without a corresponding increase in positive health outcomes. According to polling, Americans’ rating of the quality of healthcare in the U.S. is at its lowest point in Gallup’s study since 2001, when they began tracking the metrics.
Misaligned financial incentives are at the heart of building resentment. Under the current business model, insurance companies make more money the more claims they deny. In the extreme, if patients die because care was denied outright or delayed through the use of prior authorization or a step therapy there is little impact for the insurer.
At the same time, it’s remarkably challenging for consumers to get information about cost, quality and outcomes in healthcare. Even after they’ve undergone a procedure and are looking at the explanation of benefits sent by their insurer, they aren’t always sure what services they received, how much those services cost or what if anything they owe. For too many, the message is: my insurer doesn’t care about me or my health needs. This erosion of trust stems from years of broken promises and opaque practices that insurers must now actively work to reverse.
Trust must be earned by establishing credibility; it’s the outcome of consistently meeting promises, communicating value and acting transparently and predictably. When insurance providers fail to follow through on promises—whether through surprise billing, unexpected denials, or opaque decision-making—it sets the entire system back, and positions insurers as the enemy rather than a partner in maintaining health.
Instead of seeing insurance as a valuable investment in their health and financial security, consumers now expect their insurance companies to disappoint them with denied claims, despite the high premiums and deductibles they pay month after month.
Customers believe they are following the rules and fulfilling their obligations, but because insurers operate so opaquely, they often end up blindsided with bills in the thousands of dollars. This is how trust is lost.
A small way to rebuild lost trust is to acknowledge mistakes: There is value in saying “this wasn’t clear.” Andrew Witty, CEO of UnitedHealth Group did this effectively in an op-ed in The New York Times in the aftermath of the Brian Thompson killing, saying “health care is both intensely personal and very complicated, and the reasons behind coverage decisions are not well understood.”
Coverage decisions tend to be a black box for consumers, who feel frustrated and powerless without the ability to figure out the answer on their own. Insurers that openly acknowledge their mistakes and demonstrate a commitment to making things right not only regain credibility but also humanize their operations.
But rebuilding trust requires more than words—it demands transparency, clear communication and a consistent effort to ensure consumers understand the value they’re paying for.
Transparency is a foundation of trust, and for insurers, this means replacing the opacity that has long defined healthcare with clear, consistent communication. Say what you’re going to do, do what you say, and if there’s a gap, explain why.
A true commitment to transparency requires standardized, easily accessible information on pricing, coverage policies and claims decisions. Consumers should not need a degree to understand their coverage or be blindsided by hidden charges. Rules must be clear, logical and consistently applied. And when insurers cannot fulfill a request, they must explain why, and better yet, offer reasonable alternative solutions rather than merely saying no.
Engaging in these principles consistently over time will re-establish credibility and earn the trust of consumers. Insurers can deliver valuable services and work as credible experts and partners. Payers are best positioned to be partners in good health when incentives are aligned to reward better health outcomes. This means embracing a new business model that makes prevention, early intervention and coordinated care important to the bottom line—replacing the outdated focus on claim denials. And they need to do this in partnership with healthcare delivery organizations who have struggled to embrace a different model.
By committing to transparency and aligning incentives around a new business model, insurers can empower consumers with the tools and information they need to make confident decisions while demonstrating value in ways that matter: better health outcomes, fewer financial surprises and simpler processes.
Ultimately, embracing this shift is a competitive advantage for payers. Repairing the broken relationship with the public—being perceived as allies rather than adversaries—is essential to remaining profitable.
Resentment toward insurance companies is not inevitable—it’s a symptom of an opaque, broken system. A commitment to honesty, clarity and demonstrating value is the first step toward eliminating hostility and creating a healthier future.
