Consumers Want AI to Inform Their Health Decisions, Not Make Them

Companies across every industry are implementing AI at a rapid pace, and as consumers rack up more direct experience with these tools, they're forming sharper opinions about what's genuinely useful and what isn't. They're becoming more vocal about what they want AI to do for them — and what they don't.

Getting this right is particularly important in the health insurance space. For many consumers, health insurance and how to get the most out of their coverage already feels like a black box. Introduce AI into that equation, and you risk nesting one black box inside another. Even if they find they’re getting more value from their insurance plan or their health outcomes improve, members may come away with less clarity about what happened or how decisions were made — and have less confidence that they were the ones making them.

That tension showed up clearly in our proprietary research, which examined AI alongside a range of other features and experiences health plans could offer. What we learned is that members don't want AI to simply act on their behalf; they're more receptive to AI that helps them understand their healthcare on a deeper level, so they can make better decisions for themselves. They're not yet ready to outsource their healthcare decisions — they want a human (themselves) in the loop. The same holds true when they see their doctors using AI: they want assurance that clinical judgment, not an algorithm, is still driving the care plan.

At its core, this is about members having agency. They want better information and tools that support their own decision-making, not tools that casually take the decision away. As health plans build out their AI capabilities, the key question is where members are willing to offload tasks (such as scheduling and routine reminders) versus where they want AI to educate and reassure while they retain control.

AI is reshaping the consumer experience across every industry, and many of these lessons are universal. But health plans face a particular nuance: as you expand your AI capabilities, consider what decisions you’re asking members to cede, as well as how your tools are actively building their knowledge and confidence. The plans that get this right won't just deploy AI — they'll use it to grow their members' sense of agency in their own health.

If you are looking for a partner that has been studying and building expertise specifically around AI in healthcare and insurance, reach out the empatiX Consulting team at hello@empatixconsulting.com.