Research shows Americans are highly receptive to provider-sponsored health plans, particularly younger adults and parents
STONY BROOK, N.Y. – March 12, 2026 – With health insurance premiums increasing among public and private payers and ACA subsidies no longer in effect, new research suggests Americans are receptive to alternative insurers. A survey by healthcare technology company Softheon found that 74% of U.S. adults would likely choose a plan from a local hospital or health system if it cost about the same as other options.
Softheon’s research suggests room for expansion of provider-sponsored plans from hospitals or health systems for consumers seeking alternatives to traditional models. Among respondents, interest in provider-led plans was highest among parents with children under 18 and individuals who are self-employed. More than 80% of each group said they would likely choose a local health system plan at comparable pricing.
“Health insurance decisions are becoming increasingly difficult for many. Millions have experienced ACA premium subsidies expiring, and private insurance holders are likely to see premium increases this year, if they haven’t already. This is prompting consumers and even employers to reconsider how they engage with health coverage,” said Eugene Sayan, founder and CEO of Softheon. “More people want their insurance and their doctors working together. That expectation creates opportunities for health systems that can deliver a provider-aligned model of integrated care and coverage, and for technology companies like ours that provide the technological backbone to deliver both seamlessly.”
Trust Varies by Function
The survey revealed a split in trust depending on the specific insurance function.
Respondents favored provider-sponsored health plans for:
- Understanding their health needs (53%)
- Acting in members’ best interests (54%)
Traditional national insurers maintained an edge in operational areas:
- Providing clear coverage information (54%)
- Processing approvals quickly (56%)
Notably, neither type of insurer achieved more than 60% trust in any category, indicating that strong performance in a few key areas could allow any plan – including provider-sponsored plans – to differentiate and compete effectively.
Provider-Sponsored Plan Benefits Address Consumer Pain Points
Survey respondents identified several persistent problems with their current health insurance:
- 47% cited high costs
- 34% reported confusion about what is covered
- 23% cited poor communication between insurance companies and healthcare providers
When asked what benefits they would expect from a plan where doctors and insurance are part of the same organization:
- 59% cited better communication between doctors and insurance
- 50% expected faster approvals for care
- 38% anticipated lower overall costs
More than half of respondents (57%) said most of their regular doctors already work within the same hospital or health system, suggesting existing care patterns that align with integrated insurance models.
Market Pressures May Accelerate Integration
The research arrives as healthcare systems face mounting financial pressure. With uncertainty around federal subsidies and potential coverage losses, healthcare providers risk increased uncompensated care, creating additional incentive for closer integration between providers and insurers. This scenario could strengthen the case for provider-sponsored health plans.
“When you have people coming in to get care, you need mechanisms to ensure they have the right insurance and programs in place,” Sayan said. “Tighter integration between providers and payers can help manage those dynamics and drive better outcomes.”
Provider-sponsored health plans seeking practical guidance and growth best practices can access The Provider-Sponsored Playbook, available now at Softheon’s website.
Survey Methodology
Dynata conducted the survey in September 2025. The results included 1,000 online responses from adults aged 25+ across the United States.
About Softheon
Founded in 2000, Softheon’s healthcare Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) solutions solve complex challenges for health plans, their distribution networks, and government health agencies. Currently, Softheon’s solutions serve over 100 health plans. Issuers and consumers in Small Group, ICHRA, Dental, Medicare, and Affordable Care Act (ACA) markets benefit from Softheon’s technology that reduces administrative overhead and enhances user experiences. Softheon is an Agent and Merchant of Record that facilitates health insurance enrollment, administration, and renewal. Softheon is recognized as one of the World’s Top HealthTech Companies of 2025 by TIME. For more information on Softheon’s solutions, visit softheon.com.
Contact
Allyson Van Wagnen
avanwagnen@softheon.com
SOURCE Softheon
