Top seven questions life insurance carriers ask about consumer-mediated EHR networks

Yes, you can make decisions using data from consumer-mediated networks. In fact, consumer-mediated networks have the highest rate of decision-making by carriers, suggesting they provide more targeted, more comprehensive data for underwriting decisions than HIPAA-enabled networks.

Our internal data shows that carriers make decisions on up to 79% of cases when data is obtained through consumer-mediated networks. This “decision rate “is their ability to make an underwriting decision on up to 79 out of 100 cases—without having to order additional evidence. In contrast, we’ve observed carriers making decisions with data obtained via HIPAA-enabled sources up to 55% of the time.

No. Consumers can notify data providers about errors in their medical records, but they cannot edit or change the information directly. Notably, when consumers notify data providers of errors, the edits apply to the source EHR data—meaning the edits are reflected in data obtained through HIPAA-enabled or consumer-mediated networks.

No. Digging into this question, the underlying concern is that carriers might not get a complete picture of risk with EHRs from consumer-mediated networks. However, we’ve already seen evidence that consumer-mediated networks provide more targeted, comprehensive data for underwriting decisions than data from HIPAA-enabled networks.

Further, most healthcare providers are part of a larger network. Because EHRs capture network-level data, a consumer-mediated approach to EHRs will surface records within that network—favorable or not.

Initially, asking for consumer-mediated consent to EHRs may seem to increase friction for applicants. However, this is only true if you ignore the alternative: without an electronic record, a carrier would need an APS. Typically, waiting for an APS adds 4-8 weeks to the process and includes the possibility of invasive lab tests and exams.

In contrast, asking for consent to access consumer-mediated networks adds minutes to the application process.

So, while obtaining EHRs via consumer-mediated networks requires an extra step, it can double the amount of health data received and ultimately, helps to avoid more time-consuming and intrusive steps in the process.

Yes. There’s a misconception that older demographics are averse to technology but in 2023, 76% of Americans aged 65 and over owned a smartphone (an increase of 22% from 2021) and 88% used the internet. Further, a 2023 study found that 78% of adults aged 50-80 had used a patient portal. Among that group, 85% had used a portal within the past 6 months and 57% felt very confident navigating a portal.

Our internal data shows minimal variability in connection rates to our consumer-mediated network, across all ages from 20 to 70-plus—indicating that an individual’s age is not an impediment to leveraging consumer-mediated networks.

Yes. We work with multiple large carriers who target the affluent market and they’ve leveraged consumer-mediated networks with great success.

We’ve observed that affluent buyers are already active users of patient portals, likely due to a preference for efficiency and convenience. The consumer-mediated approach aligns with these preferences, as it reduces friction in the buying process.

No. Although data is available via HIPAA-enabled networks, they do not offer a foreseeable path to achieve the 80% coverage that will result in EHRs being broadly embedded in underwriting workflows. Consequently, relying only on HIPAA-enabled networks will not enable carriers to deliver the simplified buying experience that customers expect.

To accelerate the pace of EHR adoption and achieve 80% coverage, carriers must adopt a hybrid strategy for obtaining EHRs, that includes both consumer-mediated and HIPAA-enabled networks.