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When members go direct, experience gaps become visible
Rising direct-to-consumer (DTC) health care adoption reveals what members want most: simplicity, transparency and confidence. Learn what the trend signals for employers and the opportunities it creates.
When members go direct, what does it mean for employers?
When members seek care on their own—booking a virtual visit, comparing prescription costs, enrolling in a program directly—they’re responding to friction in the traditional experience. The barrier usually isn’t willingness to engage. It’s knowing where to go, what it costs and whether it’s the right choice. The data points to the same conclusion: the demand is there; the path is not always clear.
65%
of U.S. adults
find managing their care overwhelming and time-consuming1
61%
of consumers
say it’s difficult to know when to use the many benefits solutions their employer offers²
78%
of members
expect to see out-of-pocket costs before visiting the pharmacy³
What this means for your clients: the demand signal is already in their population. The question is whether the benefits experience is meeting it—and that’s a conversation you can lead.
DTC growth signals where the traditional experience breaks down
The pull toward direct-to-consumer care is consistent and rational. Each driver marks a moment where the conventional benefits journey asks too much of the member—and where guidance could close the gap.
Cost transparency
Members want to know what care costs before they commit.
Speed
and access
When care is needed, every extra step feels like a barrier.
Simpler navigation
Fewer logins, fewer handoffs, fewer decisions to make alone.
Confidence at the moment of need
Members want to feel sure they’re making the right choice.
Rising DTC adoption isn't a rejection of employer-sponsored benefits. It's a response to friction in the member experience.
More entry points, less continuity
Direct access solves for immediacy. But left unmanaged, it can fragment the very experience it was meant to improve. For employers, the risks tend to compound quietly—surfacing as cost, confusion or lost trust well after the fact.
Key risks
Disconnected care journeys: care happens in silos, with no shared record or follow-through.
Inconsistent clinical oversight: quality and safety vary when programs don’t connect.
Loss of employer visibility and governance: spend and outcomes become harder to see and manage.
Erosion of trust: a disjointed experience quietly lowers confidence in the plan.
Better experiences start with better guidance
The answer to rising DTC demand isn’t more entry points—it’s better guidance through them. When connected data and personalized navigation point members to the right care at the right moment, guided navigation drives engagement and engagement sustains outcomes.
The case studies show how that mechanism works in practice, with proof your clients can evaluate. The pattern is consistent across both: medication or access alone isn’t enough. Sustained engagement—prompted by guidance—is what drives lasting results.
Guided navigation turns access into engagement
Our vendor-agnostic benefits navigation solution simplifies the member experience and improves engagement.
46%
of employees
and 34% of members registered for the Benefits Navigation experience⁴
30%
of registered users
log in monthly, and 76% enrolled in a vendor or program after accepting a recommendation⁴
Guidance sustains outcomes over time
See how MD Live by Evernorth leverages provider-guided engagement to drive results.
27.4
lbs average weight loss for those who reported weight loss at six months5
23
average monthly engagements for those who lost weight5
Questions consultants should be asking
+ Are members finding the right benefits at the right moment?
+ How easy is it to understand costs before seeking care?
+ Where are disconnected experiences creating friction?
+ What mechanisms keep members engaged over time?
How Evernorth supports a better path forward
Evernorth® helps employers meet rising consumer expectations through connected experiences that guide members to the right care at the right time. Personalized navigation, integrated care pathways and employer-aligned transparency work together to help members access the right care while giving employers greater visibility, oversight and confidence in outcomes.
What's next for member experience?
As members increasingly interact with benefits through consumer-like entry points, experience gaps surface faster—accelerating the shift toward benefit models that embed guidance, clarity and integration earlier in the journey. Explore the next era of member experience.
Sources
- Evernorth Benefits Navigation Services Research, March 2025.
- Evernorth Annual Buyer Insights Study, 2025.
- YouGov survey of 3,000 nationally representative Americans, balanced for gender, age, education, and ethnicity.
- Evernorth Benefits Navigation client data, April 2024–October 2025.
- Welldoc internal data for patients on an MD Live weight management care plan for at least six months. Data collected May 2024–September 2025. Small sample size.