Alternative Health Plans (AHPs), once considered a niche offering, are quickly gaining popularity as payers seek new ways to manage rising costs and improve the member experience. AHPs represent a fresh alternative to traditional insurance models like PPOs and HDHPs.  These plans empower members with the ability to shop for care, compare price and quality, and choose the option that best fits their needs. With clearer costs upfront, intuitive provider search tools, and simplified navigation, AHPs shift decision-making to members—giving them the confidence to engage with their benefits proactively.  

For members, the value is clear: greater control, smarter choices, and less financial stress. For payers, it’s about enabling better experiences at scale.

According to a 2024 Mercer study, nearly one-third of employers already offer AHPs, and another 29% are considering them. But the promise of these plans can only be realized if members are empowered to use them with confidence — and that’s where Zelis comes in.

Meeting the moment: What members want, what employers need

AHPs demand a new kind of member experience—one that’s transparent, personalized, and mobile-first. Members expect tools that mirror the convenience of other industries: digital platforms that guide them to high-quality, cost-effective care, preferred pharmacies, and optimized paths tailored to their unique plan design.

And the demand is growing. A recent Zelis study shows that 70% of members are willing to pay an incremental $10/month for access to accurate cost predictions, online scheduling, and low-cost medication search tools. Forty percent say price transparency is the top area for improvement when dealing with providers and insurance.

Members also want simplicity in how they pay for care. Members report that the top three most valuable medical payment capabilities are consolidated billing, mobile payment options, and easier HSA/FSA integration.  These expectations align perfectly with the design and intent of AHPs — but only if the infrastructure exists to support them.

Purpose-built for AHP innovation

Zelis is one of the only companies that brings together all the elements needed to deliver an effective AHP experience.

With our latest acquisition, we’ve built Zelis Mobile Member Connect, a mobile-first member experience platform that brings together everything AHPs need to succeed — cost transparency, care navigation, member concierge and onboarding, and real-time benefit access — all in one integrated solution.

This platform isn’t a retrofit of legacy systems. It’s purpose-built to support innovative alternative plan designs and deliver a seamless, personalized experience for members. By combining Zelis’ deep expertise in payments and networks with consumer-grade digital technology, we’ve created a unified ecosystem that empowers members to locate, compare, and pay for care with confidence. Equipped with AI-powered personalization and smart recommendations, members get tailored insights that help them make informed decisions faster.

The result? A scalable solution that delivers exceptional AHP experiences and helps payers deliver smarter, more engaging benefits — without compromising operational efficiency.

Expanding access through affordability

In Alternative Health Plans (AHPs), members are empowered to shop for care. However, financial stress can often be a major barrier, causing them to hesitate even when they’ve found a high-value option. That’s why Zelis partnered with Paytient to deliver a payment experience that fully aligns with the forward-thinking design of AHPs — making care more affordable, predictable and accessible.

Paytient provides an interest-free way for members to manage their out-of-pocket costs, allowing them to pay their share of care over time. This solution simplifies the payment process by consolidating all costs into a single, predictable monthly bill with no credit checks, fees or surprises.

By integrating Paytient’s innovative, market-leading solution directly into our platform, we’re providing more than just flexible payments; we’re giving members a new kind of benefit that removes a key obstacle to care. This empowers members to confidently engage with their benefits, leading to better outcomes and an even stronger value proposition for health plans, employers and members.

A new era of member-centric care

Alternative Health Plans are redefining what it means to deliver value. This shift demands more than incremental improvements; it requires bold innovation and purpose-built infrastructure. We’re not just responding to change — we’re architecting for it. By unifying the essential components of healthcare—payments, networks, navigation, transparency, and financing — into a single platform, Zelis is empowering members to shop for care with confidence, control their costs, and access a simpler, more personalized experience. It’s not just about helping payers modernize — it’s about delivering the kind of healthcare journey people actually want.