Creating The Conditions For A Trustworthy Healthcare System

Healthcare is facing a trust crisis, and the industry won’t be able to solve many of its other problems until it addresses the roots causes of that breakdown.

“Trust has two legs… One is, are you dealt with fairly, judiciously, honestly? The other is reliability — are you consistent? Healthcare is breaking down on both of those,” David Brailer, M.D., executive vice president, chief health officer, and chief transformation officer at The Cigna Group, said during the opening session at the 2025 Oliver Wyman Health Innovation Summit. He was interviewed by Oliver Wyman’s Ashley Smith.

For Brailer, trust is not a fixed outcome. It is an evolving relationship built on expectations and experience. In the current environment, consumers don’t believe the information coming out of healthcare organizations, and many view it as a zero-sum game: if something is good for a healthcare organization, it is bad for the American public.

“We’re not just talking about lost trust,” he said. “We’re talking about a trust deficit.”

Brailer is not alone in his thinking. Consumer confidence across the healthcare landscape has dropped sharply, with a majority of people saying that businesses and governments purposefully mislead them when it comes to healthcare issues, according to the 2025 Edelman Trust Barometer.

‘It’s time for a refresh’

Brailer identified a few ways for the industry to rebuild trust. Doing so will take action across multiple dimensions, including technology, measurement, consumer engagement, and public policy. Below are three areas he highlighted:

Modernize the backbone: Decades-old technology systems stitched together with manual workarounds continue to limit how healthcare can advance data transparency, improve coordination among stakeholders, and innovate for the future. Brailer, who served as the nation’s first National Coordinator for Health Information Technology during the George W. Bush administration, argued that the industry must embrace application programming interfaces (APIs) that enable data to flow freely between all stakeholders, including consumers.

Design for simplicity: Healthcare is full of vulnerable moments — getting a diagnosis, navigating benefits, seeking follow-up care. Brailer urged organizations to focus on reducing complexity at these critical points. Artificial intelligence can help integrate data seamlessly and in consumer-friendly ways, including scheduling, cost expectations, and follow-up care. Consider how easily consumers can order a rideshare, know who the driver is, see where the car is, know when they’ll get to the destination, and know the cost. Relevant data exists in healthcare to give consumers a similar experience, but the industry must build the infrastructure and user interfaces to support it.

Measure what matters: Beyond systemic changes, Brailer challenged Summit attendees to take action within their own organizations, starting with deep dives into data. Using consumer sentiment data, for instance, Cigna can map problem areas and address operating variables that need to be fixed. He noted that Cigna unveiled its “Pledge to Better” in January, aimed at not only improving the consumer experience but also holding the company and leaders accountable. The pledge focuses on five areas: easier access to care, better support, better value, accountability, and transparency. To “hold our feet to the fire,” Brailer said a performance report is due out next year, and the board of directors will get regular updates as the initiative unfolds.

“Either we create the conditions for a self-directed, trustworthy system,” Brailer said, “or change will be imposed on us. The fire is already burning — the only question is how we respond.”