WESTLAKE VILLAGE, Calif.: 23 May 2008—Health plan performance varies widely among some insurers across the U.S., yet contacting plan members regularly and increasing their understanding of plan details can lead to more consistent and positive satisfaction ratings, more renewal business and additional sales of services to members, according to the J.D. Power and Associates 2008 National Health Insurance Plan StudySM released today.
Now in its second year, the study measures member satisfaction among 107 health plans in 17 regions throughout the U.S. by examining seven key factors: coverage and benefits; choice of doctors, hospitals and pharmacies; information and communication; approval processes; claims processing; insurance statements; and customer service.
The study finds that the majority of health plan members rate their insurer lowest for the communications and information that are provided to help them understand their plan. Only 45 percent of members reported they fully understand how to use their health insurance coverage and member services. Enhancing member understanding with critical plan details—such as prescription coverage, co-pays, how to locate physicians and how to appeal coverage denials—can lead to higher satisfaction ratings for insurers.
“Health insurer performance fluctuates greatly—even among different regional plans from the same insurance company—and this lack of service consistency can present a real challenge for human resources executives attempting to select the best health benefits for their employees working in multiple regions across the country,” said Jim Dougherty, executive director of the healthcare practice at J.D. Power and Associates. “With increasing healthcare costs and an aging workforce that needs additional services, businesses have less and less tolerance for insurers that aren’t consistently engaging members and helping them manage their own health care and the associated costs. However, we find that those plan members who are most engaged by their insurer through effective communication better understand how to use their plans and have particularly high satisfaction levels. Those higher satisfaction scores translate into better retention rates and more positive recommendations for the plan.”
J.D. Power and Associates Reports:
Satisfaction with Health Plans Varies Dramatically From Region To Region,
Largely Due to Poor Communication From Insurance Providers
Nearly 50 Percent of Members Say They Don’t Fully Understand the Details of
Their Health Insurance Plan
WESTLAKE VILLAGE, Calif.: 23 May 2008—Health plan performance varies widely among some insurers across the U.S., yet contacting plan members regularly and increasing their understanding of plan details can lead to more consistent and positive satisfaction ratings, more renewal business and additional sales of services to members, according to the J.D. Power and Associates 2008 National Health Insurance Plan StudySM released today.
Now in its second year, the study measures member satisfaction among 107 health plans in 17 regions throughout the U.S. by examining seven key factors: coverage and benefits; choice of doctors, hospitals and pharmacies; information and communication; approval processes; claims processing; insurance statements; and customer service.
The study finds that the majority of health plan members rate their insurer lowest for the communications and information that are provided to help them understand their plan. Only 45 percent of members reported they fully understand how to use their health insurance coverage and member services. Enhancing member understanding with critical plan details—such as prescription coverage, co-pays, how to locate physicians and how to appeal coverage denials—can lead to higher satisfaction ratings for insurers.
“Health insurer performance fluctuates greatly—even among different regional plans from the same insurance company—and this lack of service consistency can present a real challenge for human resources executives attempting to select the best health benefits for their employees working in multiple regions across the country,” said Jim Dougherty, executive director of the healthcare practice at J.D. Power and Associates. “With increasing healthcare costs and an aging workforce that needs additional services, businesses have less and less tolerance for insurers that aren’t consistently engaging members and helping them manage their own health care and the associated costs. However, we find that those plan members who are most engaged by their insurer through effective communication better understand how to use their plans and have particularly high satisfaction levels. Those higher satisfaction scores translate into better retention rates and more positive recommendations for the plan.”
Study results by region are:
BlueCross BlueShield of Arizona ranks highest, receiving a satisfaction index score of 763 on a 1,000-point scale.
Kaiser Foundation Health Plan of California ranks highest with 755.
Kaiser Foundation Health Plan of Colorado ranks highest with 748.
BlueCross BlueShield of Alabama ranks highest with 759.
BlueCross BlueShield of Florida ranks highest for the second consecutive year with 751.
Ranking highest in the Heartland region is Wellmark BlueCross BlueShield of Iowa with 742.
BlueCross BlueShield of Illinois ranks highest, earning a score of 729.
Health Alliance Plan of Michigan ranks highest with 772.
HealthPartners ranks highest with 768.
Anthem BlueCross BlueShield of Connecticut ranks highest with 772.
United Healthcare (New Jersey/New York) ranks highest with 749.
Group Health Cooperative ranks highest with 778.
Humana of Ohio ranks highest in customer satisfaction with 748.
Highmark Blue Cross and Blue Shield ranks highest with 784, which marks the highest score across all regions included in the study.
Kaiser Foundation Health Plan of Georgia ranks highest with 746.
Humana of Texas ranks highest with 753.
CareFirst BlueCross BlueShield ranks highest with 740.
