Health Insurance Reviews



J.D. Power and Associates has been conducting studies in consumer satisfaction among various industries for many years, and 2013 was the seventh year for their health insurance evaluation. This year proved the American consumer population’s serious consideration for healthcare reform and how it will affect their coverage. According to their 2013 Member Health Plan Study, released on March 11th of this year, nearly 3 out of 4 health plan members with individual insurance claim they would buy a plan through a health insurance exchange, given the opportunity.

A lesser amount of group health plan members also expressed interest in the exchange concept. This year, 36 percent of those surveyed in a group plan with a choice of plans said they would consider an exchange, while interest has been piqued in 50 percent of those who have no choice of health plans. This year’s study showed elevated interest in the exchanges among individual rather than group plan members, and much more so than the previous year.

Exchanges have the potential for changing the face of both group and individual markets, depending on how successful they become. With the promise of lower premiums, they are likely to draw the massive audience the government anticipates. Many who receive employer-sponsored benefits have shown interest due to a lack of satisfaction with their group plans. Senior director of the healthcare practice at J.D. Power and Associates, Rick Millard remarks on the state exchanges:

“As healthcare costs continue to increase and members pay a higher percentage of the premium, health plan members are increasingly aware of exactly what they are getting for their premium… If a member has experienced problems and perceives the possibility of having more control over costs through exchanges, this new purchasing method may become more appealing.”

Another option is the ability for employers to obtain vouchers for individual plans through an exchange, in which the study also found a great level of consumer interest. According to the study, about 41 percent of people enrolled in employer-sponsored plans are in favor of utilizing such an alternative.

Overall member satisfaction in 2013 decreased by one point from one year ago, now averaging 701 out of 1,000 possible points. Member satisfaction is clearly an essential property to maintaining enrollment in a health plan, and for private insurers to compete or assist with exchanges. However, it is expected that the cost factor will be more highly valued than member feedback when the exchanges offer their plans. With the hope that exchanges will provide better benefits and results than existing health plans, it is important that these government plans match up to their expectations.

“Income-eligible members with high out-of-pocket costs and less tenure with a health plan are most likely to try exchanges,” said Millard. “The exchange also appeals to those working at small companies who want to take more direct control over their healthcare expenses.”

 

The Study

Over 33,000 plan members of commercial health plans throughout the United States were surveyed between December 2012 and January 2013. The health insurance plan member study collects information regarding member satisfaction across 136 health plans in 17 regions nationwide by taking multiple factors into account. The most important factors evaluated include:

  • Coverage and benefits
  • Provider selection
  • Information and communication
  • Customer service
  • Approval processes
  • Claims processing
  • Statements

 

Top Regions for Health Plan Satisfaction

The regions with the highest level of member satisfaction include Michigan, Texas, and the East South Central area, including Alabama, Louisiana, Kentucky, Mississippi, and Tennessee. Health plan members in Colorado and the Mountain region were the least content with their experiences, unchanged from the previous year.

 

Highest Ranking Health Plans

 

 

2013 Health Plan Member Satisfaction by Region

Each of these rankings is based on a 1,000 point scale, and all of the following health plans with the greatest number of points also received a 5 out of 5 (Among the Best) J.D. Power Circle Rating.

 

California

Kaiser Foundation Health Plan ranks highest with 760.

Colorado

Kaiser Foundation Health Plan ranks highest at 718.

East South Central Region

Blue Cross and Blue Shield of Alabama ranks highest at 730.

Florida

AvMed Health Plans ranks highest at 729.

Heartland Region

Blue Cross and Blue Shield of Kansas City ranks highest at 720.

Illinois-Indiana Region

Blue Cross and Blue Shield of Illinois ranks highest at 712.

Michigan

Health Alliance Plan (HAP) ranks highest at 749.

MInnesota-Wisconsin Region

HealthPartners ranks highest at 731.

Mountain Region

SelectHealth ranks highest at 745.

New England Region

Anthem Health Plans of New Hampshire ranks highest at 717.

New York-New Jersey Region

Independent Health Association ranks highest at 763.

Northwest Region

PacificSource Health Plans ranks highest at 724.

Ohio

UnitedHealthcare ranks highest at 735.

Pennsylvania

Geisinger Health Plan ranks highest at 739.

South Atlantic Region

Kaiser Foundation Health Plan ranks highest at 757.

Texas

Blue Cross Blue Shield of Texas ranks highest at 714.

Virginia-Maryland-Washington, D.C. Region

Kaiser Foundation Health Plan ranks highest at 768.

 

 

 

Sources:

 

1. J.D. Power and Associates.  2013 Member Health Plan Study.