Keeping track of health insurers and their performance is helpful to not only the consumer but to the health insurance brokerages who sell the plan. Like a potential buyer, we look at the various evaluations of companies released every year to decide whether or not to sell a plan. The high standards of quality measured by national organizations, such as the National Committee for Quality Assurance (NCQA) and URAC, indicate a certain level of success among policyholders and keep people buying. Accreditation with both of these companies is essential to a carrier’s continued business.
NCQA also runs the Healthcare Effectiveness Data and Information Set (HEDIS), which more accurately describes the quality of care and service given through a company’s network. Physicians Plus received a rating of 76% for their health plans, 84% for health care, 89% for customer service, all of which are above the national average for 2012. Dean Health Plan was rated in the 90th percentile for Access to Care among all age groups, and above average with all other types of care.
The annual member satisfaction survey conducted by J.D. Power and Associates is also a great indicator of quality when choosing a health plan in Wisconsin. In the Minnesota-Wisconsin regional review, 1,930 privately insured residents were asked about their various aspects of their coverage in 2012. The seven factors rated by the Member Health Plan Study include: provider choice; information and communication; coverage and benefits; claims processing; statements; approval processes; and customer service.
Overall member satisfaction in the Minnesota-Wisconsin region is an average of 697 out of 1,000 total points, which has decreased since the previous year. Last year, improvements were evidenced mostly in the information and communication, statements, and claims processing categories, yet in 2013 the highs and lows were not defined. Most likely, no specific factors stood out.
Dean Health Plan proved to be the best plan in six of seven factors for the two-state region surveyed. The HMO excelled in 2013 with 715 points, performing especially well in coverage and benefits; provider selection; approval processes; customer service; statements; and information and communication. However, they did not perform nearly as well as the previous year with 753 points.
Only two other providers in the state of Wisconsin made it onto the survey, both of which received member satisfaction results below the regional average. If another Wisconsin insurer was not included, it is likely due to a lower membership rate than the featured companies, not necessarily a lower satisfaction rating., though the latter could also be true.
Wisconsin Health Plan Rankings
Ranked according to a 1,000-point scale, the following companies in Wisconsin were mentioned in the J.D. Power and Associates study. They also can receive up to five J.D. Power Circles based on overall quality.
1. Dean Health Plan: 715 points, J.D. Power Circle Rating of 4 (Better than most)
2. UnitedHealthcare: 697 points, J.D. Power Circle Rating of 3 (About average)
3. Anthem Blue Cross and Blue Shield of Wisconsin: 665 points, J.D. Power Circle Rating of 2 (The rest)
1. Physicians Plus. “Commitment to Healthcare Quality.” http://www.pplusic.com/home/quality-commitment.
2. Dean Health Plan. “Our Quality.” http://www.deancare.com/about-dean/quality/.
3. J.D. Power and Associates. 2013 Member Health Plan Study.