2014

J.D. Power Reports: Concerns about Not Having Enough Health Coverage Drive Down Member Satisfaction

WESTLAKE VILLAGE, Calif., March 10, 2014 /PRNewswire/ -- While health insurance companies are introducing themselves to customers in new markets through new channels, 41 percent of existing health plan members feel they do not have enough coverage for routine visits, serious illness or injury, health and wellness programs, routine diagnostics and drug coverage. Concerns over not having enough health coverage negatively impacts overall satisfaction by 133 points, more than any other coverage-related issue, according to the J.D. Power 2014 Member Health Plan StudySM released today.

Now in its eighth year, the study measures satisfaction among members of 136 health plans in 18 regions throughout the United States by examining six key factors: coverage and benefits; provider choice; information and communication; claims processing; cost; and customer service. In 2014, overall member satisfaction averages 669 (on a 1,000-point scale).

KEY FINDINGS

  • The study finds that 55% of members indicate having experienced an increase in costs in 2013, which negatively impacts cost satisfaction.
  • More than one-third (35%) of members say they received a notice of changes in their coverage, networks or rates from their health plan in the past 12 months.
  • In the 2013 plan year, 74% of health plan members maintained their preferred physician and 83% retained their same hospital network.
  • Seventy-five percent of members indicate having submitted a claim in the past 12 months.
  • The average monthly premium paid in 2013 is $285.
  • Nearly half (49%) of members indicate their plan does not offer the most common types of health and wellness discount/incentive programs.

"On average, members wait eight days for communication from their provider after a pre-approval request has been submitted," said Rick Johnson, senior director of the healthcare practice at J.D. Power. "Health plans must look for ways to promptly communicate both pre-approvals and cost in order to minimize member anxiety and mitigate concerns about access to care, ultimately increasing customer satisfaction."

Study Rankings
Satisfaction is highest among health plan members in the California and Michigan regions (in a tie); the Indiana-Illinois and Mid-Atlantic regions (in a tie); and the East South Central and South Atlantic regions (in a tie). Satisfaction is lowest in the New England, New York-New Jersey and Southwest regions.

WEST

  • Kaiser Foundation Health Plan ranks highest among health plan members in the California region for a seventh consecutive year, with a score of 756. No other plans in this region perform above the region average.
  • Kaiser Foundation Health Plan (703) ranks highest among health plan members in the Colorado region for a seventh consecutive year, followed by Anthem Blue Cross Blue Shield of Colorado (671).
  • SelectHealth (698) ranks highest among health plan members in the Mountain region (which includes Idaho, Montana, Utah and Wyoming) for a fifth consecutive year, followed by Regence Blue Cross Blue Shield of Utah (689) and BlueCross of Idaho (672).
  • Kaiser Foundation Health Plan (732) ranks highest among health plan members in the Northwest region (which includes Oregon and Washington), followed by Group Health Cooperative (GHC) (706).
  • Blue Cross Blue Shield of Arizona (675) ranks highest among health plan members in the Southwest region (which includes Arizona, New Mexico and Nevada), followed by Aetna (668) and Cigna (666).

MIDWEST

  • Wellmark Blue Cross Blue Shield of Iowa (680) ranks highest among health plan members in the Heartland region (which includes Arkansas, Iowa, Kansas, Missouri, Nebraska and Oklahoma), followed by Anthem Blue Cross Blue Shield of Missouri and Blue Cross Blue Shield of Kansas City (in a tie at 678 each).
  • Health Alliance Medical Plans (692) ranks highest among health plan members in the Indiana-Illinois region, followed by BlueCross BlueShield of Illinois (689).
  • Health Alliance Plan of Michigan (711) ranks highest among health plan members in the Michigan region for a seventh consecutive year, followed by Priority Health (685) and Blue Cross Blue Shield of Michigan (683).
  • Dean Health Plan (703) ranks highest among health plan members in the Minnesota-Wisconsin region, followed by HealthPartners (681) and Blue Cross Blue Shield of Minnesota (671).
  • Medical Mutual of Ohio (697) ranks highest among health plan members in the Ohio region, followed by UnitedHealthcare (676) and Aetna (673).

EAST

  • Kaiser Foundation Health Plan (732) ranks highest among health plan members in the Mid-Atlantic region (which includes Maryland, Virginia and Washington, D.C.) for a sixth consecutive year followed by CareFirst Blue Cross Blue Shield (696).
  • Tufts Associated Health Plans (681) ranks highest among health plan members in the New England region (which includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont), followed by Anthem Blue Cross Blue Shield of Connecticut (674) and Blue Cross Blue Shield of Massachusetts (669).
  • Capital District Physicians Health Plan (727) ranks highest among health plan members in the New York-New Jersey region, followed by Independent Health Association (705) and Horizon Blue Cross Blue Shield (679).
  • Geisinger Health Plan (705) ranks highest among health plan members in the Pennsylvania region for a third consecutive year, followed by Highmark BlueShield (678) and Capital BlueCross and UPMC Health Plan (in a tie at 672 each).

SOUTH

  • Cigna (689) ranks highest among health plan members in the East South Central region (which includes Alabama, Kentucky, Louisiana, Mississippi and Tennessee), followed by BlueCross Blue Shield of Alabama (688) and Humana (677).
  • AvMed Health Plans and Humana (in a tie at 690 each) rank highest among health plan members in the Florida region, followed by Cigna (680) and Florida Blue (677). AvMed ranks highest in the Florida region for a third consecutive year.
  • Kaiser Foundation Health Plan (784) ranks highest among health plan members in the South Atlantic region (which includes Georgia, North Carolina and South Carolina) for a fifth consecutive year, followed by UnitedHealthcare (684) and Blue Cross Blue Shield of North Carolina (681).
  • Aetna (677) ranks highest among health plan members in the Texas region, followed by Cigna (672) and UnitedHealthcare (668).

J.D. Power plans to release a study focused on health plan members satisfaction with the Affordable Care Act (ACA) in April 2014.

Customer Satisfaction Index Scores


 J.D. Power.com Power Circle Ratings

(Based on a 1,000-point scale)


 For Consumers




California



Kaiser Foundation Health Plan

756

5

California Average 

680

3

Cigna

674

3

UnitedHealthcare

667

3

Aetna

655

2

Health Net

653

2

Anthem Blue Cross of California

650

2

Blue Shield of California

639

2




Colorado



Kaiser Foundation Health Plan

703

5

Anthem BlueCross BlueShield of Colorado

671

3

Colorado Average

664

3

Aetna

662

3

UnitedHealthcare

642

2

Cigna

633

2




East South Central Region



Cigna

689

5

BlueCross BlueShield of Alabama

688

5

Humana

677

3

BlueCross BlueShield of Tennessee

675

3

East South Central Region Average

675

3

Aetna

674

3

UnitedHealthcare

674

3

BlueCross BlueShield of Louisiana

668

3

Anthem BlueCross BlueShield of Kentucky

657

2

BlueCross BlueShield of Mississippi

651

2




Florida



AvMed Health Plans

690

5

Humana

690

5

Cigna

680

4

Florida Blue

677

4

Florida Average

664

3

Aetna

649

3

UnitedHealthcare

646

2

Coventry Health Care

602

2




Heartland Region



Wellmark BlueCross BlueShield of Iowa

680

5

Anthem BlueCross BlueShield of Missouri

678

5

BlueCross BlueShield of Kansas City

678

5

BlueCross BlueShield of Kansas

673

4

BlueCross BlueShield of Nebraska

673

4

BlueCross BlueShield of Oklahoma 

673

4

UnitedHealthcare

672

4

Heartland Region Average

667

3

Aetna

662

3

BlueCross BlueShield of Arkansas

655

2

Cigna

655

2

Coventry Health Care

635

2




Indiana-Illinois



Health Alliance Medical Plans

692

5

BlueCross BlueShield of Illinois

689

5

Indiana-Illinois Average

676

3

Cigna

666

3

Anthem BlueCross BlueShield of Indiana

662

2

Humana

654

2

Aetna

651

2

UnitedHealthcare

636

2




Michigan



Health Alliance Plan of Michigan

711

5

Priority Health

685

3

BlueCross BlueShield of Michigan

683

3

Michigan Average

680

3

UnitedHealthcare

634

2




Mid-Atlantic Region



Kaiser Foundation Health Plan

732

5

CareFirst BlueCross BlueShield

696

4

Mid-Atlantic Region Average

676

3

Anthem Health Plans of Virginia

670

3

Cigna

669

3

Aetna

658

2

UnitedHealthCare

651

2




Minnesota-Wisconsin



Dean Health Plan

703

5

HealthPartners

681

4

BlueCross BlueShield of Minnesota

671

4

Minnesota-Wisconsin Average

661

3

Medica Health Plans

660

3

Humana

648

2

Anthem BlueCross BlueShield of Wisconsin

643

2

UnitedHealthcare 

642

2




Mountain Region



SelectHealth

698

5

Regence BlueCross BlueShield of Utah

689

4

Blue Cross of Idaho

672

3

Mountain Region Average

672

3

BlueCross BlueShield of Montana

637

2

UnitedHealthcare

635

2




New England Region



Tufts Associated Health Plans

681

5

Anthem BlueCross BlueShield of Connecticut

674

4

BlueCross BlueShield of Massachusetts

669

4

Harvard Pilgrim Health Care

662

3

New England Region Average

657

3

Anthem Health Plans of New Hampshire

656

3

Cigna

640

2

Aetna

638

2

BlueCross BlueShield of Rhode Island

637

2

UnitedHealthcare

634

2

Anthem BlueCross BlueShield of Maine

626

2




New York-New Jersey



Capital District Physicians Health Plan

727

5

Independent Health Association

705

4

Horizon BlueCross BlueShield

679

4

MVP Health Care

673

4

Empire BlueCross BlueShield

670

3

BCBS of Western New York and BlueShield



of Northeastern New York

668

3

Emblem Health

660

3

Excellus BlueCross BlueShield

660

3

Aetna 

659

3

New York-New Jersey Average 

658

3

UnitedHealthcare

653

3

Cigna

632

2

Oxford Health Plan

598

2




Northwest Region



Kaiser Foundation Health Plan

732

5

Group Health Cooperative

706

4

Northwest Region Average

671

3

Premara Blue Cross

665

3

Providence Health Plan

662

3

Regence BlueShield of Oregon

662

3

Regence BlueShield of Washington

661

3

Cigna

650

3

UnitedHealthcare

624

2




Ohio



Medical Mutual of Ohio

697

5

UnitedHealthcare

676

4

Aetna

673

3

Humana

670

3

Ohio Average

669

3

Anthem BlueCross BlueShield of Ohio

659

2

Cigna

651

2




Pennsylvania



Geisinger Health Plan

705

5

Highmark BlueShield

678

4

Capital BlueCross

672

4

UPMC Health Plan

672

4

Highmark BlueCross BlueShield

669

3

Independence BlueCross

669

3

BlueCross of Northeastern Pennsylvania

664

3

Pennsylvania Average

661

3

Aetna

646

3

HealthAmerica/HealthAssurance

632

2

UnitedHealthcare

632

2

Cigna

614

2




South Atlantic Region



Kaiser Foundation Health Plan

784

5

UnitedHealthcare

684

3

BlueCross BlueShield of North Carolina

681

3

Anthem BlueCross BlueShield of Georgia

675

3

South Atlantic Region Average

675

3

Cigna

672

3

Aetna

666

3

BlueCross BlueShield of South Carolina

663

3

Humana

660

3

Coventry Health Care

627

2




Southwest Region



BlueCross BlueShield of Arizona

675

5

Aetna

668

4

Cigna

666

4

Southwest Region Average

658

3

Anthem BlueCross BlueShield of Nevada

657

3

UnitedHealthcare

657

3

BlueCross BlueShield of New Mexico

615

2

Presbyterian Health Plan of New Mexico

614

2




Texas



Aetna

677

5

Cigna

672

4

UnitedHealthcare

668

4

Texas Average

662

3

Humana

656

2

BlueCross BlueShield of Texas

651

2

Power Circle Ratings Legend
5 – Among the best
4 – Better than most
3 – About average
2 – The rest

The 2014 Member Health Plan Study is based on responses from more than 34,000 members of 136 commercial health plans across 18 regions in the United States. The study was fielded in December 2013 and January 2014. For more comprehensive health plan rankings for all 18 U.S. regions, please visit www.jdpower.com.

Media Relations Contacts
Jeff Perlman; Brandware Public Relations; Woodland Hills, Calif.; 818-317-3070; jperlman@brandwarepr.com 
John Tews; J.D. Power; Troy, Mich.; 248-680-6218; media.relations@jdpa.com

About J.D. Power and Advertising/Promotional Rules http://www.jdpower.com/about/index.htm About McGraw Hill Financial www.mhfi.com 

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SOURCE J.D. Power



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