Member Satisfaction Significantly Increases as Health Plans Take Customer-Centric Approach

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J.D. Power

Mar 09, 2015, 07:00 ET

WESTLAKE VILLAGE, Calif., March 9, 2015 /PRNewswire/ -- Following a year filled with negative news coverage about health insurance, a bumpy start to the launch of the Affordable Care Act, and an atmosphere of fear, member satisfaction with health plans has increased significantly as plan administrators take a customer-centric approach, helping to build member trust and loyalty, according to the J.D. Power 2015 Member Health Plan StudySM released today.

Now in its ninth year, the study measures satisfaction among members of 134 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. Satisfaction is calculated on a 1,000-point scale.

Overall member satisfaction averages 679, which is a 10 point improvement from 2014. The increase in satisfaction is driven by improved performance across all factors, most notably in information and communication (+17 points), which is primarily a result of efforts among many of the health plans to retool their approach by refining messaging, adjusting message frequency and upgrading their website. Satisfaction in the customer service factor has increased by 11 points, driven partially by matching communication methods to member preferences, such as mobile and text. Cost satisfaction increases by 13 points while fewer members indicate having experienced an increase in their monthly premium, as well as a decline in overall out-of-pocket expenses for individuals and families.

"Health plans have come a long way since last year as the focus has shifted toward better serving member needs and building trust. However, there is still a lot of work to do," said Rick Johnson, senior director of the healthcare practice at J.D. Power. "Health plans need to take a more customer-centric approach and keep their members engaged through regular communications about programs and services available through their plan. When members perceive their plan as a trusted health partner, there is a positive impact on loyalty and advocacy."

According to the study, overall satisfaction is significantly higher among the 19 percent of members who strongly agree their health plan is a trusted partner in managing their health. Among members who say they "strongly agree" that their health plan is a trusted partner, satisfaction increases by 201 points.

KEY FINDINGS

  • Members who say they "strongly agree" that their health plan is a trusted advisor are less likely to switch health plan providers.
  • Within information and communication, satisfaction ratings have improved from 2014 in the factor's four attributes: ease of understanding your plan's benefits and services (6.4 vs. 6.2, respectively, on a 10-point scale); frequency of communications (6.3 vs. 6.1, respectively); usefulness of information (6.4 vs. 6.2, respectively); and variety of communications (6.3 vs. 6.1, respectively).
  • Similarly, satisfaction ratings have also improved year over year in the attributes within the cost factor: premiums (5.9 vs. 5.7, respectively); deductible amount (5.8 vs. 5.7, respectively); co-pays for prescription medication (6.4 vs. 6.2, respectively); and co-pays for doctor visits (6.3 vs. 6.2, respectively).
  • Overall member satisfaction is 108 points higher among members who have contacted their plan via mobile app at least once in the past 12 months than among those who haven't. While members under 40 years old contact their plan via text and mobile app at a significantly higher rate than older members, the telephone is still the most frequently used contact method across all age cohorts.

Study Rankings
Satisfaction is highest among health plan members in the California (695), Northwest (693), Illinois–Indiana (689), Michigan (688) and Mountain (686) regions. Satisfaction is lowest among members in the New England (664) and the Southwest and Minnesota–Wisconsin regions at a tie (665).

WEST

  • Kaiser Foundation Health Plan (778) ranks highest among health plans in the California region for an eighth consecutive year. No other plans in this region perform above the region average.
  • Kaiser Foundation Health Plan (733) ranks highest among health plans in the Colorado region for an eighth consecutive year. No other plans in this region perform above the region average.
  • SelectHealth (711) ranks highest among health plans in the Mountain region—which includes Idaho, Montana, Utah and Wyoming—for a sixth consecutive year, followed by Aetna (694).
  • Kaiser Foundation Health Plan (736) ranks highest among health plans in the Northwest region—which includes Oregon and Washington—for a second consecutive year, followed by Group Health Cooperative (710) and Providence Health Plan (707).
  • Cigna (676) ranks highest among health plans in the Southwest region—which includes Arizona, New Mexico and Nevada—followed by Aetna (674) and BlueCross BlueShield of Arizona (672).

MIDWEST

  • BlueCross BlueShield of Kansas (701) ranks highest among health plans in the Heartland region—which includes Arkansas, Iowa, Kansas, Missouri, Nebraska and Oklahoma—followed by BlueCross BlueShield of Kansas City (698) and BlueCross BlueShield of Oklahoma (685).
  • BlueCross BlueShield of Illinois (699) ranks highest among health plans in the Illinois–Indiana region. No other plans in this region perform above the regional average.
  • Health Alliance Plan of Michigan (692) ranks highest among health plans in the Michigan region for an eighth consecutive year, followed by BlueCross BlueShield of Michigan and Priority Health in a tie (691).
  • Dean Health Plan (698) ranks highest among health plans in the Minnesota–Wisconsin region, for a second consecutive year, followed by HealthPartners (684) and Medica Health Plans (671).
  • Anthem BlueCross BlueShield of Ohio (686) ranks highest among health plans in the Ohio region, followed by Aetna (685).

EAST

  • Kaiser Foundation Health Plan (762) ranks highest among health plans in the Mid–Atlantic region—which includes Maryland, Virginia and Washington, D.C.—for a seventh consecutive year, followed by Cigna (683) and CareFirst BlueCross BlueShield and UnitedHealthcare in a tie (676).
  • Anthem Health Plans of New Hampshire (682) ranks highest among health plans in the New England region—which includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont—followed by Harvard Pilgrim Health Care (677) and BlueCross BlueShield of Massachusetts (676).
  • Capital District Physicians' Health Plan, Inc. (739) ranks highest among health plans in the New York–New Jersey region for a second consecutive year, followed by Independent Health Association (733) and BlueCross BlueShield of Western New York and BlueShield of Northeastern New York (692).
  • Highmark BlueCross BlueShield (696) ranks highest among health plans in the Pennsylvania region, followed by Highmark BlueShield and Independence BlueCross in a tie (692) and Capital BlueCross (691).

SOUTH

  • Humana (687) ranks highest among health plans in the East South Central region—which includes Alabama, Kentucky, Louisiana, Mississippi and Tennessee—followed by BlueCross BlueShield of Louisiana (684) and Cigna (683).
  • AvMed (718) ranks highest among health plans in the Florida region for a fourth consecutive year, followed by Cigna (688) and Humana (682).
  • Kaiser Foundation Health Plan (718) ranks highest among health plans in the South Atlantic region—which includes Georgia, North Carolina and South Carolina—for a sixth consecutive year, followed by Aetna (703) and Cigna (690).
  • BlueCross BlueShield of Texas and UnitedHealthcare tie for the highest ranking among health plans in the Texas region (690). No other plans in this region perform above the region average.

J.D. Power plans to release a Health Insurance Marketplace Exchange Shopper and Re-enrollment Study (HIX), focused on member satisfaction with health plans purchased through public exchanges, as well as the shopping experience on those exchanges, in April, 2015. In October 2015, J.D. Power will also release a Medicare Advantage Study, focused on member satisfaction with Medicare Advantage plans.

The 2015 Member Health Plan Study is based on responses from more than 31,000 members of 134 commercial health plans across 18 regions in the United States. The study was fielded in November and December 2014. For more comprehensive health plan rankings for all 18 U.S. regions, please visit www.jdpower.com.

Regions Included in the Member Health Plan Study

California
Colorado
East South Central (includes Alabama, Kentucky, Louisiana, Mississippi and Tennessee)
Florida
Heartland (Includes Arkansas, Iowa, Kansas, Missouri, Nebraska and Oklahoma)
Illinois–Indiana
Michigan
Mid–Atlantic (includes Maryland, Virginia and Washington, D.C.)
Minnesota–Wisconsin
Mountain (includes Idaho, Montana, Utah and Wyoming)
New England (includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and
Vermont)
New York–New Jersey
Northwest (includes Oregon and Washington)
Ohio
Pennsylvania
South Atlantic (includes Georgia, North Carolina and South Carolina)
Southwest (includes Arizona, New Mexico and Nevada)
Texas

Top Three Plans in Overall Member Satisfaction by Region

California*
Highest: Kaiser Foundation Health Plan

Colorado*
Highest: Kaiser Foundation Health Plan

East South Central
Highest: Humana
BlueCross BlueShield of Louisiana
Cigna

Florida
Highest: AvMed
Cigna
Humana

Heartland
Highest: BlueCross BlueShield of Kansas
BlueCross BlueShield of Kansas City
BlueCross BlueShield of Oklahoma

Illinois-Indiana*
Highest: BlueCross BlueShield of Illinois

Michigan
Highest: Health Alliance Plan of Michigan
BlueCross BlueShield of Michigan
Priority Health

Mid–Atlantic
Highest: Kaiser Foundation Health Plan
Cigna
CareFirst BlueCross BlueShield (tie)
UnitedHealthcare (tie)

Minnesota–Wisconsin
Highest: Dean Health Plan
HealthPartners
Medica Health Plans

Mountain*
Highest: SelectHealth
Aetna

New England
Highest: Anthem Health Plans of New Hampshire
Harvard Pilgrim Health Care
BlueCross BlueShield of Massachusetts

New York–New Jersey
Highest: Capital District Physicians' Health Plan, Inc.
Independent Health Association
BCBS of Western New York and BS of Northeastern New York

Northwest
Highest: Kaiser Foundation Health Plan
Group Health Cooperative
Providence Health Plan

Ohio*
Highest: Anthem BlueCross BlueShield of Ohio
Aetna

Pennsylvania
Highest: Highmark BlueCross BlueShield
Highmark BlueShield (tie)
Independence BlueCross (tie)
Capital BlueCross

South Atlantic
Highest: Kaiser Foundation Health Plan
Aetna
Cigna

Southwest
Highest: Cigna
Aetna
BlueCross BlueShield of Arizona

Texas*
Highest: BlueCross BlueShield of Texas (tie)
UnitedHealthcare (tie)

* No other plan in this region performs above the region average

Media Relations Contacts
John Tews; J.D. Power; Troy, Mich.; 248-680-6218; [email protected]

About J.D. Power and Advertising/Promotional Rules www.jdpower.com/about-us/press-release-info About McGraw Hill Financial www.mhfi.com  

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SOURCE J.D. Power