J.D. Power and Associates Reports: As Health Plans in Various States Prepare for Increasing Health Insurance Enrollments, Many Health Plan Members Consider Using Health Insurance Exchanges

Mar 11, 2013, 09:00 ET from J.D. Power and Associates

WESTLAKE VILLAGE, Calif., March 11, 2013 /PRNewswire/ -- The introduction of health insurance exchanges is generating interest among health plan members who purchase insurance directly, as well as those who have high deductibles and/or lower levels of overall satisfaction, according to the J.D. Power and Associates 2013 Member Health Plan StudySM released today.

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Now in its seventh year, the study measures satisfaction among members of 136 health plans in 17 regions throughout the United States by examining seven key factors: coverage and benefits; provider choice; information and communication; claims processing; statements; customer service; and approval process. In 2013, overall member satisfaction averages 701 (on a 1,000-point scale), compared with 702 in 2012.

Nearly three-fourths (73%) of members who purchase insurance on their own instead of through their employer say they "definitely will" or "probably will" shop for coverage using a state exchange, if available. The new insurance purchasing method intends to make it easier for members to access insurance and, ideally, at more competitive rates. The desire to reduce costs may also attract all types of members to the concept of exchange purchasing. A higher percentage of members in high-deductible health plans indicate they are interested in using exchanges, compared with those in low-deductible plans (59% vs. 45%, respectively). Service quality may also play a role in shaping demand, as members with the highest levels of interest in using exchanges are those who have contacted their health plan regarding a problem during the past year (60%), compared with those who have not had a problem with their health plan (45%).

"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," said Rick Millard, senior director of the healthcare practice at J.D. Power and Associates. "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."

Overall, 48 percent of health plan members (combining both group and individual markets) indicate they are interested in using a state exchange, if it were available to them. Among members with group coverage, interest in state exchanges is more prevalent when their employer has not offered a choice of health plans. Members who have a choice of health insurance brands are less interested in exchanges (36%) than do those who have no choice (50%).

"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."

Satisfaction is highest among health plan members in the Michigan, Texas and East South Central regions, and is lowest among those in the Mountain and Colorado regions.

Health plans ranking highest in their respective regions (in alphabetical order) are Anthem Health Plans of New Hampshire; AvMed Health Plans; Blue Cross and Blue Shield of Alabama; Blue Cross and Blue Shield of Illinois; Blue Cross and Blue Shield of Kansas City; Blue Cross and Blue Shield of Texas; Geisinger Health Plan; Health Alliance Plan (HAP) of Michigan; HealthPartners; Independent Health Association; Kaiser Foundation Health Plan (which ranks highest in the California, Colorado, South-Atlantic and Mid-Atlantic regions); PacificSource Health Plans; SelectHealth; and UnitedHealthcare.

J.D. Power offers the following tips to health plan members and consumers who are shopping for health insurance coverage:

  • When shopping for a health insurance plan, consider the cost-to-benefit ratio. Generally speaking, the higher the cost, the higher the number of plan features and healthcare provider flexibility. Conversely, while lower-cost plans may provide lower premiums, they may also provide fewer choices of plan features or healthcare providers.
  • If you purchase coverage on your own, research state-sponsored health insurance exchanges to learn how they work, and particularly how your state's exchange will be offered. Beginning later this year, you may qualify for state exchanges if your income is within a certain range or if you work for a small company, which may mean the possibility of more choices of coverage at a lower cost.
  • While some states are implementing exchange ratings programs based on health plan quality (e.g., did the doctor order the right tests), be sure to review J.D. Power and Associates health plan rankings, which are based on member satisfaction, to see how your plan compares in the rankings.
  • Understand your coverage. Health insurance plans are sometimes difficult to understand, with complex rules for deductibles, co-payments and other expenses. If you don't have a clear understanding of the coverage and you have a choice of plans, opt for the simpler approach. For example, you may be more satisfied with fewer choices of healthcare providers in order to have coverage with less complicated costs.

The 2013 Member Health Plan Study is based on responses from more than 33,000 members of 136 commercial health plans across 17 regions in the United States. The study was fielded in December 2012 and January 2013. For more comprehensive health plan rankings for all 17 U.S. regions, please visit www.jdpower.com.

Regions Included in the Member Health Plan Study
East South Central (Includes Alabama, Kentucky, Louisiana, Mississippi and Tennessee)
Heartland (Includes Arkansas, Iowa, Kansas, Missouri, Nebraska and Oklahoma)
Mid-Atlantic (Includes Maryland, Virginia and Washington, D.C.)
Mountain (Includes Arizona, Nevada, New Mexico and Utah)
New England (Includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont)
New York-New Jersey
Northwest (Includes Idaho, Oregon and Washington)
South-Atlantic (Includes Georgia, North Carolina and South Carolina)

Top Three Plans in Overall Member Satisfaction by Region

Highest: Kaiser Foundation Health Plan
Blue Shield of California

Highest: Kaiser Foundation Health Plan

East South Central
Highest: Blue Cross Blue Shield of Alabama
Blue Cross Blue Shield of Louisiana
Blue Cross Blue Shield of Tennessee

Highest: AvMed Health Plans
Florida Blue

Highest: Blue Cross Blue Shield of Kansas City
Blue Cross Blue Shield of Oklahoma
Wellmark Blue Cross Blue Shield of Iowa

Highest: Blue Cross Blue Shield of Illinois
Health Alliance Medical Plans

Highest: Health Alliance Plan of Michigan
Blue Cross Blue Shield of Michigan
Priority Health

Highest: Kaiser Foundation Health Plan
CareFirst Blue Cross Blue Shield

Highest: HealthPartners
Dean Health Plan
Blue Cross Blue Shield of Minnesota

Highest: SelectHealth
Blue Cross Blue Shield of Arizona
Regence Blue Cross Blue Shield  of Utah

New England
Highest: Anthem Health Plans of New Hampshire
Tufts Associated Health Plans
Blue Cross Blue Shield of Rhode Island

New York-New Jersey
Highest: Independent Health Association
Empire Blue Cross Blue Shield

Highest: PacificSource Health Plans
Group Health Cooperative
Blue Cross of Idaho
Premera Blue Cross

Highest: UnitedHealthare
Medical Mutual of Ohio

Highest: Geisinger Health Plan
UPMC Health Plan
Highmark Blue Shield

Highest: Kaiser Foundation Health Plan

Highest: Blue Cross Blue Shield of Texas

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

About J.D. Power and Associates
Headquartered in Westlake Village, Calif., J.D. Power and Associates is a global marketing information services company providing forecasting, performance improvement, social media and customer satisfaction insights and solutions. The company's quality and satisfaction measurements are based on responses from millions of consumers annually. For more information on car reviews and ratings, car insurance, health insurance, cell phone ratings, and more, please visit JDPower.com. J.D. Power and Associates is a business unit of The McGraw-Hill Companies.

About The McGraw-Hill Companies

The McGraw-Hill Companies (NYSE: MHP), a financial intelligence and education company, signed an agreement to sell its McGraw-Hill Education business to investment funds affiliated with Apollo Global Management, LLC in November 2012. Following the sale closing, expected in early 2013, the Company will be renamed McGraw Hill Financial (subject to shareholder approval) and will be a powerhouse in benchmarks, content and analytics for the global capital and commodity markets. The Company's leading brands will include: Standard & Poor's, S&P Capital IQ, S&P Dow Jones Indices, Platts, Crisil, J.D. Power and Associates, McGraw-Hill Construction and Aviation Week. The Company will have approximately 17,000 employees in more than 30 countries.  Additional information is available at www.mcgraw-hill.com.

Media Relations Contacts: Jeff Perlman; Brandware Public Relations; Woodland Hills, Calif.; (818) 598-1115; jperlman@brandware.com John Tews; J.D. Power and Associates; Troy, Mich.; (248) 680-6218; media.relations@jdpa.com

No advertising or other promotional use can be made of the information in this release without the express prior written consent of J.D. Power and Associates. www.jdpower.com/corporate


SOURCE J.D. Power and Associates