While consumers continue to give low satisfaction ratings to health plans in general, they assign higher marks to nonprofit health plans, according a recent survey.
J.D. Power and Associates released its annual 2013 Member Health Plan Study for the seventh time last week. It surveyed more than 33,000 members belonging to 136 commercial health plans across the U.S.
Rick Millard, senior director of the healthcare practice at J.D. Power and Associates says on the whole, nonprofit companies, such as Kaiser and some Blue Cross Blue Shield licensees received higher satisfaction ratings than for-profit plans.
"This year, the for-profits are essentially all below average, and that's kind of a pattern we've seen for a while," says Millard.
The nonprofit Kaiser Foundation Health Plans was a top-ranked health plan in seven states as well as Washington D.C. Only two for-profit health plans received a top ranking: Anthem Health Plans of New Hampshire in the New England region and UnitedHealthcare in Ohio.
The study ranks health plans by region, though there are some states that are not included in the survey, such as Hawaii, because there is too little competition (only two health plans operate Hawaii: Kaiser Permanente and Hawaii Medical Service Association). The study analyzed health plans based on seven categories:
- Coverage and benefits
- Provider choice
- Information and communication
- Claims processing
- Statements
- Customer service
- Approval process
Since the survey divvies up the country into 17 regions, there are, essentially, 17 different top-ranked health plans. Millard says however, that there are broad conclusions to make. According to the study results, satisfaction is highest among health plan members in three regions: Texas, Michigan, and East South Central, which includes Alabama, Kentucky, Louisiana, Mississippi, and Tennessee. Conversely, health plan members are unhappiest in the Colorado and the Mountain regions, which include Arizona, Nevada, New Mexico, and Utah.
Health plans are given a numerical score based on a 1,000 point scale. The 2013 study shows that overall member satisfaction averages 701 compared with 702 in 2012. The stability of the health plans' satisfaction score isn't necessarily a good thing, especially when compared to other business sectors.
"Satisfaction with commercial health insurance is among the lowest of any industry that we study at JD Power and has been for a while," says Millard. "But, it's not getting worse."
Millard says it's also clear from the study that the focus some health plans have put on improving its communication with members is paying off.
"In the area of online… Kaiser has a lot of applications. Another company that's done strongly in that area is Health Partners in the Twin Cities area," says Millard, who also points to Buffalo, NY-based Independent Health Association as an example of providing good customer service for its members in its high deductible plans.
Another broad conclusion that can be made from the study, says Millard, is that members are placing more importance on coverage and benefits than provider choice and communication.
"In years past they all had comparable influence on member satisfaction. In recent years, coverage and benefits have really pulled away to be the most influential factor driving member satisfaction," he says, adding that it may be because members are becoming more cost-sensitive.
"I think fundamentally people see that they are paying the same or more, but they're not necessarily receiving more coverage, and that's part of the reason this has become a more acute concern year over year," says Millard.
One group is hoping that the higher ranked nonprofit health plans will catch the attention of newly created health insurance exchanges.
The Alliance for Advancing Nonprofit Health Care (AANHC), a group that represents nonprofit hospitals, health plans, and other health care organizations, wants insurance exchanges to include the ownership status when health plan choices are presented to consumers.
Bruce McPherson, president and CEO of AANHC, lobbied the Centers for Medicare & Medicaid Services in 2010 to include the ownership status of health plans on the Summary of Benefits and Coverage form for insurance exchanges.
"CMS did not include our recommendation in the final version, but that doesn't mean individual state exchanges can't add that item if they choose, and we hope that many of them will," says McPherson.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.