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Member Satisfaction With Commercial Health Plans Declined in 2023

Analysis  |  By Jay Asser  
   June 14, 2023

Poor customer service and communication scores brought down customer satisfaction in J.D. Power's new study.

Commercial health plans are struggling to meet patients' engagement needs as member satisfaction continues to plummet, a study by J.D. Power shows.

The data analytics, advisory services, and consumer insights company released its 2023 U.S. Commercial Member Health Plan Study, which measures satisfaction among members of 147 health plans in 22 regions throughout the country. Responses for the 17th annual report are from 32,656 commercial health plan members, fielded from January to April 2023.

Member satisfaction is measured by evaluating six factors: billing and payment, cost, coverage and benefits, customer service, information and communication, and provider choice.

The study found that overall satisfaction dropped by 13 points (on a 1,000-point scale) this year, mostly due to a 33-point decrease in satisfaction with customer service. Other areas that suffered notable decline were coverage and benefits (-20), provider choice (-16), and information and communication (-16).

Meanwhile, among patients with a self-reported health status of "poor/fair," 36% said their health plan helped them coordinate care. That figure jumped to 43% among patients with a self-reported status of "very good/excellent."

Additionally, the study revealed that the average Net Promoter Score for new members was 6 (on a scale of -100 to 100), compared to 25 for established plan members, indicating that health plans are falling short on providing information and support on navigating their benefits.

Finally, the report uncovered that digital usage by members for all tools and support remains under 50%. Usage of online health assessments was 18% among the sickest patients, while use of chronic disease management tools was 8%, use of online triage and nursing support was 10%, and remote monitoring was 6%.

Though the study found members' usage of digital tools lacking, another report by Accenture identified ease of navigation, including poor experiences using digital tools, as the top reason why beneficiaries leave their health plans.

A separate study by American Customer Satisfaction Index found that the most important experience benchmarks for health insurance customers were quality of mobile apps and reliability of mobile apps.

Health plans wanting to retain and attract new members, especially in the younger generations, need to prioritize how they engage their patients.

"The transition to value-based care is predicated on the idea that payors and providers can drive better outcomes at a lower cost by improving patient engagement, yet many commercial health plans are having challenges getting the right information and support to patients when and where they need it," Christopher Lis, managing director, global healthcare intelligence at J.D. Power, said in a press release.

"Moreover, in patients with self-reported health status of 'poor and fair,' only 17% were assigned to a case manager. Yet for these patients with oftentimes complex health conditions, seeing multiple providers and taking several prescriptions, care fragmentation leads to poor health outcomes and higher spending in the very population that needs coordinated care the most."

Jay Asser is the contributing editor for strategy at HealthLeaders. 


J.D. Power's 2023 U.S. Commercial Member Health Plan Study analyzes customer satisfaction among members in of 147 health plans, based on six factors.

This year's overall satisfaction fell 13 points (on a 1,000-point scale) thanks in large part to a 33-point decline in satisfaction with customer service.

The study also found that sicker patients are less likely to receive proactive care coordination compared to patients with a self-reported health status of "very good/excellent."

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