Study: Health plan members most value easy access to doctors

BLUE CROSS & BLUE SHIELD of Rhode Island is the only health insurer in the Ocean State to earn 4 out of 5 circles, or the
BLUE CROSS & BLUE SHIELD of Rhode Island is the only health insurer in the Ocean State to earn 4 out of 5 circles, or the "better than most" ranking, in the J.D. Power 2017 Member Health Plan Study. /COURTESY J.D. POWER AND ASSOCIATES

PROVIDENCE – Coordination of care among health care providers is the single most important criteria influencing member satisfaction with their health plan, according to the J.D. Power and Associates 2017 Member Health Plan Study, released in late May.

“Amidst sweeping changes in health care delivery and payment models, our data is showing that the one thing consumers value most is clear-cut, easy access to doctors and other health care providers,” Valerie Monet, J.D. Power’s senior director of U.S. insurance operations, said in a statement. “These findings set the stage for the future of health care in which close coordination among health plans and providers that reduces friction points for members will be the key to success.”

Satisfaction is highest among health plan members in the regions of Maryland, East South Central, California, Michigan and Ohio, and lowest among members in the regions of Colorado and the Northeast, which includes Connecticut, Maine, New Hampshire and Rhode Island. In Massachusetts, Blue Cross Blue Shield of Massachusetts, BCBS Anthem and Pilgrim Harvard Health Care received the highest J.D. Power ranking, “among the best.”

In Rhode Island, BCBSRI received the second-best J.D. Power ranking, of “better than most,” UnitedHealthcare ranked “about average” and Harvard Pilgrim Health Care received J.D. Power’s lowest ranking, “the rest.”

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“BCBSRI is proud to be the only health insurer in Rhode Island to earn 4 out of 5 circles [better than most] in the J.D. Power Circle rankings,” Jill Flaxington, a BCBSRI spokesperson, wrote in an email. “The ranking reflects our ongoing commitment to providing our members with access to high-quality health care and exceptional customer service as we work to make Rhode Island a healthier place to live.”

At UnitedHealthcare, Mary McElrath-Jones, a spokesperson, emailed this statement, “UnitedHealthcare has introduced many new innovations over the past several years, with a focus on improving a consumer’s health care experience. Our recent selection as Fortune Magazine’s ‘World’s Most Admired Company’ in health care – including ranking number one for innovation, social responsibility and quality of products and services – as well as our 95 percent member satisfaction rate based on tens of thousands of telephonic surveys, illustrate the impact our ongoing improvements are making in simplifying health care and meeting or exceeding our customers’ expectations.”

Among the survey’s key findings:

  • Close coordination is lacking among health plans and providers. The single most effective lever of members’ satisfaction is helpful coordination of care among doctors and other health care providers. The ability to help members successfully navigate among providers is associated with a 136-index point (on a 1,000-point scale) increase in overall customer satisfaction, yet only 25 percent of members report receiving this service from their health insurance plan.
  • Integrated delivery systems dominate rankings. Health plans using an integrated delivery system, a network of health care and health insurance organizations presented to members as a single entity, outperform traditional health plans on every factor measured in the study.
  • Offering low-cost narrow network options improves satisfaction. Although having access only to a limited network of care providers may frustrate members, commercial health plans with a narrow or tiered network may reduce costs. Individuals presented with lower-cost narrow network options were significantly more satisfied with their health plan than those not offered such an option or unaware of its existence, yet only 33 percent of survey respondents reported being offered a narrow network option.
  • Payer-provider alliances proving a mixed bag. Aetna, Cigna, Anthem and other providers have begun offering commercial products in collaboration with specific providers, and J.D. Power found mixed results about insureds’ satisfaction. Significant opportunity exists to improve members’ understanding of how plans work and what plans cover before enrolling.

Now in its 11th year, the Member Health Plan Study evaluates satisfaction among members of 168 health plans in 22 regions across the nation. It examines six key factors: coverage and benefits, provider network, communication, claims processing, premiums and customer service, and looks at plan enrollment and member engagement.

The study is based on responses from 33,624 commercial health plan members during January through March of this year. To see comprehensive health plan rankings for all 22 U.S. regions, click HERE.

Nancy Kirsch is a PBN contributing writer.

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