|Satisfaction With Health Plans Lower Among
Individual Purchasers, Says J.D. Power
Health plan members who individually purchase
their plans or work for small employers are considerably less satisfied
with their health plan experience, compared with health plan members
who work for larger organizations, according to the J.D. Power and
Associates 2009 National Health Insurance Plan Study.
Now in its third year, the study measures member
satisfaction among 131 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 processes.
The study finds that health plan members working
for small employers (50 employees or fewer) are less likely to be
satisfied with their health plan than those working for larger
Satisfaction among members working for small
employer groups averages 692 on a 1,000-point scale, while members of
health plans sponsored by large employers (501-5,000 employees) and
jumbo employers (more than 5,000 employees) have satisfaction levels
averaging 717 and 725, respectively. Health plan members working for
larger organizations are also more likely to re-enroll and recommend
their plan to others, compared with members working for small
Satisfaction among individual purchasers, which
account for 9 percent of health plan members, is comparable to that
among members of plans sponsored by small employers, averaging 694
Likewise, among individual purchasers, likelihood
to re-enroll, recommend and purchase other products is lower compared
with members working for larger organizations.
"As unemployment rates rise across the nation,
more members are moving to individual health plans from
employer-sponsored plans," said Jim Dougherty, executive director of
the healthcare practice at J.D. Power and Associates. "By more
effectively managing the member experience for this growing segment of
members, health plans could reap considerable financial benefits
through increased retention and recommendations, and prepare themselves
for the anticipated healthcare reform measures facing the industry,
which are likely to drive additional enrollment among previously
uncovered individuals and small employers."
Health plans ranking highest in their respective
regions are (in alphabetical order):
- Anthem Blue Cross and Blue Shield of Kentucky;
- BlueCross and BlueShield of Alabama (these two
plans tie in the East South Central region);
- BlueCross BlueShield of Arizona;
- BlueCross BlueShield of Florida;
- BlueCross BlueShield of Illinois;
- BlueCross BlueShield of Nebraska;
- Dean Health Insurance;
- Harvard Pilgrim Health Care;
- Health Alliance Plan;
- Highmark Blue Cross Blue Shield;
- HIP Health Plan of New York;
- Humana (which ranks highest in the South
Atlantic and Texas regions);
- Kaiser Foundation Health Plan (which ranks
highest in the California, Colorado, Northwest and Virginia-Maryland
- Medical Mutual of Ohio.
The study also finds that — while
satisfaction levels have increased significantly from 2008 in the New
England, South Atlantic, California, Arizona-Utah and Illinois-Indiana
regions — health plan members in the New England, Michigan,
Pennsylvania-Delaware, California and South Atlantic regions are the
most satisfied overall.
"Across the industry, satisfaction with health
plans remains fairly stable, increasing only slightly compared to
2008," said Dougherty. "Members still tend to be least satisfied with
the information and communications they receive from their health plan
— the third-most-important factor in overall satisfaction.
Consequently, improving member communications can go a long way in
driving higher levels of overall member satisfaction —
particularly since only one-third of members say they fully understand
how their health plans work."
The 2009 National Health Insurance Plan Study
includes responses from more than 33,000 members of commercial health
plans. Members were surveyed online in December 2008 and January 2009.
Address: J.D. Power and Associates, 2625 Townsgate
Road, Suite 100, Westlake Village, CA 91361; (805) 418-8000, www.jdpower.com.