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Home / News & IndustryManaged Care Insight and Analysis
Updated: Oct. 28, 2008
J.D. Power Ranks Health Plan Member Satisfaction By Region 2.7 Million

Health plan performance varies widely among some insurers across the U.S., yet contacting plan members regularly and increasing their understanding of plan details can lead to more consistent and positive satisfaction ratings, more renewal business and additional sales of services to members, according to the J.D. Power and Associates 2008 National Health Insurance Plan Study.

J.D. Power said the study, now in its second year, measures member satisfaction among 107 health plans in 17 regions throughout the U.S. by examining seven factors: coverage and benefits; choice of doctors, hospitals and pharmacies; information and communication; approval processes; claims processing; insurance statements; and customer service.

The study found that the majority of health plan members rate their insurer lowest for the communications and information that are provided to help them understand their plan. Only 45 percent of members reported they fully understand how to use their health insurance coverage and member services.

Enhancing member understanding with critical plan details — such as prescription coverage, co-pays, how to locate physicians and how to appeal coverage denials — can lead to higher satisfaction ratings for insurers, according to J.D. Power.

"Health insurer performance fluctuates greatly — even among different regional plans from the same insurance company — and this lack of service consistency can present a real challenge for human resources executives attempting to select the best health benefits for their employees working in multiple regions across the country," said Jim Dougherty, executive director of the healthcare practice at J.D. Power and Associates.

"With increasing healthcare costs and an aging workforce that needs additional services, businesses have less and less tolerance for insurers that aren’t consistently engaging members and helping them manage their own healthcare and the associated costs. However, we find that those plan members who are most engaged by their insurer through effective communication better understand how to use their plans and have particularly high satisfaction levels. Those higher satisfaction scores translate into better retention rates and more positive recommendations for the plan," he said.

According to the study results, the organizations with the highest ranked customer satisfaction index score on a scale of 1,000 points by region are:

Arizona-Utah Region

BlueCross BlueShield of Arizona: 763

California Region

Kaiser Foundation Health Plan of California: 755

Colorado Region

Kaiser Foundation Health Plan of Colorado: 748

East South Central Region

BlueCross BlueShield of Alabama: 759

Florida Region

BlueCross BlueShield of Florida: 751 (ranked highest for the second consecutive year.)

Heartland Region

Wellmark BlueCross BlueShield of Iowa: 742

Illinois-Indiana Region

BlueCross BlueShield of Illinois: 729

Michigan Region

Health Alliance Plan of Michigan: 772

Minnesota-Wisconsin Region

HealthPartners: 768

New England Region

Anthem BlueCross BlueShield of Connecticut: 772

New York-New Jersey Region

United Healthcare (New Jersey/New York): 749

Northwest Region

Group Health Cooperative: 778

Ohio Region

Humana of Ohio: 748.

Pennsylvania-Delaware Region

Highmark Blue Cross and Blue Shield: 784 (the highest score across all regions included in the study.)

South Atlantic Region

Kaiser Foundation Health Plan of Georgia: 746

Texas Region

Humana of Texas: 753

Virginia-Maryland Region

CareFirst BlueCross BlueShield: 740

Address: J.D. Power and Associates, 2625 Townsgate Rd., Westlake Village, CA 91361; (800) 274-5372, www.jdpower.com.


  This article was taken from:
The Executive Report on Managed Care

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