Richard Millard, senior director, health care practice, JD Power and Associates, pointed out that the overall results of the study, now in its fifth year, weren't surprising. What was surprising, he went on to say, was what the study said about differences between the national health plans such as Humana, Cigna and Anthem WellPoint.

"They all scored in below-average satisfaction, but were indistinguishable from each other," Millard said. "These are companies, with national brands, that work hard to differentiate themselves in the minds of consumers. Yet in the minds of those who participated in the survey, they were indistinguishable, and not in a favorable range."

Millard speculated on a few reasons why these results popped up in the survey. One of the reasons boiled down to a simple scenario: Communication. The more members understand what their health plans cover, the more satisfied with the health plans they are. However, "that can be a larger challenge for national health plans," Millard commented.

Millard cautioned that regional differences play a huge factor in member satisfaction. "In certain regions of the country, for example, Anthem WellPoint may be doing well in member satisfaction, but not in others," he said. The Blue Cross/Blue Shield plans are also a good example of regional differences in satisfaction, Millard added; in some states, the plans are highly regarded by their members, while in others, the plans draw complaints.

Though the IDS plans did rank higher on the satisfaction scale, Millard acknowledged that the future of such plans is uncertain.  "This is only conjecture," he commented, "but IDS will be challenged in the future to control costs, and to do so, they may have to have higher deductibles or different types of coverage." Once IDS plans get into the area of different types of coverage, they become confusing and therefore, harder to understand. Plans that are more difficult to understand mean lower member satisfaction, Millard explained.

In 2009, the New England Journal of Medicine published an article explaining why IDS would be more effective in terms of cost savings and patient care.  One factor was that payment for physicians' services work better at the medical-group or health-system level, but tend to fall apart at the small-practice level. Individual capitation by health plans in the 1990s, the NEJM article said, led to disasters.

Furthermore, the article noted, integrated systems tend to be more accountable – and this led to more patient satisfaction. The downside of such systems, however, is that it requires a move from fee-for-service payments to prospective payment, and not everyone is on board with that.

Though the future of IDS is cloudy, Millard pointed out one current trend from the study about which there was no doubt. "More and more people are paying more and receiving less coverage," Millard said. "That's a difficult market situation for anyone to consider satisfying."