Consumer satisfaction rising for health plans—with a caveat

Consumer satisfaction with health plans is rising, but in some areas—such as cost and navigation—health plans still are struggling to please customers, a new study from J.D. Power finds.

The J.D. Power 2019 Commercial Member Health Plan Study reports that member satisfaction with commercial health plans is the highest in three years. The average satisfaction in the latest report was 713 out a possible 1,000 points; up 7 points over the previous three years. The analysis said the increase is driven in part by improved satisfaction with coverage and the benefits offers. Those two elements were the most important drivers of consumer satisfaction, the study added.

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“Health plans are doing a good job managing the operational aspects of their businesses, but they are having a harder time addressing the expectations members have based on their experiences in other industries where their service needs are more effectively addressed with better technology,” said James Beem, managing director of global health care intelligence at J.D. Power. “Across the board, health plan members are satisfied with the coverage and benefits they have, but once they start looking to their health plans for guidance in areas like navigating issues related to cost or when to use primary care versus urgent care, many plans miss the mark on customer expectations.”

Cost sharing and balky apps bring down satisfaction scores

The two most challenging areas for health plans remain cost and mobile apps. High co-pays for office visits are driving down the satisfaction with costs for health plans. This fits with recent surveys that show serious consumer concerns with cost sharing in the form of high-deductibles and copays.

“Overall satisfaction scores are 254 points higher when members perceive their plan actively keeps out-of-pocket costs low, helped coordinate care and that there was enough coverage, yet 54 percent or fewer of health plan members say their plan delivers on each of these criteria,” the report said.

New models of health care have caught consumers’ eyes

This study, like others, point to a growing interest in telehealth, urgent care, and retail health care as new delivery systems that address cost and convenience concerns.

The survey found that among all survey respondents, 48 percent say they are very or somewhat likely to look at telehealth as an option for care. Among Gen Y members, that number was 51 percent. And 32 percent of health plan members reported visiting urgent care facilities.

“Digital access to personal health data and improved coordination of care could encourage further use of these lower-cost treatment channels.”

Top performers

The J.D. Power survey identified top performing health plans from different regions; but most of the top overall scores were found on the East Coast. The top scoring plans were:

1. Kaiser Foundation Health Plan, South Atlantic Region, score of 805
2. Kaiser Foundation Health Plan, Maryland Region, 799
3. Kaiser Foundation Health Plan, California Region, 792
4. (tie). AvMed, Florida Region, 774 (tie). Capital District Physicians Health Plan, New York District, 774
5. Humana, Florida District, 763

Read more: 

• Benefits satisfaction increasing, but health care costs still vex employees
• Which benefits are employees more satisfied with?
• Employees want more help understanding their health care coverage