Health plan members report high satisfaction with their insurers

Most health plan members either are “very satisfied” or “satisfied” with their insurers, according to a new survey of 3,500 consumers. But one-third of them still are considering switching insurers next year; members with individual and employer-sponsored coverage are the most likely to switch.

The survey from HealthEdge, a next-generation health care SaaS company, identifies key trends in health care member expectations and satisfaction, and it features respondents from health plan members with a variety of health insurance types — including employer-provided, Medicaid, dual-eligible, and individually purchased. The survey also shows equal representation across all ages, demographics, and health statuses.

The health insurance industry remains competitive, with 92% of members in the marketplace now having access to three or more insurance options. On top of increased competition, consumers continue looking for more from their health plans.

Here are other key takeaways from the survey:

• More than one-quarter (26%) of respondents have been assigned a care manager. This group is among the most satisfied, but the level of satisfaction varies.

• Health plan members are interested in artificial intelligence, as 65% say they are likely to opt for a health insurer that provides cutting-edge solutions and AI-powered tools for personalized health care experiences.

• When asked to rank the top challenges in their health management, members report long wait times (51%), managing health insurance coverage (37%), managing their prescriptions and refills (33%), and researching health information (29%).

• Nearly half of respondents report having one or two chronic conditions, and 12% of those with chronic conditions cite tools to help them find less costly care or to locate a doctor or specialist to improve satisfaction with their health coverage.

• More than half of all survey respondents (55%) cite personalized support and preventative care as top of mind, with clear explanations of benefits and coverage trailing closely behind. Members are seeking more tailored support and preventative care that will improve engagement and satisfaction.

Related: Private plans cover more Americans: CDC

“At HealthEdge, we are working with health plans to address critical challenges across the landscape,” Alan Stein, chief product and strategy officer and chief commercial officer at HealthEdge, said in a statement. “Those challenges range from rising health care costs and more choices for consumers, which puts health plan members in the driver’s seat. Now more than ever, members are expecting more from their insurers. This latest survey highlights the importance of investment in personalized plans that meet members where they are.”

Care managers, in particular, remain a key feature in driving more personalization engagement with members, according to HealthEdge. When implemented appropriately, the company says care managers play a vital role in supporting wellness programs and helping members manage their health; reviewing medical services against necessity standards and coordinating with health care providers; conducting assessments and establishing personalized care plans to encourage positive health behaviors; and utilizing automation, digital engagement, and integrated clinical data to enhance care delivery and member experience.