2012 U.S. Member Health Plan Study
J.D. Power and Associates Reports:
Interest in Health Insurance Exchanges Grows in Both the Individual and Group Health Insurance Markets
Health Plans Face Challenges in Finding Simple and Understandable Ways of
WESTLAKE VILLAGE, Calif.: 13 March 2012 -- Anticipating the impact of healthcare reform, nearly four in 10 health plan members with employee-sponsored insurance say they would shop for coverage through a health insurance exchange if they had the opportunity, according to the J.D. Power and Associates 2012 U.S. Member Health Plan StudySM released today.
Now in its sixth year, the study measures member satisfaction among 141health 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.
A majority of health plan members who purchase insurance on their own indicate they would likely use one of the state health insurance exchanges (55%), which are conceived, in part, to address their needs. However, a sizable percentage of health plan members who are covered under an employer-sponsored program--39 percent--also indicate they would shop for insurance through an exchange if it were available.
In addition, the 2012 study finds increased levels of interest in state-sponsored health insurance exchanges, compared with the previous year. In 2012, only 37 percent of health plan members say they would not be likely to use an exchange, compared with 50 percent in 2011 who expected to continue obtaining coverage at work.
"Health insurance exchanges are meant to appeal to individuals who must buy coverage on their own, yet the level of interest among those who obtain health insurance at work could have important implications for the future of employer-sponsored coverage," said Rick Millard, senior director of the healthcare practice at J.D. Power and Associates. "Satisfaction among some health plan members may be low enough that an alternative, direct retail model could become more attractive than traditional wholesale purchasing by employers."
The study also finds substantial interest among health plan members in private health insurance exchanges, in which an employer might provide employees with vouchers for purchasing health insurance independently. Approximately 41 percent of employer-insured health plan members indicate they would use this approach if it were available.
"The private exchange model could further erode reliance on obtaining health insurance at work," said Millard. "Creating new channels for purchasing insurance could trigger more changes. It could mean more attention will be paid to direct purchasers, and also make higher levels of satisfaction critically important for health plans that strive to acquire and retain members."
In 2012, overall member satisfaction averages 702 on a 1,000-point scale, compared with 696 in 2011. There are notable gains in the information and communication; statements; and claims processing factors.
"Health plans that excel in member satisfaction know how to create simpler benefit designs that members perceive to be consistent and dependable," said Millard. "As health insurance exchanges take hold and consumer shopping for coverage increases, it will become even more critical for plans to communicate in clear and concise ways."
Health plan members in Michigan, the Illinois/Indiana region and Ohio are the most satisfied with their health plan experience, while members in the Mountain region and Colorado are the least satisfied.
Health plans ranking highest in their respective regions are (in alphabetical order): Anthem Blue Cross and Blue Shield of Connecticut; AvMed Health Plans; Blue Cross Blue Shield of Alabama; Blue Cross Blue Shield of Illinois; Blue Cross Blue Shield of Kansas City; Blue Cross Blue Shield of Texas; Dean Health Plan; Geisinger Health Plan; Health Alliance Plan (HAP); Independent Health Association; Kaiser Foundation Health Plan (which ranks highest California, Colorado, the Northwest region, the South Atlantic region and the Virginia-Maryland-Washington D.C., region); Medical Mutual of Ohio; and SelectHealth.
J.D. Power offers the following tips to health plan members and consumers who are shopping for health insurance coverage:
- Understand your coverage. Health insurance plans are sometimes difficult to understand, with complex rules for deductibles, co-payments, and other kinds of expenses. If you don't have a clear understanding of the coverage and you have a choice of plans, opt for the simpler approach. For example, you may be more satisfied with fewer options for doctors in order to have coverage with less complicated costs.
- Before enrolling in a health plan, familiarize yourself with online tools that may be offered by your insurance company. Some health plans are set up to offer online services to track your medical condition, receive prescriptions, make appointments, or even email your doctor.
- If you obtain health insurance coverage through your employer, be prepared for fewer choices. More than one-half of health plan members who receive health insurance at work are given only one option.
- If you purchase coverage on your own, understand how your state will offer a health insurance exchange (such as the Massachusetts Connector). This is a new feature based on the Affordable Care Act, which is intended to make it easier for individuals to find affordable coverage.
The 2012 U.S. Member Health Plan Study is based on responses from more than 32,000 members of commercial health plans. The study was fielded in November 2011 and January 2012. For more comprehensive health plan rankings for all 17 U.S. regions, please visit www.jdpower.com.
About J.D. Power and Associates
Headquartered in Westlake Village, Calif., J.D. Power and Associates is a global marketing information services company providing forecasting, performance improvement, social media and customer satisfaction insights and solutions. The company's quality and satisfaction measurements are based on responses from millions of consumers annually. For more information on car reviews and ratings, car insurance, health insurance, cell phone ratings, and more, please visit JDPower.com. J.D. Power and Associates is a business unit of The McGraw-Hill Companies.
About The McGraw-Hill Companies
McGraw-Hill announced on September 12, 2011, its intention to separate into two public companies: McGraw-Hill Financial, a leading provider of content and analytics to global financial markets, and McGraw-Hill Education, a leading education company focused on digital learning and education services worldwide. McGraw-Hill Financial's leading brands include Standard & Poor's Ratings Services, S&P Capital IQ, S&P Indices, Platts energy information services and J.D. Power and Associates. With sales of $6.2 billion in 2011, the Corporation has approximately 23,000 employees across more than 280 offices in 40 countries. Additional information is available at http://www.mcgraw-hill.com.
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NOTE: Two charts follow.
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