Members of Health Plans with Integrated Delivery Models Are More Satisfied than Members without Integrated Plans
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Satisfaction among Health Plan Members Decreases from 2010
WESTLAKE VILLAGE, Calif.: 17 March 2011 — Member satisfaction with health plans that share characteristics of integrated delivery systems (IDS) is considerably higher than member satisfaction with plans in which the provider and payer are not part of the same organization, according to the J.D. Power and Associates 2011 U.S. Member Health Insurance Plan StudySM released today.
Now in its fifth year, the study measures member satisfaction among 137 health 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.
Satisfaction among members in integrated health plans, such as Health Alliance Plan and Kaiser Foundation Health Plan, averages 741 on a 1,000-point scale, compared with 691 among members of plans where care is not integrated. In addition, members of integrated plans have a better understanding of their coverage and the processes necessary to receive services. Among integrated plan members, 63 percent say they “completely understand” the benefits covered, compared with 52 percent among non-IDS plan members. Similarly, 44 percent of IDS plan members say they “completely understand” how to receive preventive services, while just 24 percent of non-IDS plan members say the same.
“While not every IDS is created alike, an advantage of these plans is that interactions center on the member as a patient, because the provider and plan are integrated,” said Richard Millard, senior director of the healthcare practice at J.D. Power and Associates. “The higher level of satisfaction with integrated plans is particularly important with the passage of the Affordable Care Act, which will result in the creation of accountable care organizations modeled after the IDS approach.”
According to Millard, members of integrated plans tend to be more satisfied with information and communication, as well as coverage and benefits, than do members of non-IDS plans, which highlights how improvement in these factors may go a long way toward improving overall health plan satisfaction.
In 2011, overall member satisfaction is at the lowest point since the study’s inception in 2007, averaging 696, compared with 701 in 2010. Member satisfaction with coverage and benefits has decreased slightly, with considerable declines occurring in satisfaction with information and communication; claims processing; and statements.
“Information and communication remains the factor with lowest satisfaction among all plans, possibly reflecting the increasing complexity of health benefits,” said Millard. “Because members are increasingly concerned about the uncertainties surrounding cost and coverage, plans that focus on delivering useful information to manage these changes tend to earn higher satisfaction scores.”
Overall satisfaction of health insurance plan members is among the lowest across the industries in which
J.D. Power and Associates conducts research, including mortgage, banking and investment services. Health plan members in Pennsylvania, New England and the Northwest region are the most satisfied with their health plan experience.
Health plans ranking highest in their respective regions are (in alphabetical order): Aetna (which ties to rank highest in Texas); Blue Cross and Blue Shield of Florida; BlueCross BlueShield of Alabama; BlueCross BlueShield of Illinois; BlueCross Blue Shield of Nebraska; BlueCross BlueShield of Texas (which ties to rank highest in Texas); Dean Health Plan; Group Health Cooperative; Harvard Pilgrim Health Care; Health Alliance Plan (HAP); Independent Health Association; Kaiser Foundation Health Plan (which ranks highest in California, Colorado, and the South Atlantic and the Virginia-Maryland-Washington, D.C. regions); Medical Mutual of Ohio; SelectHealth; and UPMC Health Plan.
The study also finds the following key trends:
- More than one-half (57%) of members say that they either chose to or were required to make changes involving cost or coverage during the past year—continuing a trend where more members say they are powerless in being able to control costs on their own.
- In the growing market of individually purchased health insurance, satisfaction averages 667 points, compared with 700 among group health plan members. This gap indicates challenges ahead in improving the member experience for individual health plan members.
- Exchange-based purchasing, which may result in further growth of the individual market, is not yet well understood. However, only one-half of all members think that by 2014 they will continue to purchase health insurance as they do now.
The 2011 U.S. Member Health Insurance Plan Study is based on responses from more than 34,000 members of commercial health plans. The study was fielded in December 2010 and January 2011. For more comprehensive health plan rankings for all 17 U.S. regions, please visit .
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
Founded in 1888, The McGraw-Hill Companies is a leading global financial information and education company that helps professionals and students succeed in the Knowledge Economy. Leading brands include Standard & Poor’s, McGraw-Hill Education, Platts energy information services and J.D. Power and Associates. The Corporation has approximately 21,000 employees with more than 280 offices in 40 countries. Sales in 2010 were $6.2 billion. Additional information is available at http://www.mcgraw-hill.com.
An IDS is a network of health plans, hospitals and/or physician groups that work together to provide insurance, administrative and clinical healthcare functions.
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