Health Plan Member Satisfaction in 2014

Issues surrounding the time a member must wait after a pre-approval request has been submitted to their health plan before they hear from their provider, to concerns about having adequate health coverage, and health plan notices of changes in their coverage, networks or rates are having an impact on members satisfaction with their plan, found a recent study.

Some 41 percent of existing health plan members believe that they lack enough coverage for routine visits, serious illness or injury, health and wellness programs, routine diagnostics and drug coverage, found the study by market research firm J.D. Power.

Concerns over not having enough health coverage negatively impacts overall satisfaction by 133 points, more than any other coverage-related issue, according to the J.D. Power 2014 Member Health Plan StudySM.

The study, in its eight year, measures satisfaction among members of 136 health plans in 18 regions throughout the United States by examining six key factors: coverage and benefits; provider choice; information and communication; claims processing; cost; and customer service.

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In 2014, overall member satisfaction averages 669 (on a 1,000-point scale), the firm said.

Key Findings include:  

– 55 percent of plan members reported having experienced an increase in costs in 2013, which negatively impacts cost satisfaction.

– Some 35  percent of members say they received a notice of changes in their coverage, networks or rates from their health plan in the past 12 months. In the 2013 plan year, 74 percent of members participating in the study maintained their preferred physician and 83 percent were able to retain their same hospital network.

– Almost half (49%) of the members indicated their plan does not offer the most common types of health and wellness discount/incentive programs.

– Seventy-five percent of members reported having submitted a claim in the past 12 months.

– The average monthly premium paid in 2013 was $285.

“On average, members wait eight days for communication from their provider after a pre-approval request has been submitted,” Rick Johnson, senior director of the healthcare practice at J.D. Power, said.

“Health plans must look for ways to promptly communicate both pre-approvals and cost in order to minimize member anxiety and mitigate concerns about access to care, ultimately increasing customer satisfaction,” he added.

The study results also included satisfaction rankings of health plans in regions of the country.

Member satisfaction is highest among health plans in the California and Michigan regions.


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