Health Plans Often Fail To Provide Free Coverage For Women’s Health : Shots – Health News : NPR

Health Plans Often Fail To Provide Free Coverage For Women’s Health : Shots – Health News : NPR.

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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:   Continue reading

News Release – 2014 National Directory of Managed Care Organizations Database Produced

News Release

For Immediate Release

New Edition of Database Provides Overview, Details and Managed Care Market Key Decision Makers

Phone: 1- 800-516-4343

ALLENWOOD, NJ – The 2014 edition of the National Directory of Managed Care Organizations has been published by the Managed Care Information Center.

As in other industries – there has been consolidation in the managed care organization arena as well, Managed Care Information research has found.

Research on the 2014 edition of the National Directory of Manaaged Care Organizatyions project results reflects the various health plan consolidations – mergers and acquisitions.

The unique database provides market intelligence information on more than 1180 managed care organizations representing 5,279 health insurance plans.

The new edition includes listings of all managed care companies including health maintenance organizations (HMOs), preferred provider organizations (PPOs), consumer driven health plans (CDHPs), health savings accounts (HSAs), point-of-service plans (POS), and several other types of managed care organizations.

The directory database also covers specialty HMOs and PPOs, and includes details on TPAs, POSs, EPOs, Medicare and Medicaid health insurance plans, and Medicare Advantage Health plans and Medicare Part D prescription plans.

The directory is known for providing more “need to know” detail in the managed care organization profiles presented.

Organization profiles include the health insurance companies’ main address, phone, fax, and key executive officers.

To help users ‘size’ a market, the directory includes the number of primary care physicians and specialist physicians in the managed care company network; and the number of hospitals with which the health plan has contracts.

The database includes such key contact names as CEO, CFO, COO, medical director, and CIO. The name of the parent organization, the year the organization was founded, and web site address also is provided.

The National Directory of Managed Organizations Database with user’s manual and instructions is delivered on CD-Rom.

For more information contact The Managed Care Information Center – Health Resources Online  toll-free telephone 1-800-516-4343, email: info@healthresourcesonline.com

Or click on this link: National Directory of Managed Care Organizations Database

Address: The Managed Care Information Center, PO Box 456, Allenwood, NJ 08720

Contact: 1-800-516-4343

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Are MCOs adequately addressing member satisfaction needs?

Related to the member communication initiatives of MCOs is meeting member\patient satisfaction.

So are health plans addressing patient satisfaction as a top priority?

This is question, from our Managed Care Leadership Survey, stirs strong opinions from providers, payers and others.

For instance: “No. Major carriers are doing just enough to maintain their satisfaction levels. They are also building their own satisfaction surveys to give the impression that they are top notch. A better way would to use a consistent measure like CAHPS to monitor.”

“Yes. New rules and bonus payments”

“No. Too little in the way of real tools, peer to peer assistance”

“No. Growing limits on provider access and increased carveouts are creating growing member dissatisfaction.”

“Yes. Adequately, yes. Meeting expectations, probably not. All depends on the benchmarks one is willing to use to measure member satisfaction.”

Source: Managed Care Information Center