2015 Health Plan Member Satisfaction Study Released by J.D. Power

Health plan overall member satisfaction averages 679, a 10 point improvement from 2014, found a new study by J.D. Power.

The study now in its ninth year measures satisfaction among members of 134 health plans in 18 regions throughout the U.. by examining six key factors: coverage and benefits; provider choice; information and communication; claims processing; cost; and customer service. Satisfaction is calculated on a 1,000-point scale, the firm said..

“Following a year filled with negative news coverage about health insurance, a bumpy start to the launch of the Affordable Care Act, and an atmosphere of fear, member satisfaction with health plans has increased significantly as plan administrators take a customer-centric approach, helping to build member trust and loyalty,” the study revealed.

The increase in satisfaction is driven by improved performance across all factors, most notably in information and communication (+17 points), which is primarily a result of efforts among many of the health plans to retool their approach by refining messaging, adjusting message frequency and upgrading their website. Satisfaction in the customer service factor has increased by 11 points, driven partially by matching communication methods to member preferences, such as mobile and text. Cost satisfaction increases by 13 points while fewer members indicate having experienced an increase in their monthly premium, as well as a decline in overall out-of-pocket expenses for individuals and families.

“Health plans have come a long way since last year as the focus has shifted toward better serving member needs and building trust. However, there is still a lot of work to do,” said Rick Johnson, senior director of the healthcare practice at J.D. Power.

“Health plans need to take a more customer-centric approach and keep their members engaged through regular communications about programs and services available through their plan. When members perceive their plan as a trusted health partner, there is a positive impact on loyalty and advocacy.”

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The study found that overall satisfaction is significantly higher among the 19 percent of members who strongly agree their health plan is a trusted partner in managing their health. Among members who say they “strongly agree” that their health plan is a trusted partner, satisfaction increases by 201 points.

 KEY FINDINGS

  • Members who say they “strongly agree” that their health plan is a trusted advisor are less likely to switch health plan providers.
  • Within information and communication, satisfaction ratings have improved from 2014 in the factor’s four attributes: ease of understanding your plan’s benefits and services (6.4 vs. 6.2, respectively, on a 10-point scale); frequency of communications (6.3 vs. 6.1, respectively); usefulness of information (6.4 vs. 6.2, respectively); and variety of communications (6.3 vs. 6.1, respectively).
  • Similarly, satisfaction ratings have also improved year over year in the attributes within the cost factor: premiums (5.9 vs. 5.7, respectively); deductible amount (5.8 vs. 5.7, respectively); co-pays for prescription medication (6.4 vs. 6.2, respectively); and co-pays for doctor visits (6.3 vs. 6.2, respectively).
  • Overall member satisfaction is 108 points higher among members who have contacted their plan via mobile app at least once in the past 12 months than among those who haven’t.  While members under 40 years old contact their plan via text and mobile app at a significantly higher rate than older members, the telephone is still the most frequently used contact method across all age cohorts.

Study Rankings

Satisfaction is highest among health plan members in the California (695), Northwest (693), IllinoisIndiana (689), Michigan (688) and Mountain (686) regions. Satisfaction is lowest among members in the New England (664) and the Southwest and MinnesotaWisconsin regions at a tie (665).

In a related development, J.D. Power plans to release a Health Insurance Marketplace Exchange Shopper and Re-enrollment Study (HIX), focused on member satisfaction with health plans purchased through public exchanges, as well as the shopping experience on those exchanges, this month. In October 2015, J.D. Power will also release a Medicare Advantage Study, focused on member satisfaction with Medicare Advantage plans.

The 2015 Member Health Plan Study is based on responses from more than 31,000 members of 134 commercial health plans across 18 regions in the United States. The study was fielded in November and December 2014. For more comprehensive health plan rankings for all 18 U.S. regions, please visit www.jdpower.com.

Following Are Member Satisfaction Index Rankings :

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Focus On Data in Era of Value-Based Models of Reimbursement

“Despite the continued prevalence of the traditional fee for service reimbursement models as the primary method of payment, over time healthcare’s reimbursement will give way to value-based models of reimbursement.”

That prediction made by longtime friend and consultant Russell Foster surrounding the need for accurate data as value-based models of reimbursement continue to emerge has come true.

You know that valued-based reimbursement today is a significant focus. Payer reimbursement strategies are tipping in favor of providers who can deliver the clinical and financial goods. In the mix are bundled payments, shared savings, pay for performance and bonuses.

Payment Bundling, PHO Shared Savings, and Pay for Performance are all in the mix of emerging models of episode-based payments, physician-hospital organizations and physician bonus structures.

One major health payer’s 6,300 enrolled primary care physicians can earn bonus payments across six measure sets — a broad spectrum of measures from clinical and quality measures to prescribing Continue reading

More than 4000 Physicians Now Designated Patient Centered Medical Homes by Blue Cross Blue Shield of Michigan

Some 4,022 primary care doctors, have been designated as patient-centered medical homes for the 2014 program year by Blue Cross Blue Shield of Michigan.

The doctors are members of 1,422 physician practices that combined care for more than 1.2 million BCBSM members in 78 of Michigan’s 83 counties.

The program, in its sixth year, continues to lead the nation in size and cost savings, BCBSM said.

The health plan said it recorded certified savings of $155 million in prevented ER and hospital claims from the first three years of the PCMH designation program.  Savings estimates for year four are expected later this year.

“Data from 2013-2014 shows adult patients in Blue-designated PCMH practices had a 27.5 percent lower rate of hospital stays for certain conditions than non-designated practices,” BCBM said. Continue reading

Driving Value-Based Reimbursement with Integrated Care Models

The burgeoning fee-for-value environment is rewarding networks of providers who collaborate and coordinate care, bridging the gap between health systems and physicians and sparking dialog and care compacts between primary care and specialists.

Even top-performing Pioneer ACOs are rethinking the role of specialists in care coordination.

Driving Value-Based Reimbursement with Integrated Care Models, a new report from the Healthcare Intelligence Network, examines WellPoint’s practice transformation effort and the reimbursement models that support it, while providing a framework in which to evaluate the patient-centered medical neighborhood (PCM-N) model.

Julie Schilz, director of care delivery transformation for WellPoint, and Terry McGeeney, MD, MBA, director of BDC Advisors, share their visions for this emerging care experience, from structuring incentives and reimbursement to rewarding high-quality and efficient care to identifying and engaging specialists in a medical home neighborhood.

Learn more about driving value-based reimbursement with integrated care models.

NEWS FACTS: This 45-page resource provides details on the following:

  • Three key practice transformation roles developed by WellPoint that address the critical elements of transformation;
  • How the physician practice transformation program complements WellPoint’s overall reimbursement strategy with fee-for-service and a shared savings component;
  • The Quality Gate for clinical and utilization metrics for WellPoint’s shared savings arrangement;
  • How to identify and engage specialists to participate in a medical neighborhood;
  • How to help physicians understand the link between meaningful use, the patient-centered medical home and medical neighborhoods;
  • Lessons learned in building medical neighborhoods;

and much more.

Learn more about driving value-based reimbursement with integrated care models.

Target Audience: Presidents/CEOs, CFOs, chief operating officers, vice presidents, medical directors, analysts, business development executives, consultants, directors, executive directors, financial/business managers, marketing executives, principals and strategic planning executives.

 

 

Physicians Need To Adapt and Develop A Vision For the Future, IPA-PHO Survey Finds

The resurgence of hospitals buying physician practices, the shortage of primary care physicians, contract and reimbursement models, market consolidation and the pressure to transform primary care practices are among the key issues the leadership of the nation’s physician organizations – PHOs and IPAs are keenly concerned about.

The issues emerged from the results of the IPA -PHO Physician Organization Leadership Survey 2012 by the Managed Care Information Center (MCIC.) Continue reading

Health Systems Seen Needing New Strategies to Reorganize Delivery Models

To succeed in this new post-health reform arena, Health systems should prioritize information technology infrastructure development, information sharing, and timely distribution of information to ensure outstanding patient care, prepare for a patient-centered medical home and bundled payment system, and move toward best practice levels of care coordination, according to Health Strategies & Solutions, a Philadelphia-based consulting firm.

“The Supreme Court decision to uphold the major provisions of the ACA launches a new era in health care in the United States. Development of a robust foundation of primary care services must move to the forefront of strategic priorities for all health care providers,” the firm, with offices in a number of states, says in a white paper.

According to the firm’s white paper “Primary Care In An Era of Healthcare Reform” health care organizations that  Continue reading

Lessons From Florida – The Patient-Centered Medical Home: Statewide Rollout

A primary care focused pay-for-performance program at Florida Blue has been transitioned this year into a statewide patient-centered medical home initiative.

While the Recognizing Physician Excellence program (RPE) program had moved the bar on quality metric performance, the move to the PCMH provides a look at both the quality and efficiency factors of a patient’s care.

An under-the-hood look into the details of this successful new program will be presented during The Patient-Centered Medical Home: Lessons from a Statewide Rollout, a 45-minute webinar on May 10th at 1:30 pm Eastern, Barbara Haasis, R.N., CCRN, senior clinical lead, quality reward and recognition programs at Florida Blue, will share how the health plan transitioned from the RPE program into a medical home model.
She will share:

  •     Lessons learned from the first year of a PCMH pilot program and how this shaped the statewide rollout;
  •     The criteria for which physician practices were selected to participate in the program;
  •     The shared savings approach through which practices will be reimbursed;
  •     The role of a nurse educator in helping the practices transform;
  •     Reporting practice results to drive further improvement;
  •     Results in total cost of care from physicians originally enrolled in the pay-for-performance program, now in the first quarter of the PCMH.

For more information or to register, please contact call 800-516-4343 or click on this link now: http://store.hin.com/product.asp?itemid=4401