Health plan performance across the US varies widely among some insurers, and just 45% of plan members report fully understanding how to use their insurance coverage and member services, according to the J.D. Power and Associates 2008 National Health Insurance Plan Study.
The study of? member satisfaction among 107 health plans in 17 regions throughout the US finds that the majority of health plan members rate their insurer lowest for the communications and information that are provided to help them understand their plan.
The following factors – led by coverage and benefits – contribute to overall health plan satisfaction, according to J.D. Powers:
Enhancing member understanding with critical plan details – such as prescription coverage, co-pays, how to locate physicians and how to appeal coverage denials – can lead to higher satisfaction ratings for insurers, J.D. Power said.
“Health insurer performance fluctuates greatly – even among different regional plans from the same insurance company – and this lack of service consistency can present a real challenge for human resources executives attempting to select the best health benefits for their employees working in multiple regions across the country,” said Jim Dougherty, executive director of the healthcare practice at J.D. Power and Associates.
Study results by region are as follows:
- Arizona-Utah Region: BlueCross BlueShield of Arizona ranks highest, receiving a satisfaction index score of 763 on a 1,000-point scale.
- California Region: Kaiser Foundation Health Plan of California ranks highest with 755.
- Colorado Region: Kaiser Foundation Health Plan of Colorado ranks highest with 748.
- East South Central Region: BlueCross BlueShield of Alabama ranks highest with 759.
- Florida Region: BlueCross BlueShield of Florida ranks highest for the second consecutive year with 751.
- Heartland Region: Ranking highest in the Heartland region is Wellmark BlueCross BlueShield of Iowa with 742.
- Illinois-Indiana Region: BlueCross BlueShield of Illinois ranks highest, earning a score of 729.
- Michigan Region: Health Alliance Plan of Michigan ranks highest with 772.
- Minnesota-Wisconsin Region: HealthPartners ranks highest with 768.
- New England Region: Anthem BlueCross BlueShield of Connecticut ranks highest with 772.
- New York-New Jersey Region: United Healthcare (New Jersey/New York) ranks highest with 749.
- Northwest Region: Group Health Cooperative ranks highest with 778.
- Ohio Region: Humana of Ohio ranks highest in customer satisfaction with 748.
- Pennsylvania-Delaware Region: Highmark Blue Cross and Blue Shield ranks highest with 784, which marks the highest score across all regions included in the study.
- South Atlantic Region: Kaiser Foundation Health Plan of Georgia ranks highest with 746.
- Texas Region: Humana of Texas ranks highest with 753.
- Virginia-Maryland Region: CareFirst BlueCross BlueShield ranks highest with 740.
About the study: The 2008 National Health Insurance Plan Study includes responses from 37,060 members of large commercial health plans. Members were surveyed online in November and December 2007. Criteria for inclusion were plans with approximately 250,000 members across all commercial products, excluding Medicare and Medicaid.