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 a new report released today by
Now in its fifth year, the 2011 U.S. Member Health Insurance Plan 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% of IDS plan members say they "completely understand" how to receive preventive services, while just 24% 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, visit
Regions included in U.S. Member Health Insurance Plan Study:
Arizona-Utah California Colorado East South Central (includes Alabama, Kentucky, Mississippi and Tennessee) Florida Heartland (includes Iowa, Kansas, Missouri and Nebraska) Illinois-Indiana Michigan Minnesota-Wisconsin New England (includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont) New York-New Jersey Northwest (includes Idaho, Oregon and Washington) Ohio Pennsylvania South Atlantic (includes Georgia, North Carolina and South Carolina) Texas Virginia-Maryland-Washington, D.C.
Top Three Plans in Overall Member Satisfaction by Region:
Arizona-Utah*
• Highest: SelectHealth
• BlueCross BlueShield of Arizona
California
• Highest: Kaiser Foundation Health Plan
• CIGNA
• PacifiCare
Colorado*
• Highest: Kaiser Foundation Health Plan
East South Central
• Highest: BlueCross BlueShield of Alabama
• CIGNA
• BlueCross BlueShield of Tennessee
Florida
• Highest: Blue Cross and Blue Shield of Florida
• Humana
• UnitedHealthcare
Heartland
• Highest: BlueCross BlueShield of Nebraska
• Wellmark
• BlueCross BlueShield of Iowa
• BlueCross BlueShield of Kansas City
Illinois-Indiana*
• Highest: BlueCross BlueShield of Illinois
• Health Alliance Medical Plans
Michigan*
• Highest: Health Alliance Plan (HAP)
• Priority Health
Minnesota-Wisconsin
• Highest: Dean Health Plan
• HealthPartners
• BlueCross BlueShield of Minnesota
New England
• Highest: Harvard Pilgrim Health Care
• Tufts Associated Health Plans
• Blue Cross Blue Shield of Massachusetts
New York-New Jersey
• Highest: Independent Health Association
• Excellus BlueCross BlueShield
• Empire BlueCross BlueShield
Northwest
• Highest: Group Health Cooperative
• Kaiser Foundation Health Plan of the Northwest
• Providence Health Plan
Ohio*
• Highest: Medical Mutual of Ohio
• Aetna
Pennsylvania
• Highest: UPMC Health Plan
• Geisinger Health Plan
• Highmark BlueCross BlueShield
South Atlantic
• Highest: Kaiser Foundation Health Plan
• BlueCross BlueShield of North Carolina
• BlueCross BlueShield of Georgia
Texas*
• Highest: Aetna (tie)
• Highest: BlueCross BlueShield of Texas (tie)
Virginia-Maryland-Washington, D.C.
• Highest: Kaiser Foundation Health Plan
• CIGNA
• Aetna
*No other plan in this region performs above the region average.
