Overall health plan member satisfaction has declined significantly in 2010, according to the J.D. Power and Associates 2010 U.S. Member Health Insurance Plan Study.
In its fourth year, the study measures satisfaction among 34,000 members who purchased their coverage individually or through their employer from 133 health plans in 17 regions throughout the United States. It examines seven key factors: coverage and benefits, provider choice, information and communication, claims processing, statements, customer service and approval processes.
This year, overall member satisfaction averages 701 on a 1,000-point scale, declining from 712 in 2009 and falling below even lower 2008 levels. Member satisfaction has declined in all factors except customer service, where satisfaction has remained flat, with notable decreases in coverage and benefits and information and communication.
"This significant decline in overall satisfaction is partially driven by a lack of members' understanding of their plan's coverage and benefits and how to successfully access them," said Jim Dougherty, director of the healthcare practice at J.D. Power and Associates.
According to Dougherty, plans that focus on building relationships through member education, communication and reliable, consistent delivery of health insurance services and that effectively manage member expectations during periods of change will likely have a competitive edge.
Health plan members in Pennsylvania, Michigan and New England remain the most satisfied with their health plan experience, although the average satisfaction score in each region decreased significantly in 2010, compared with 2009. Member satisfaction in the Illinois-Indiana region remains constant compared with 2009, moving the region to rank among the regions with the highest satisfaction scores in 2010.
"The recent healthcare debate has demonstrated just how complicated the health insurance market can be," said Dougherty. "While the full implications of the recent healthcare reforms will not take effect for a number of years, it is likely that individual consumers will have more choices than they have had in the past due to new exchanges and portability."
Eleven percent of health plan members said the changes to the healthcare system introduced by healthcare reform laws will result in the loss of their current coverage, while 56 percent say they don't know whether their coverage will be affected. Forty percent of health plan members said their healthcare coverage will be worse as a result of the changes to the healthcare system, while 9 percent said it will be better.
Among members who are able to choose their carrier, those with the highest satisfaction levels (901 points or higher) are seven times more likely to remain with their carrier in the future and 13 times more likely to recommend their carrier to others, compared to those with the lowest satisfaction levels (550 points or less).