Health insurance member satisfaction took a tumble this year, likely because members don't understand their health plans, according to the new J.D. Power and Associates 2010 U.S. Member Health Insurance Plan Study.
The fourth annual study found that member satisfaction averages dropped from 712 on a 1,000-point scale in 2009 to 701 this year. J.D. Power and Associates measures health plan satisfaction of 133 health plans in 17 U.S. regions in seven areas: coverage and benefits, provider choice, information and communication, claims processing, statements, customer service, and approval process.
J.D. Power and Associates reported that member satisfaction dropped in all areas except customer service, which remained flat.
"The significant decline in overall satisfaction is partially driven by a lack of members' understand of their plans' coverage and benefits and how to successfully access them," said Jim Dougherty, director of J.D. Power and Associates' healthcare practice. "Understanding alone does not explain member satisfaction, although it may help to mitigate other problems with the member experience. While satisfaction with many plans has declined this year, satisfaction decreases are less severe for those plans able to substantially increase member understanding."
According to J.D. Power and Associates, members in Pennsylvania, Michigan, and New England remained the most satisfied with their health plan experience though the satisfaction scores have dropped in those regions this year too.
Dougherty said health plans can improve member satisfaction by providing new and existing members with a better understanding of their coverage and "proactively" communicating with members about impending changes in benefits, physician or hospital networks or costs. Dougherty added that plans should build relationships through "member education; communication; and reliable, consistent delivery of health insurance services."
About 60% of members surveyed said they do not fully understand their plans. That's an issue for insurers because having members better understand their benefits usually lead to more loyal and "better advocates for the health plan," according to J.D. Power and Associates.
In fact, members with the highest satisfaction levels are seven times more likely to remain with their insurer and 13 times more likely to recommend their insurer to others when compared to members with the lowest satisfaction levels.