Trust in payers hits all-time low, survey finds

Providers and consumers don't place much trust in health insurance companies, a new survey suggests.

Healthcare marketing firm ReviveHealth's annual trust index examined consumer, payer and provider views on trust in the industry, and found that while trust is low across the board, it's at its worst for payers. Payers' score on the index was at an all-time low, the lowest recorded in more than a decade. 

Payers have long struggled with public perception, but at times have been especially hard with healthcare reform in the Washington spotlight. Sen. Lindsey Graham, R-S.C., said payer opposition to his healthcare bill was a good thing, for example, because the Graham-Cassidy bill would have taken money away from insurers and redistributed it to states.

During recent bipartisan hearings on stabilizing the individual insurance market, Sen. Elizabeth Warren, D-Mass., took Anthem to task for not standing up for its members when Republicans tried to repeal the ACA—as well as for the profits it makes and for getting “buckets of taxpayer money.”

ReviveHealth surveyed 117 hospital and health system executives, 600 practicing physicians, 48 health plan executives and 604 consumers between June and August of this year. Payers received a "failing grade" on the index (a score of 59.1 out of 100) based on several factors, including narrowing networks, administrative inefficiencies and aggressive negotiation tactics. 

“Consumers’ lack of trust should come as no surprise given the complexity of the healthcare system and how little healthcare’s central players trust each other,” Brandon Edwards, CEO of ReviveHealth, said in an announcement. 

"If the onus continues to be placed on individuals to manage their financial responsibility for healthcare, it’s reasonable to expect physicians, health systems and health plans must band together to close the trust gap amongst each other and their customers." 

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Participants ranked organizations on a scale from zero to 100 on their reliability, honesty and fairness.

Health systems' trust in payers scored an average of 52, and physicians' trust scored an average of 55.8, according to the report. Health system executives in particular offered a wide range of scores; the lowest reported score was a 36.3 and the highest was a 68. 

Cigna earned the highest score, while UnitedHealth ranked last. The margin between specific insurers was not very wide, according to the report. 

"I want to deal with the insurance company they show in their advertising," one health system executive said. 

RELATED: Payers, providers must narrow their trust gap 

The feelings of mistrust may not be entirely mutual, as health plan executives ranked their trust in health systems as a 68.4. Payers were more likely to trust "low power organizations," and one health plan executive said "everyone seems to be holding cards close to [their] chest." 

The survey also found that payers may not be especially concerned about consumer preferences as the industry continues to transition to value-based care. When asked to rank 11 factors driving that transformation, health plan executives ranked "public sentiment about healthcare costs and coverage" last.