WESTLAKE VILLAGE, Calif., April 30 /PRNewswire/ -- Health plan performance varies widely among some insurers across the U.S., yet contacting plan members regularly and increasing their understanding of plan details can lead to more consistent and positive satisfaction ratings, more renewal business and additional sales of services to members, according to the J.D. Power and Associates 2008 National Health Insurance Plan Study(SM) released today.
Now in its second year, the study measures member satisfaction among 107 health plans in 17 regions throughout the U.S. by examining seven key factors: coverage and benefits; choice of doctors, hospitals and pharmacies; information and communication; approval processes; claims processing; insurance statements; and customer service.
The study 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. Only 45 percent of members reported they fully understand how to use their health insurance coverage and member services. 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.
"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. "With increasing healthcare costs and an aging workforce that needs additional services, businesses have less and less tolerance for insurers that aren't consistently engaging members and helping them manage their own health care and the associated costs. However, we find that those plan members who are most engaged by their insurer through effective communication better understand how to use their plans and have particularly high satisfaction levels. Those higher satisfaction scores translate into better retention rates and more positive recommendations for the plan."
Study results by region are:
BlueCross BlueShield of Arizona ranks highest, receiving a satisfaction index score of 763 on a 1,000-point scale.
BlueCross BlueShield of Florida ranks highest for the second consecutive year with 751.
Ranking highest in the Heartland region is Wellmark BlueCross BlueShield of Iowa with 742.
Highmark Blue Cross and Blue Shield ranks highest with 784, which marks the highest score across all regions included in 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.
For more information on the performance of national health insurance plans, visit http://www.jdpower.com/healthcare/ratings/health-plan-ratings/.
United Healthcare is included in the study, but not ranked due to small sample size.
Included in the East South Central Region are: Alabama, Kentucky, Mississippi and Tennessee.
Included in the New England Region are: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont.
Regence Blue Shield of Idaho is included in the study, but not ranked due to small sample size.
Included in the South Atlantic Region are: Georgia, North Carolina and South Carolina.
NOTE: J.D. Power and Associates qualifies its sample for the 2008 National Health Insurance Plan Study through enrollment data from an independent source. Plans that do not report enrollment data by state are not included in the study. Plans whose commercial HMO, PPO and POS enrollment was less than 250,000 members were also not included in the sampling for the study.
About J.D. Power and Associates
Headquartered in Westlake Village, Calif., J.D. Power and Associates is a global marketing information services firm operating in key business sectors including market research, forecasting, performance improvement, training and customer satisfaction. The firm's quality and satisfaction measurements are based on responses from millions of consumers annually. For more information on car reviews and ratings, car insurance, health insurance, cell phone ratings, and more, please visit JDPower.com. J.D. Power and Associates is a business unit of The McGraw-Hill Companies.
About The McGraw-Hill Companies
Founded in 1888, The McGraw-Hill Companies (NYSE: MHP) is a leading global information services provider meeting worldwide needs in the financial services, education and business information markets through leading brands such as Standard & Poor's, McGraw-Hill Education, BusinessWeek and J.D. Power and Associates. The Corporation has more than 280 offices in 40 countries. Sales in 2007 were $6.8 billion. Additional information is available at http://www.mcgraw-hill.com.
SOURCE J.D. Power and Associates