J.D. Power: Medicaid managed care plans do better than commercial plans on customer satisfaction

Health insurance benefits form
Among Medicaid managed care enrollees, a major concern is whether the services they will need—with their provider of choice—are covered. (Getty/michaelquirk)

As states increasingly turn to private insurers to help them manage Medicaid beneficiaries, a recent report offers encouraging news: Customer satisfaction is higher among Medicaid managed care enrollees than for commercial health plan enrollees.

Those findings come from the inaugural J.D. Power 2017 Managed Medicaid Special Report, which measured customer satisfaction among companies in 36 states and the District of Columbia. It found that overall satisfaction with managed Medicaid organizations, as measured on a 1,000-point scale, is an average of 784—78 points higher than commercial health plan member satisfaction as measured by the J.D. Power 2017 Member Health Plan Study.

While J.D. Power has conducted research on commercial health plans for years, it decided to start examining managed care products because of the rising popularity of these privately run Medicaid plans, Valerie Monet, senior director of U.S. health insurance operations at J.D. Power, told FierceHealthcare.

“It is growing; it’s something that most health plans are very, very interested in,” she said. “As this becomes more prevalent in more states, I think the focus absolutely has to shift to the members and what we’re doing to help make sure that they’re getting the access to care that they need.”

RELATED: Medicaid enrollment slows, but managed care growth continues

While coverage and benefits are the key drivers of customer satisfaction among commercially insured individuals, the biggest factor for Medicaid managed care members is provider choice, the report said.

That finding surprised Monet, as she predicted cost would be the biggest driver of satisfaction levels for the Medicaid population. Cost concerns are indeed a major issue, as J.D. Power found that 1 in 4 Medicaid managed care recipients put off getting needed care because of cost, and 40% put off buying prescriptions.

Yet while this is a “huge factor” when it came to people’s perceptions around getting access to care, Monet said, “ultimately, once they figure out how to work with the plan, it’s really minimized.”

Instead, enrollees were more concerned that the services they would need—with their provider of choice—would be covered.

Along similar lines, J.D. Power examined the Healthy Indiana Plan and found that while it raised enrollees’ out-of-pocket costs, it did so without compromising customer satisfaction. The program, which requires beneficiaries to pay small amounts toward their monthly premiums, has been in the national spotlight under the Trump administration, as Vice President Mike Pence and Centers for Medicare & Medicaid Services Administrator Seema Verma have championed it as a successful example of state innovation.

“It’s the old adage—surprise is the enemy,” Monet said. In other words, the state’s Medicaid program did a good job of engaging enrollees to explain what costs they would face, lessening the possibility of a negative customer experience. “These types of programs—unless the costs far outweigh what somebody can afford to pay—they can work.”

The organization also found that Medicaid recipients in states where there is a dominant regional plan or a plan that owns a health system—like in Tennessee, Arizona and Indiana—tended to have the easiest access to doctors and hospitals, a major satisfaction driver.

Further, unlike what J.D. Power often sees when it ranks commercial plans—with integrated delivery systems dominating—in Medicaid managed care, some Blue Cross Blue Shield plans are actually doing the best, Monet noted.

“This space is, I would say, almost ‘open game,’ in terms of being able to figure out how to manage that particular part of the population,” she said.