An annual survey of insurance customers showed little overall improvement in customer experience (CX) among the nation's largest insurers over the last few years.
And while some health plans made big improvements this year, others got worse, leaving CX quality flat year over year since 2016.
Six out of the 17 insurers scored an "OK" in performance (a 65-74 in Forrester's CX Index), including the top three insurers: Kaiser Permanente, Humana and Empire Blue Cross Blue Shield. The other 11 scored "Poor," a 55-64 in the index.
None of the insurers evaluated by Forrester scored a "Good" or "Excellent."
The three top insurers are all incumbents in those positions from last year's survey. Kaiser has topped the list for the last four years, and Humana has been runner-up for the same period.
Forrester cited Kaiser's emphasis on its employees and its nature as an integrated delivery network as reasons for its continued leadership in customer experience.
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"Kaiser Permanente is an integrated delivery network that provides both healthcare services and a health insurance plan," Forrester wrote in the report. "This gives it an advantage over most of its competitors—allowing for more control throughout the entire customer life cycle and for increased transparency with customers and employees."
| Brand | 2018 ranking | 2017 ranking |
| Kaiser Permanente Health Plan | 1 | 1 |
| Humana | 2 | 2 |
| Empire Blue Cross Blue Shield | 3 | 3 |
| Blue Cross Blue Shield of Michigan | 4 | 9 |
| Highmark Blue Cross Blue Shield | 5 | 16 |
| Florida Blue | 6 | 5 |
| Blue Cross Blue Shield of Texas | 7 | 7 |
| Blue Cross Blue Shield of Illinois | 8 | 14 |
| Blue Shield of California | 9 | 11 |
| UnitedHealthcare | 10 | 6 |
| CareFirst Blue Cross Blue Shield | 11 | 8 |
| Anthem Blue Cross and Blue Shield | 12 | 12 |
| Cigna | 13 | 13 |
| Health Net | 14 | 4 |
| Anthem Blue Cross | 15 | 17 |
| Other Blue Cross Blue Shield | 16 | 10 |
| Aetna | 17 | 15 |
The rest of the list looked notably different than the previous year, however. Blue Cross Blue Shield of Michigan rose from ninth place to fourth place, and Highmark Blue Cross Blue Shield jumped 11 places to fifth place—the only statistically significant increase across the industry, Forrester noted.
Like Kaiser, Highmark—with its connections to Highmark Health, another integrated network—touches more of the customer life cycle than the average health insurer, and as a result, has more influence over the customer experience. That can cut both ways, however—last year the insurer fell 10 rankings from the fifth-place spot it occupied in 2016.
The biggest drop this year was seen by Centene's Health Net, which fell from fourth place to 14th place. Forrester noted that Health Net's customer experience had been stagnant for years, but this year saw a statistically significant decline.
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"It performed worse than every other insurer in four areas, most notably in making it easy to get routine healthcare," Forrester said in the report. "Based on the negative customer ratings and reviews on ConsumerAffairs.com—Health Net receives just one out of five stars—many customers seem both confused and frustrated."
Neither Kaiser Permanente nor Health Net could immediately be reached for comment.
To perform better in customer experience, Forrester found that insurers could invest more in customer service, as only 56% of customers feel that they can get help when they need it. Meanwhile, the firm suggested that insurers can largely eschew a mobile app, as not many customers expect one. Many insurers, however, have sunk money into tech offerings designed to improve consumer experience.
As for treating customers with respect, Forrester downplayed the need to make customers "happy." It instead asserted that the top emotions that increase loyalty are feeling appreciated, confident and valued, while the emotions that decrease customer loyalty include annoyance, disappointment and frustration.