Consumers express dissatisfaction with healthcare coverage

Health insurance companies historically haven’t gotten much love from the public, and that seems to still be the case even as the COVID-19 pandemic ebbs.

Americans are dissatisfied with their health insurance coverage, saying it costs too much, and the policies are often confusing, according to a poll from consulting firm Ipsos and the Pharmaceutical Research and Manufacturers of America (PhRMA), the pharmaceutical industry's largest lobbying group.

Most of the 2,510 respondents (86%) want Congress to do something about it. And there isn't a partisan divide for this sentiment, as both Democrats and Republicans expressed frustration with health plans. Ninety-two percent of Democrats and 84% of Republicans want lawmakers to crack down on what they consider to be attempts by health insurance companies that make it harder for them to get the care they need.

Debra DeShong, PhRMA’s executive vice president of public affairs, said in a press release that “it’s time to bring the patient perspective to the health care reform debate and focus on immediate solutions that Americans value the most.”

DeShong argues that insurers should provide more dependable coverage, and policies should lower the out-of-pocket costs for medications. “We are ready to do our part, and we remain committed to working with policymakers to improve our health care system," she said.

Eighty-three percent of respondents say consumers should know which health insurance companies are most prone to deny claims to groups of people such as those battling a particular disease.

The survey also specifically questioned potential voters, and 77% said that health insurers should publicly disclose when they deny doctor-recommended care. In addition, 82% of voters want lawmakers to make the lowering of out-of-pocket costs a priority.

The results suggest voters want more transparency from insurers. But can they digest those data?

That question came up when insurers July 1 began complying with federal mandates for more transparency. As directed by the Centers for Medicare & Medicaid Services (CMS), insurers began releasing pricing data. And while compliance isn't a problem, insurers have released so much data that average consumers and employers may find it difficult to make sense of the information.

CMS anticipated that might be a problem and said the situation would “offer third party developers and innovators the ability to create private sector solutions to help drive additional price comparison and consumerism in the health care market.”

Many health plan officials are only too aware of consumer dissatisfaction, and they want to try to lessen it.

Debbie Williams, the chief sales and marketing officer at Blue Cross Blue Shield of Massachusetts, said her company works hard to win the trust of members.

“As the cost of healthcare services continues to rise, it is critical that we find ways to guide our members to high-quality care at a lower cost,” Williams told Fierce Healthcare. “Listening to the market and developing products and services—like our new virtual network of clinicians that we’ll be announcing soon—that meet the needs of our members is key as they navigate the healthcare system and the costs associated with it.”

Employers also need to take stock of what’s going on in the healthcare coverage realm, especially in light of labor shortages. Julie Stone is the managing director for health and benefits at WTW, a consulting firm, and she tells Fierce Healthcare that she has one word for employers: Listen.

“The healthcare benefits ecosystem continues to evolve, employee needs and expectations are growing given the world we live in, and employers who listen, learn and adapt to their population’s needs will be best served in terms of talent acquisition and retention and, most importantly, health and productivity," Stone said.

Stone said that according to WTW’s Global Benefits Attitudes Survey, employees rank healthcare benefits as the second most important factor when deciding to work for a company, and they’re the third most important factor that encourages them not to leave.

“This is much more of a factor than it was pre-COVID and is likely to remain a high priority for the foreseeable future,” Stone said.

And in WTW’s 2021 Benefits Trend Survey, 40% of employees said they value “intentional listening” on the part of their employers, but only 12% of employers think that’s important.

There’s some good news for employers, however, when it comes to the health benefits that they offer.

“We do see an increase over the past five years in the percent of employees reporting that the resources provided by their employer meets their needs moving from 39% in 2017 to 54% in 2022,” Stone said. “That said, there is an equity issue here, too, relative to salary. Importantly, employees who self-report that they have health issues are less likely to feel that their employer’s programs are meeting their needs.”