J.D. Power: A look at the widening gap between plans with the best and worst consumer experience

A significant gap exists between health plans that have the highest consumer experience scores and those with the lowest, according to a new survey from J.D. Power.

The consumer insights firm released its annual look at commercial health plans and found that overall satisfaction lands at a score of 595 out of 1,000 points, an increase of three points from 2023's survey. However, the analysts found a 79-point gap between plans with the highest and lowest scores.

Further, plans with the best consumer satisfaction ratings are getting better, while the lowest-performing plans are sliding. Scores at the highest performers increased by 20 points, while lower scores declined by eight points.

“In many cases, employer-sponsored health insurance is consumers’ primary window into the healthcare system,” said Christopher Lis, Ph.D., managing director of global healthcare intelligence at J.D. Power, in a press release. “Access to care, cost of care, chronic condition management—the central pillars of the consumer healthcare experience—are all heavily influenced by commercial health plans."

"That’s why it’s so concerning that J.D. Power sees such a large gap in overall performance between plans across everything from cost to digital tools to provider choice," Lis said.

The report found the largest satisfaction gaps for how well the plan saves money for the customer, how readily the member can secure the services they want when they want them and overall trust. A universal area for improvement is the digital health experience, where almost all health insurers are falling short.

For instance, the gap in savings between the highest and lowest scores was 87 points for how well they're generating savings. However, overall satisfaction with digital experiences across commercial health plans was far lower than in other sectors like banking or other types of coverage like Medicare Advantage.

Given the challenges here, J.D. Power released its first Health Insurance Experience Study earlier this year, which found that 45% of adults ran into issues using their plan's website and/or mobile apps in the past year.

The commercial plan study also found lengthy wait times for provider visits. The average wait to see a specialist was 22 days, and the average wait for an annual physician exam was 15 days. Waits increase to 25 days and 18 days, respectively, for the lowest-performing plans.

The analysis includes a look at the highest performers in 22 different regions, with some of these plans holding that title for many years. The Kaiser Foundation Health Plan, for example, has been the highest-rated plan in California for 17 straight years in the study and the highest-rated plan in the south Atlantic region for 13 years in a row.