J.D. Power: MA plans falling short on mental health, substance abuse treatment

Overall satisfaction with Medicare Advantage (MA) plans continues to rise, but there are areas where these insurers still fall short, according to a new survey.

J.D. Power released its annual study of MA plans Thursday, and the analysts found members' general satisfaction is up from 2021 and is higher than satisfaction reported by people in employer-sponsored plans. However, while members said they're happy with access to preventive and routine care, coverage of mental health and substance abuse treatment is lacking.

Most (91%) of members said they have enough coverage for routine diagnostics and 89% said they had enough coverage for preventive care. By comparison, just 38% said the same about mental health coverage and 27% for substance abuse treatment.

Christopher Lis, managing director for global healthcare intelligence at J.D. Power, said there are multiple things that could make it harder for members to access mental health care or substance abuse treatment. For one, they may be correct in the assessment that their benefits are lacking, he said.

A member's benefits could be comprehensive, Lis said, but they lack the understanding of their coverage to use those options effectively. And third, their benefits may be what they need and they may understand them, but they struggle with access anyway.

He said the findings offer a significant opportunity for insurers to "peel back the onion" and determine where members may be running into these barriers.

"If we think about it, access and appropriate mental health treatment is going to have an impact on a whole lot of things." Lis said.

The study also found a decline in telehealth use among MA members, with less a quarter of beneficiaries (24%) using telemedicine in the past year, down from 35% of members in 2021's study. While utilization decreased, member satisfaction with these platforms is increasing. 

Nearly half (48%) of those who used telehealth said they would do so again, up five percentage points from the previous year. Lis said that telehealth is here to stay post-COVID, but there are a number of concerns to be ironed out to ensure its longevity, including reimbursement models and coverage.

Another way to boost member satisfaction, according to the study, is ensuring they're using online portals. Most members—about 82% of MA beneficiaries—are enrolled in portals. Despite this, 14% of members had never actually logged into the portals.

J.D. Power found that member satisfaction with the plans is notably higher when members enroll in and connect to their online portals.

"I think health plans need to continuously understand what the customer values most and find a way to deliver on that," Lis said.