Some 60 percent of privately insured U.S. health plan members say they were not contacted by their health plan with guidance or information related to COVID-19, and 48 percent say their health plan has not shown concern for their health since the pandemic began, according to a new J.D. Power 2020 U.S. Commercial Member Health Plan Study. J.D. Power is based in Troy.
The two data points are the most visible indicators of a health insurance marketplace that lacks focus on customer engagement, putting it at risk for disruption as a growing crop of alternative health insurance providers prepare to enter the marketplace, the report says.
“Health plans are widely perceived as lacking a customer-centric mindset and not putting the best interests of their members first,” says James Beem, managing director of global health care intelligence at J.D. Power. “The COVID-19 pandemic has amplified these shortcomings, but they are not new. If traditional health insurance plans want to resist the threat from disruptors, they need to demonstrate partnership with members – and on behalf of employers – to improve member health, reduce costs, and help members navigate the health care system.”
About 36 percent of commercial health plan members say their health plan acts in their best interest “always” or “most of the time.” About 25 percent of members say they view their health plan as a trusted partner in their health and wellness. The industry has an overall satisfaction score of 719 on a 1,000-point scale, which is among the lowest of all industries evaluated by J.D. Power.
Proactive efforts by health plans to engage with members, such as those to provide advice on how to control costs or help coordinate care, drive significant overall customer satisfaction. For example, when a health plan helps members keep out-of-pocket costs low, the average overall satisfaction score is 819, which is 152 points higher than when no such effort is made.
Expanding telehealth usage is associated with a 39-point increase in overall customer satisfaction. With telehealth usage increasing since the COVID-19 pandemic began, J.D. Power projects the trend will continue to grow rapidly. According to the study, which was fielded largely before the COVID-19 pandemic hit the U.S., 9 percent of commercial health plan members have used telehealth. Of those who have not, 48 percent say they would consider using it if it were covered by their plan.
Additional J.D. Power research conducted from March 15-May 1 shows that 75 percent of U.S. health insurance members are aware of telehealth, but 54 percent do not understand if telehealth services are offered as part of their health care benefits.
The study measures customer satisfaction with commercial member health plans in 21 geographic regions. Highest ranking health plans and scores, by region, are as follows:
- Michigan: Blue Cross and Blue Shield of Michigan (736)
- California: Kaiser Foundation Health Plan (784)
- Colorado: Kaiser Foundation Health Plan (718)
- East South Central: Blue Cross and Blue Shield of Alabama (761)
- Florida: Humana (783)
- Heartland: Blue Cross and Blue Shield of Kansas City (719)
- Illinois/Indiana: Blue Cross and Blue Shield of Illinois (733)
- Maryland: Kaiser Foundation Health Plan (802)
- Massachusetts: Blue Cross and Blue Shield of Massachusetts (722)
- Minnesota/Wisconsin: HealthPartners (721)
- Mountain: Regence BlueCross BlueShield of Utah (723) and SelectHealth (723)
- New Jersey: Horizon Blue Cross and Blue Shield of New Jersey (728)
- New York: Independent Health Association (783)
- Northeast: Anthem Blue Cross and Blue Shield of Connecticut (726)
- Northwest: Kaiser Foundation Health Plan (739)
- Ohio: Aetna (727)
- Pennsylvania: Geisinger Health Plan (739)
- South Atlantic: Kaiser Foundation Health Plan (791)
- Southwest: Cigna (730)
- Texas: Humana (797)
- Virginia: Aetna (735)
The study is now in its 14th year and measures satisfaction among members of 149 health plans in 21 regions throughout the U.S. by examining six factors: billing and payment, cost, coverage and benefits, customer service, information and communication, and provider choice. It also measures other aspects of the experience and member engagement. The study is based on responses from 31,283 commercial health plan members and was fielded from January-March.
J.D. Power offers consumer insights, advisory services, and data and analytics. It was established in 1968 and has offices serving North America, Asia Pacific, and Europe.