J.D. Power Reports: Concerns about Not Having Enough Health Coverage Drive Down Member Satisfaction

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1 w J.D. Power Reports: Concerns about Not Having Enough Health Coverage Drive Down Member Satisfaction WESTLAKE VILLAGE, Calif.: 10 March 2014 While health insurance companies are introducing themselves to customers in new markets through new channels, 41 percent of existing health plan members feel they do not have enough coverage for routine visits, serious illness or injury, health and wellness programs, routine diagnostics and drug coverage. Concerns over not having enough health coverage negatively impacts overall satisfaction by 133 points, more than any other coverage-related issue, according to the J.D. Power 2014 Member Health Plan Study SM released today. Now in its eighth year, the study measures satisfaction among members of 136 health plans in 18 regions throughout the United States by examining six key factors: coverage and benefits; provider choice; information and communication; claims processing; cost; and customer service. In 2014, overall member satisfaction averages 669 (on a 1,000-point scale). KEY FINDINGS The study finds that 55% of members indicate having experienced an increase in costs in 2013, which negatively impacts cost satisfaction. More than one-third (35%) of members say they received a notice of changes in their coverage, networks or rates from their health plan in the past 12 months. In the 2013 plan year, 74% of health plan members maintained their preferred physician and 83% retained their same hospital network. Seventy-five percent of members indicate having submitted a claim in the past 12 months. The average monthly premium paid in 2013 is $285. Nearly half (49%) of members indicate their plan does not offer the most common types of health and wellness discount/incentive programs. On average, members wait eight days for communication from their provider after a pre-approval request has been submitted, said Rick Johnson, senior director of the healthcare practice at J.D. Power. Health plans must look for ways to promptly communicate both pre-approvals and cost in order to minimize member anxiety and mitigate concerns about access to care, ultimately increasing customer satisfaction. Study Rankings Satisfaction is highest among health plan members in the California and Michigan regions (in a tie); the Indiana-Illinois and Mid-Atlantic regions (in a tie); and the East South Central and South Atlantic regions (in a tie). Satisfaction is lowest in the New England, New York-New Jersey and Southwest regions. WEST Kaiser Foundation Health Plan ranks highest among health plan members in the California region for a seventh consecutive year, with a score of 756. No other plans in this region perform above the region average. Page 1 of 5

2 Kaiser Foundation Health Plan (703) ranks highest among health plan members in the Colorado region for a seventh consecutive year, followed by Anthem Blue Cross Blue Shield of Colorado (671). SelectHealth (698) ranks highest among health plan members in the Mountain region (which includes Idaho, Montana, Utah and Wyoming) for a fifth consecutive year, followed by Regence Blue Cross Blue Shield of Utah (689) and BlueCross of Idaho (672). Kaiser Foundation Health Plan (732) ranks highest among health plan members in the Northwest region (which includes Oregon and Washington), followed by Group Health Cooperative (GHC) (706). Blue Cross Blue Shield of Arizona (675) ranks highest among health plan members in the Southwest region (which includes Arizona, New Mexico and Nevada), followed by Aetna (668) and (666). MIDWEST Wellmark Blue Cross Blue Shield of Iowa (680) ranks highest among health plan members in the Heartland region (which includes Arkansas, Iowa, Kansas, Missouri, Nebraska and Oklahoma), followed by Anthem Blue Cross Blue Shield of Missouri and Blue Cross Blue Shield of Kansas City (in a tie at 678 each). Health Alliance Medical Plans (692) ranks highest among health plan members in the Indiana- Illinois region, followed by BlueCross BlueShield of Illinois (689). Health Alliance Plan of Michigan (711) ranks highest among health plan members in the Michigan region for a seventh consecutive year, followed by Priority Health (685) and Blue Cross Blue Shield of Michigan (683). Dean Health Plan (703) ranks highest among health plan members in the Minnesota-Wisconsin region, followed by HealthPartners (681) and Blue Cross Blue Shield of Minnesota (671). Medical Mutual of Ohio (697) ranks highest among health plan members in the Ohio region, followed by (676) and Aetna (673). EAST Kaiser Foundation Health Plan (732) ranks highest among health plan members in the Mid-Atlantic region (which includes Maryland, Virginia and Washington, D.C.) for a sixth consecutive year followed by CareFirst Blue Cross Blue Shield (696). Tufts Associated Health Plans (681) ranks highest among health plan members in the New England region (which includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont), followed by Anthem Blue Cross Blue Shield of Connecticut (674) and Blue Cross Blue Shield of Massachusetts (669). Capital District Physicians Health Plan (727) ranks highest among health plan members in the New York-New Jersey region, followed by Independent Health Association (705) and Horizon Blue Cross Blue Shield (679). Geisinger Health Plan (705) ranks highest among health plan members in the Pennsylvania region for a third consecutive year, followed by Highmark BlueShield (678) and Capital BlueCross and UPMC Health Plan (in a tie at 672 each). SOUTH (689) ranks highest among health plan members in the East South Central region (which includes Alabama, Kentucky, Louisiana, Mississippi and Tennessee), followed by BlueCross Blue Shield of Alabama (688) and Humana (677). Page 2 of 5

3 AvMed Health Plans and Humana (in a tie at 690 each) rank highest among health plan members in the Florida region, followed by (680) and Florida Blue (677). AvMed ranks highest in the Florida region for a third consecutive year. Kaiser Foundation Health Plan (784) ranks highest among health plan members in the South Atlantic region (which includes Georgia, North Carolina and South Carolina) for a fifth consecutive year, followed by (684) and Blue Cross Blue Shield of North Carolina (681). Aetna (677) ranks highest among health plan members in the Texas region, followed by (672) and (668). J.D. Power plans to release a study focused on health plan members satisfaction with the Affordable Care Act (ACA) in April The 2014 Member Health Plan Study is based on responses from more than 34,000 members of 136 commercial health plans across 18 regions in the United States. The study was fielded in December 2013 and January For more comprehensive health plan rankings for all 18 U.S. regions, please visit Media Relations Contacts Jeff Perlman; Brandware Public Relations; Woodland Hills, Calif.; ; jperlman@brandwarepr.com John Tews; J.D. Power; Troy, Mich.; ; media.relations@jdpa.com About J.D. Power and Advertising/Promotional Rules About McGraw Hill Financial # # # NOTE: Two charts follow. Page 3 of 5

4 J.D. Power 2014 Member Health Plan Study SM Regions Included in the Member Health Plan Study California Colorado East South Central (includes Alabama, Kentucky, Louisiana, Mississippi and Tennessee) Florida Heartland (Includes Arkansas, Iowa, Kansas, Missouri, Nebraska and Oklahoma) Indiana-Illinois Michigan Mid-Atlantic (includes Maryland, Virginia and Washington, D.C.) Minnesota-Wisconsin Mountain (includes Idaho, Montana, Utah and Wyoming) New England (includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont) New York-New Jersey Northwest (includes Oregon and Washington) Ohio Pennsylvania South Atlantic (includes Georgia, North Carolina and South Carolina) Southwest (includes Arizona, New Mexico and Nevada) Texas Source: J.D. Power 2014 Member Health Plan Study SM Charts and graphs extracted from this press release must be accompanied by a statement identifying J.D. Power as the publisher and the study from which it originated as the source. Rankings are based on numerical scores, and not necessarily on statistical significance. No advertising or other promotional use can be made of the information in this release or J.D. Power survey results without the express prior written consent of J.D. Power. Page 4 of 5

5 J.D. Power 2014 Member Health Plan Study SM Top Three Plans in Overall Member Satisfaction by Region California* Colorado* Anthem Blue Cross Blue Shield of Colorado East South Central Highest: BlueCross BlueShield of Alabama Humana Florida Highest: AvMed Health Plans and Humana (tie) Florida Blue Heartland Highest: Wellmark Blue Cross Blue Shield of Iowa Anthem Blue Cross Blue Shield of Missouri (tie) Blue Cross Blue Shield of Kansas City (tie) Indiana-Illinois* Highest: Health Alliance Medical Plans BlueCross BlueShield of Illinois Michigan Highest: Health Alliance Plan of Michigan Priority Health Blue Cross Blue Shield of Michigan Mid-Atlantic* CareFirst Blue Cross Blue Shield Minnesota-Wisconsin Highest: Dean Health Plan HealthPartners Blue Cross Blue Shield of Minnesota * No other plans in this region perform above the region average. Source: J.D. Power 2014 Member Health Plan Study SM Page 5 of 5 Mountain Highest: SelectHealth Regence Blue Cross Blue Shield of Utah BlueCross of Idaho New England Highest: Tufts Associated Health Plans Anthem Blue Cross Blue Shield of Connecticut Blue Cross Blue Shield of Massachusetts New York-New Jersey Highest: CDPHP Independent Health Association Horizon Blue Cross Blue Shield Northwest* Group Health Cooperative Ohio Highest: Medical Mutual of Ohio Aetna Pennsylvania Highest: Geisinger Health Plan Highmark BlueShield Capital BlueCross (tie) UPMC Health Plan (tie) South Atlantic Blue Cross Blue Shield of North Carolina Southwest Highest: Blue Cross Blue Shield of Arizona Aetna Texas Highest: Aetna Charts and graphs extracted from this press release must be accompanied by a statement identifying J.D. Power as the publisher and the study from which it originated as the source. Rankings are based on numerical scores, and not necessarily on statistical significance. No advertising or other promotional use can be made of the information in this release or J.D. Power survey results without the express prior written consent of J.D. Power.