TheMyersGroup.net. Consumer Awareness of the Health Insurance Marketplace TMG Polling Study Findings

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1 TheMyersGroup.net Consumer Awareness of the Health Insurance Marketplace 2014 The Myers Group conducted two consecutive year (2013 and 2014) polling studies to measure and compare consumer awareness of the Health Insurance Marketplace and the issues important to consumers when choosing a plan.

2 Table of Contents A Brief Look at the 2013 Health Insurance Marketplace Polling Study... 1 Upcoming Open Enrollment Expectations Health Insurance Marketplace Polling Study... 1 Findings Reveal Continued Lack of Awareness, Yet Improvement... 2 Who will be shopping the Marketplace?... 3 A Shift in the Health Insurance Market Business Model... 4 Factors Influencing Consumers when Selecting Health Insurance... 4 Consumers Perception about Costs and Coverage... 5 Impact of Recommendations from Family or Friends... 5 Member Satisfaction and Plan Loyalty... 5 Conclusion... 6 Survey Methodology... 6 Respondent Profile... 7 Insured Responders:... 8 About The Myers Group... 9

3 Consumer Awareness of the Health Insurance Marketplace 2014 TMG Polling Study A Brief Look at the 2013 Health Insurance Marketplace Polling Study In June 2013, The Myers Group conducted a national online polling study to measure consumer awareness of the new Health Insurance Marketplace (the Marketplace) and to explore the major factors influencing consumers when selecting their health insurance. Feedback and opinions from 556 adult consumers confirmed that, in approaching the first year of enrollment, Marketplace awareness levels were low (36% Very or Somewhat aware). Additionally, a majority (66%) of these consumers expressed uncertainty about how and if the Affordable Care Act would impact them or their family. Factors related to cost, followed by easy, understandable information about health insurance coverage, were of highest importance and concern to consumers. Upcoming Open Enrollment Expectations The roughly 8 million people who shopped the Marketplace and enrolled in an exchange-based health plan this year will be required to renew their existing coverage or select another health plan options for An additional 5 million people are expected shop and enroll in a plan. Open enrollment for 2015 coverage year begins Nov. 15, Health Insurance Marketplace Polling Study As we enter the second year of enrollment in Marketplace plans, The Myers Group repeated the online polling study to again measure and compare levels of awareness about the Marketplace and the issues important to consumers when choosing a plan. Among those currently insured, we also assessed existing levels of satisfaction and their intent to re-enroll with their health plan. As with any online sampling, it is important to remember that internet users tend to skew more highly educated, higher income, and younger. This study was conducted from July 24 through July 30, Sample and respondent population included insured (non-medicare) and uninsured adults years of age. A total of 799 surveys were completed from both insureds (81%) and uninsured (16%) consumers. As shown in the pie chart below, more than half of the respondents (58%) indicated they have access to their insurance coverage through an employer. This is slightly higher than what was seen in 2013 with 55% of consumers stating they were covered via an employer. Copyright 2014 The Myers Group 1

4 2014 Source of Coverage Govt. Program 7% Other 3% Parents 9% Purchased Yourself 12% Employer 58% Medicaid Plan/Program 12% Findings Reveal Continued Lack of Awareness, Yet Improvement National attention and political dialogue about the Affordable Care Act has been unrelenting over the past 12 months. Yet, there remains a majority of 2014 respondents (65%) who are uncertain or feels they don t have enough information to understand how the Affordable Care Act impacts them or their family. Little difference is seen when comparing the findings of those currently insured or uninsured. Consumer awareness of the Marketplace has, however, improved significantly when compared to our 2013 findings. 2013: 36% Very/Somewhat aware of the Marketplace 2014: 52% Very/Somewhat aware of the Marketplace Close to half (48%) of all respondents indicated they are Not at all aware or A little aware of the Marketplace. Clearly, further aggressive outreach is warranted by states, HHS/CMS and insurers to encourage and draw consumers interest in the various state exchanges. In July, 2014, Gallup reported the uninsured rate in the U.S. to be 13.4% of the population. 1 Understandably, the uninsured are a primary target for HHS/CMS and potentially have the most to gain from the Affordable Care Act. Among those uninsured, TMG findings show general awareness of the Marketplace has improved significantly from 38% in 2013 to 62% that are Very/Somewhat aware in US Uninsured Rate: Gallup, July 2014; Copyright 2014 The Myers Group 2

5 2014 vs Consumer Awareness of the Health Insurance Marketplace Survey Question: How aware are you of the health insurance Marketplace? Not at all A Litte Very/Somewhat Aware Very/SW Aware Insured Uninsured % 23.9% 51.6% 50% 62% % 31.9% 36.2% 36% 38% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% In a recent Polling Study conduct by the Kaiser Family Foundation (Oct. 2014), uninsured consumers where asked about their knowledge of the Marketplace. Kaiser reports two thirds of the uninsured say they know Only a little or Nothing at all about the Marketplaces. 2 Who will be shopping the Marketplace? Approximately, 27% of the respondents stated they are Very likely or Somewhat likely to shop the Marketplace this year. This is slightly higher than what we found in 2013 with 23% of the consumers anticipating they would likely shop the Marketplace. Of those likely to shop the Marketplace: Majority (78.8%) are white, under 45 years of age (74%), report excellent/very good/good health (84.3%), have incomes less than $50K (79%) and are employed either part-time or full time (61%). Close to half (49%) of the uninsured respondents and 23% of those currently insured expect to shop this year in the Marketplace. 2 Kaiser Health Tracking Poll: Kaiser Health Foundation, Oct. 2014; Copyright 2014 The Myers Group 3

6 A Shift in the Health Insurance Market Business Model Interestingly, while more than half (58%) of the respondents stated they obtain their coverage through an employer, 13% indicate they are Very likely or Somewhat likely to shop the 2015 Marketplace. Many industry authorities and regulators are in agreement that the health insurance market is beginning to experience a shift in the business model from that of an employer-based to individual consumer-driven purchasing model. Private health insurance exchanges will play a significant role in the shift of this business paradigm. The private exchange market is predicted, by some, to significantly outpace public exchange activity within the next 4-5 years. Insights shared by industry insiders, like the McClatchy Washington DC Bureau (May 2014) 3, about Standards and Poor s top 500 companies, suggests within 5-6 years, we will see a steady flow of private companies shift from offering employer-based health insurance coverage to offering subsidies for plans sold in the Marketplace. Factors Influencing Consumers when Selecting Health Insurance Consistent with our 2013 study findings, among insured and uninsured alike, when choosing a health plan, factors related to out of pocket cost are of highest importance followed by ease of understanding information about what they are purchasing. Importance when choosing a health plan (0=Not at all; 10 = Most Important) 9 or Monthly out-of-pocket costs for premiums 62% 2. The cost of the copayment to visit a doctor or specialist. 52% 3. The cost of the copayment for prescription drugs 48% 4. Ease of understanding plan coverage 44% 5. Clear, understandable written materials 40% 6. Ability to keep your current doctor 39% 7. Prescription drug coverage 39% 8. Choice of hospitals 38% 9. Choice of specialty doctors 34% 10. Choice of primary care doctors 34% 11. If health plan received high quality ratings 25% 12. Health and wellness programs offered 22% 13. If health plan was recommended by someone you trust 13% 3 Large Employers Could Shift All Workers Health Coverage to Marketplace: McClatchy Washington DC Bureau; Tony Pugh, July 2014; Copyright 2014 The Myers Group 4

7 Consumers Perception about Costs and Coverage A growing number of consumers are feeling the pressure of choosing the most appropriate and affordable health insurance plan options to meet their needs and the needs of their family. The outcome, for some, is continued uncertainty and anxiety. Consumers understanding and confidence about coverage, costs and how to effectively use their health insurance plan, can impact members obtaining timely, routine care or preventive care treatments or services. This ultimately can translate into additional or reduced costs for the health plan and or the member. We asked those currently insured how confident they were that they understood most of the things they needed to know about using their health insurance. Survey findings showed: 62% Very confident or Moderately confident 25% Slightly confident 13% Not at all confident We, also, asked these consumers how confident they felt about being able to pay for usual out of pocket medical costs for themselves or their family. Majority of respondents (71%) are either Very or Somewhat confident. Close to one-third (or 29%) were Not confident Impact of Recommendations from Family or Friends In years past, one of the primary reasons indicated for choosing a particular health plan was because it was recommended by family or friends. However, consistent with our 2013 poll, this currently ranks last on the above list of ten most important factors when choosing a health plan. Given the real concerns about factors of cost, understanding and choosing the right benefits and coverage options, recommendations by friends/family may now be an intangible deciding factor when choosing a health plan. Member Satisfaction and Plan Loyalty Cost and understanding of the benefit plan is of high importance and will impact the members satisfaction or rating of their health plan. Using a scale of 0 (Worst health plan) to 10 (Best health plan), on average consumers rating of their health plan are moderate at best. Survey results show: 43% of the respondents rate their plan 8 to 10. No significant difference is found between those who purchased health insurance themselves or through an employer. Copyright 2014 The Myers Group 5

8 Members willingness to recommend their health plan is, typically, reflective of how they rate the plan. Only a third (33%) of the insured respondents express a strong willingness (8 10) to recommend their current health plan to family and friends. Member retention appears encouraging as a majority of the insured (77%) respondents indicate they are Very likely to re-enroll with their current health insurer. Not surprising, those with coverage through an employer are significantly more likely (86.4% Very likely ) to re-enroll with their current insurer than those who purchased insurance themselves (55% Very likely ). It is uncertain to what extent this is reflective of experience and satisfaction or driven by factors of affordability or limited choice of plans. Conclusion Findings show consumer awareness of the Marketplace has improved significantly. Yet, HHS/CMS, states, and insurers will need to continue their efforts to attract and provide easy to understand information and tools to increase awareness and activity in the health insurance Marketplace. Approximately, one in four consumers who responded to the survey state they are likely to shop the Marketplace this year. This includes respondents who are currently insured and uninsured, as well as some who currently obtain insurance through an employer. Intent to re-enroll ratings are strong, yet not reflective of how those with insurance rate their current health plan or how likely they are to recommend the plan. Similar to what we found in 2013, of greatest concern to those shopping will be cost, ease of understanding what they are purchasing and how to use it. The health insurance Marketplace serves to empower consumers to make the right choices for themselves and their families. While empowering, this new self-service landscape may also be somewhat intimidating. Insurers may want to focus on simplifying key information about each health insurance products as well as providing alternative support and channels of communication to support the decision making of potential enrollees. Survey Methodology This poll was conducted using SurveyMonkey Audience, an online opt-in panel. SurveyMonkey recruits from the 30+ million people who complete SurveyMonkey surveys every month. They limit the number of surveys members can take and reward members with non-cash incentives. As with any online sampling, it is important to remember that the survey reached out to people with internet access. As noted, internet users tend to skew more highly educated, younger and with higher income. Recognizing this, TMG set an income cap of $50,000 on half of the sample. Copyright 2014 The Myers Group 6

9 Respondent Profile Following is a summary of the profile characteristics of the respondent population. Copyright 2014 The Myers Group 7

10 Insured Responders Through exploring how those with health insurance purchased their 2014 coverage, majority of respondents report purchasing coverage through an employers. Others channels included, online exchanges, through brokers, or assistance provided by a health plan representative. How did you last enroll in your current health insurance plan? Answer Options N=597 Through you/your spouse s/partner s employer 68.8% Online via the health plan s website 6.7% Spoke with a representative of the health plan 4.0% Online through a public health insurance marketplace Through a health insurance counsellor, broker or agent 5.7% 3.0% Other 9.9% Don't know 9.9% Copyright 2014 The Myers Group 8

11 About The Myers Group The Myers Group is a full-service healthcare improvement organization providing healthcare surveys, call center services, and performance improvement tools and consultation. The company is an NCQA-certified survey provider for the CAHPS, CAHPS PCMH, and Medicare HOS survey, and a CMS-approved Medicare CAHPS and CAHPS for ACOs survey provider. The company is also a conditionally-approved QHP Enrollee Survey provider. The Myers Group delivers valuable member feedback and reliable analysis to support improvement initiatives through survey research, phone outreach, and member engagement programs for healthcare organizations throughout the nation. As a leader in healthcare solutions since 1993, The Myers Group is dedicated to serving the healthcare community with tools and resources for improving quality and patient care. Regulatory Surveys Complete management of survey requirements Certified Survey Vendor In-depth, actionable reporting & analysis Trusted experience for the best results Insight Surveys Comprehensive line of tested, reliable surveys Valuable, in-depth insight and feedback Customization and Flexibility Experts in survey design and execution TMG Connect - Call Center Services Advanced call center support services Enhanced member outreach/engagement Full-service onsite, US-based call center Expertise in managing regulatory requirements Performance Improvement Consulting Star/Scores Improvement Experienced guidance and action planning Recommendations for quality improvement Understanding survey results and implications The Myers Group 1965 Evergreen Blvd., Suite 100, Duluth, GA TheMyersGroup.net