Two Health Plans that Rank Highest for Customer Satisfaction

Monet

Even as millions of new enrollees have joined Medicare Advantage (MA) plans in the past year, these health plans have been able to maintain customer satisfaction levels year over year, according to a new study.

MA plan membership has grown 7.6% from the last year, and is expected to continue doing so in the near future, according to the Kaiser Family Foundation. The J.D. Power 2018 Medicare Advantage Study found overall customer satisfaction with MA plans is 794 (on a 1,000-point scale), down a nominal five points from 2017, even as enrollment levels in these plans have increased in 48 of the 50 states.

The study is an annual study of member satisfaction that provides competitive benchmarks for the largest Medicare Advantage plans nationally based on total member enrollment. The study is conducted online and asks respondents to reflect on their experiences across the previous 12 months with the health plan. This year 3,442 evaluations were collected assessing member satisfaction with experiences related to: Coverage and Benefits, Information and Communications, Claims Processing, Customer Service, Provider Network, and Cost.

“The fact that MA plans have been able to maintain satisfaction levels given the extensive growth should be considered a success,” says Valerie Monet, senior director of the Insurance Practice at J.D. Power. “That being said, Medicare Advantage is probably the most competitive health plan product on the market-meaning: members have a choice, not just between an MA product and traditional Medicare, but among numerous MA health plan products. If health plans are looking to continue gaining share and keep existing members, there is significant opportunity to improve the overall experience.”

As more potential members reach an age where they are eligible for Medicare, there will naturally be growth in the MA market, according to Monet.

“Health plans looking to be successful in this market must also be concerned with churn-the number of members that switch to a different product each year. Growth potential and profitability can be negatively impacted when health plan’s fail to maintain enrollment for more than a single year. Aside from providing a product that members perceive as meeting their needs, a key element of maintaining enrollment is providing a highly satisfying member experience.”

MA plan customer service rankings

Kaiser Permanente is the highest ranked plan nationally. Kaiser also receives the highest score for being customer-driven. Specific Key Performance Indicators (actions that drive higher satisfaction) conducted by the plan include:

Kaiser excels at helping members keep out-of-pocket expenses as low as possible, with 63% indicating Kaiser has done so.

• 62% of Kaiser members said the health plan helps coordinate care among doctors and other healthcare providers; a higher percentage than any other plan in the study.

Highmark is ranked second in terms of member satisfaction. Members perceive the plan to have a good reputation overall. Highmark excels at Customer Service and member interactions with the provider network. Specific Key Performance Indicators (actions that drive higher satisfaction) conducted by the plan include:

• 100% of members feel their doctors treat them as a partner in their medical care
• 99% of members said Highmark covered a referred specialist or provider
• 91% of members said all doctors that members wanted to see were included in health plan's network
• 98% of members said their most recent question or problem was resolved

One of the primary drivers of MA satisfaction is when health plans actively help members manage their healthcare spending, according to Monet. Still, just 54% of members say their plan actively works to keep out-of-pocket costs low.

“Compared with last year, members engage less often in cost-management activities that build trust with the plan and drive higher satisfaction levels, an opportunity for health plans looking to build stronger relationships with their Medicare Advantage members,” she says.

Care coordination services have become a key driver of trust, loyalty, and advocacy and have become increasingly common among higher-risk populations, according to the study.

Specifically, among dual-eligible members who receive care coordination services, 61% say they “strongly agree” that their health plan is a trusted partner; 72% say they “definitely will” recommend their health plan; and 77% say they “definitely will” renew with their health plan.

Member satisfaction with the information and communication from their MA plan has declined significantly (-16 points) from last year, and is now the lowest-scoring factor in the overall health plan experience.

“Aside from opportunities with member onboarding, fewer members recall receiving even one communication from their health plan in the past year,” Monet says. “The combination of ineffective enrollment materials, incorrect provider directories and lack of communication throughout the year can negatively influence members’ understanding of what a plan will cover, what resources are available, resulting in the member incurring charges associated with uncovered services/treatments and visiting out-of-network providers."