Member satisfaction has always been a strong barometer for health plan success. When looking at commercial payers, the most recent J.D. Power U.S. Commercial Member Health Plan Study found that convenience/accessibility, price, and trustworthiness were the biggest differentiators between low and high-rated health plans.
To obtain a comprehensive picture, J.D. Power reported surveying 35,000 members from 147 health plans located in 22 regions across the United States.
Where are the Gaps?
While overall member satisfaction rose three points compared to the 2023 survey, there continue to be massive gaps in performance between some plans. In the three aforementioned areas, there was a significant difference of 84 to 87 points between the highest and lowest-rated plans.
Areas for Improvement
However, there are some areas where all health plans could stand to make improvements. One is payer use of digital tools such as insurer portals, which allow patients to access their accounts online. When rating the frequency of payers utilizing these digital tools, commercial health plans scored over 100 points less than Medicare Advantage plans and 165 points less when compared to other industries (including the mortgage and loan sector).
In addition, phone contact with consumers is another weak spot for the majority of health plans. Nearly three-quarters of these calls pertained to simple coverage-related questions, and around 33% of members needed to make more than one call to get the answers they needed.
Moving Forward
While health plans would benefit from investing more time and energy into improving digital resources for their members, they must also remain aware of individual member needs. Many older members continue to prefer and respond best to printed materials, while individuals with low computer and health literacy will need simplified materials that they can easily access.
There are other ways health plans can enhance their member satisfaction in the coming months:
- Beef up member education materials (both print and digital) to reduce phone calls related to basic coverage questions.
- Streamline customer service processes to lessen members’ need to make multiple calls before achieving a resolution.
- Increase follow-up with members after they make calls to learn about their experience and ensure they receive the information they need.