Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Private Payers News

Care Coordination is Tops for Health Insurance Satisfaction

The J.D. Power 2017 Member Health Plan Study shows care coordination is the number one factor that produces member satisfaction with health insurance plans.

Care Coordination tops survey of members

Source: Thinkstock

By Jesse Migneault

- Coordination of care among healthcare providers is the single most important criteria influencing member satisfaction with their health insurance plan, according to the J.D. Power 2017 Member Health Plan study.  

Members expressed clear preferences for what they wanted to see from their insurers, but payers are not keeping up with demands.

While health plan members prioritized care coordination, only 25 percent of survey respondents said their insurance companies met their standards - or even offered the service.

"Amidst sweeping changes in healthcare delivery and payment models, our data is showing that the one thing consumers value most is clear-cut, easy access to doctors and other healthcare providers," said Valerie Monet, senior director of US insurance operations at J.D. Power.

"This puts health insurers in a unique position because so much of their perceived value is reliant upon positive interactions with providers. These findings set the stage for the future of healthcare in which close coordination among health plans and providers that reduces friction points for members will be the key to success."

Integrated delivery systems (IDS) were also popular with beneficiaries.   When payers offered access to these networks of multiple providers and facilities, they ranked higher in member satisfaction than traditional healthcare insurance plans on every factor measured. 

Members also gave high ratings for insurers who offered a low-cost narrow network option, despite the fact that some members disliked their more limited options.

Health plans which offered narrow or tiered networks generally were able to offer lower costs to members.  

These lower cost networks consistently ranked highest in satisfaction for members against plans which did not offer the option.  Only 33 percent of those surveyed said their insurers offered a narrow network option.

The survey found that member satisfaction with payer-provider alliances was mixed.  Even though payers including Aetna, Cigna, and Anthem among others, have started offering commercial products in collaboration with specific providers in the past few years, there remained significant room for improvement with satisfaction in member-provider relationships.

The payer-provider alliances included in the study ranged from less integrated contractual agreements to highly integrated health systems.

The study found that overall health plan satisfaction rated highest in five regions: Maryland, East South Central, California, Michigan, and Ohio.

Satisfaction was found to be lowest among members in Colorado and the Northeast.  

For member satisfaction with individual payers, Kaiser Foundation Health Plan came out on top ranking highest in six regions: Maryland, South Atlantic, California, Virginia, Northwest and Colorado.  

The following health insurance plans ranked highest in at least one region: Highmark BlueCross BlueShield of Delaware; BlueCross BlueShield of Tennessee; AvMed; Wellmark BlueCross BlueShield of Iowa; Health Alliance Medical Plans; BlueCross BlueShield of Massachusetts; Health Alliance Plan of Michigan; Unity Health Plans; SelectHealth; Horizon BlueCross BlueShield; Capital District Physicians Health Plan; BlueCross BlueShield of Vermont; Medical Mutual of Ohio; UPMC Health Plan; BlueCross BlueShield of Arizona; and Humana.


Sign up for our free newsletter:

Our privacy policy

no, thanks

Continue to site...