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Value-Based Care News

Health Plan Consumers Report Insufficient Payer Communications

Health plan consumers do not receive enough communications from payers about benefits, wellness, and price transparency of services.

Health plan consumers receive little communication from payers

Source: Thinkstock

By Thomas Beaton

- Health plans may not be effectively communicating with consumers about member  benefits and largely fail to understand their members’ health and financial needs, a survey from Healthmine found.

A sample of 750 consumers enrolled in either employer-sponsored (75 percent) or individually purchased insurance (25 percent) plans said that their payers fall short in key communication engagement areas.

The data revealed several key areas of concern, including:

  • Seventy-three percent of respondents don’t think their health plans understand their unique personal health very well, while 60 percent want more communication from health plan sponsors besides their monthly bill
  • Fifty-two percent of consumers with chronic conditions said they only hear from their health plan once per year or less about their disease
  • Sixty-three percent of health plan members say they do not engage with their plan on social media, but 78 percent who follow their health plan on social media say it’s helpful.
  • Twenty-one percent of consumers regularly use their health plan’s member portal, yet only 30 percent say the portal helps them answer healthcare questions
  • Eighty-three percent of health plan members say they use digital health tools, but only 22 percent say health plans are utilizing their data to provide member guidance for healthcare services
  • Thirty-nine percent of consumers say their health plan does not offer a price transparency tool to compare the price of services within their plan’s network

The findings show that health plans may not be sufficiently personalizing their approach to consumer relations, leaving many health plan members in the dark about important questions they have for payers.

“Our survey shows that most members believe health plan communications are impersonal and centered around bills rather than healthcare guidance,” the report said. Just 35 percent of respondents reported that their health plan communicates with them about their health or their clinical risks.

“Most members are either disconnected from, or rarely visit their health plans on social media and member portals,” the survey added. “Additionally, many members feel they are missing valuable guidance from their plans around digital health data and price transparency.”

Members also expressed an interest in year-round communication on subjects included chronic condition management (45 percent), fees and coverage after services (41 percent), recommended health screenings (51 percent), information collected from digital tools (33 percent), and information on how to lower their healthcare costs (54 percent.)

Consumers also expressed difficulty using existing online communication tools.  Online portals were too confusing to navigate for 24 percent of respondents, and lacked incentives for use for 21 percent. Other members simply did not know how to use the portals (20 percent), or found that the portals did not help their healthcare decision-making (18 percent).

Health plan members also reported a significant lack of price transparency health tools for doctor visits (38 percent), drug prescriptions (37 percent), and transparency tools for healthcare services such as imaging or lab procedures (36 percent).

Improving consumer communications should be a top priority for payers, the survey indicated, especially online. By enhancing outreach, expanding efforts at price transparency, and offering more opportunities for engagement, health plans may be able to secure member loyalty and satisfaction while improving overall outcomes.  

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