Public Payers News

Public Payers See Higher Member Satisfaction on Network Size, Cost

Overall, 79 percent of respondents gave their Medicaid plans a high rating, compared to 70 percent of those in employer-sponsored health plans.

Medicaid, Medicare, Medicare Advantage, Member Satisfaction

Source: Getty Images

By Kelsey Waddill

- Medicare Advantage, fee-for-service Medicare, and Medicaid received higher member satisfaction scores than individual health insurance market plans and employer-sponsored health plans, according to a survey from Insure.com.

Insure.com asked 1,000 individuals about their health insurance coverage and member satisfaction. The respondents included Medicare and Medicaid beneficiaries and individuals in employer-sponsored health plans.

Survey participants assigned star ratings to their health plans based on their satisfaction with certain plan components and the health plans overall.

Nearly three-quarters of all respondents gave their health plans a total score of four or five stars out of five stars—35 percent assigned their health plan five stars, while 39 percent assigned their health plans four stars.

Employer-sponsored health plans received the lowest member satisfaction ratings. It was the first time in three years that the survey had documented employer-sponsored health plan satisfaction falling below individual health insurance marketplace and Affordable Care Act marketplace health plan satisfaction.

Medicaid received the highest number of high scores. Nearly eight in ten Medicaid beneficiaries gave the insurer a high rating.

The results were similar for fee-for-service Medicare and for Medicare Advantage. In both cases, 78 percent of respondents reported high member satisfaction.

Nearly three-quarters of the individual health insurance market place plan enrollees and Affordable Care Act marketplace enrollees reported high levels of health plan satisfaction.

At the bottom of the rankings, employer-sponsored health plans received high overall member satisfaction scores from seven out of ten respondents who were enrolled in employer-sponsored health plans.

The survey asked for participants’ feedback on five facets of health plan satisfaction: provider networks, breadth of services, claims payment, communication, and costs and deductibles.

Overall, participants expressed the most satisfaction with their provider networks. Nearly eight in ten participants (78 percent) scored their health plans’ provider networks highly. 

More than seven out of ten participants in employer-sponsored health plans (77 percent) were satisfied with their provider and hospital networks, giving them a four or five star rating. Meanwhile, in fee-for-service Medicare and Medicare Advantage, participants highly rated their provider network satisfaction at 88 percent and 82 percent respectively.

Survey respondents shared the least amount of satisfaction with their costs and deductibles. Individuals in Medicaid had the highest levels of satisfaction in cost-sharing. Nearly eight in ten rated their member satisfaction at four or five stars.

Participants in fee-for-service Medicare and Medicare Advantage also expressed satisfaction in this area, with 68 percent of participants in fee-for-service Medicare and 68 percent of those in Medicare Advantage plans saying that they would give their plans four or five stars on costs and deductibles.

Individuals in Affordable Care Act marketplace plans had the lowest member satisfaction scores, with barely over half of them saying that they would give their health plans  four or five stars on cost-sharing (51 percent).

“Why do people seem to like public plans more than private plans in the survey? One likely reason is that Medicare and Medicaid usually have lower costs than private plans, especially when compared to unsubsidized individual health insurance plans. Also, public plans may have better benefits than employer-sponsored and individual plans,” the survey explained.

Employers have been calling out the healthcare spending trajectory as unsustainable. However, 84 percent of employer respondents in a separate survey indicated that employers have control over healthcare spending.

In order to bring down costs, employers have leveraged health benefit strategies such as advanced primary care, episode-based benefits, integrated health benefits, and association health plans.

Although Medicaid’s costs were viewed more positively than employer-sponsored health plans’ costs, Medicaid programs are looking for ways to bring down spending. The Centers for Medicare & Medicaid Services Innovation Center (CMMI) has made a goal to improve affordability and lower out-of-pocket healthcare spending by 2030.