Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Private Payers News

Vermont Blue Cross Plan Reaches Highest Member Satisfaction

When payers improve price transparency, patient outreach, and communication channels, their member satisfaction levels increase.

Healthcare Price Transparency

Source: Thinkstock

By Vera Gruessner

- Blue Cross and Blue Shield of Vermont (BCBSVT) announced in a company press release this month that the payer has achieved the highest scores for member satisfaction and efficiency rankings for the fourth continuous year. This particular Blue Cross health plan has held its ongoing ranking in best member experience.

The health plan has reached high member satisfaction due to its “Member Touchpoint Measures (MTM).” These measures are used to track each patient visit and service administered to ensure best practices are followed and high quality care is provided. Additionally, members who have coverage under Blue Cross and Blue Shield of Vermont will be able to receive seamless coverage in states across the country due to the Blue Cross parent company.

“Member Touchpoint Measures” involve tracking four different types of member services: enrollment, timeliness in answering questions, accuracy, and claims processing. Additionally, first call resolution of member inquiries is another aspect of the “Member Touchpoint Measures” that is expected to improve overall patient satisfaction.

“The focus of our company is on creating positive member experiences, and our entire organization stands by that commitment,” said Don George, BCBSVT President & CEO. “We are very pleased to have received the distinction as the top performing Blue Plan four years running, and we continue to look for ways to improve the service we provide to Vermonters.”

Last year, this health plan achieved 100 percent in each category for member satisfaction. Health insurance companies looking to achieve higher scores in member satisfaction may need to improve their price transparency, according to a 2016 HealthEdge survey.

The survey found a lack of price transparency among health plans and recommends payers to look to industries like travel and banking to improve their communication channels. Low member satisfaction was found as well as less trust among consumers and wasteful spending.

The lack of price transparency led to a number of surprise medical bills. The survey shows that 40 percent of polled consumers received an unexpected bill after their health plan covered part of a healthcare service. Out of all consumers who received a surprise medical bill, 51 percent stated that the cost ranged from $100 to $500.

The survey also showed that the majority - 88 percent - of members seek greater price transparency from their health plans. Health insurance companies seeking greater member satisfaction in order to gain greater loyalty from their enrollees will need to improve price transparency across the board.

“The survey provided important information related to consumer perceptions; for example, 88 percent of respondents stated that their health plan could be doing a better job of communicating their total financial responsibility, something that should be a core capability for any health plan,” Steve Krupa, CEO of HealthEdge, said in a public statement.

“Due in large part to technology limitations, health plans are missing significant opportunities that could result in increased engagement, satisfaction and loyalty,” he continued. “We strongly believe health plans that embrace this opportunity will establish a competitive advantage.”

Some other steps to increase member satisfaction include generating stronger communication channels, patient outreach, and user-friendly patient billing practices. For better communication channels, payers could offer more customer service avenues such as phone, in-person, and online answering services.

Patient engagement and patient retention efforts depend upon outreach efforts such as incorporating patient portals and user-friendly billing systems. For example, greater patient outreach could include payers sending mailings to their members to remind them to receive health screenings, flu shots, childhood immunizations, and yearly check-ups.

Some payers have worked with employers and providers to create a mobile medical team, which bring physicians and medical supplies in a van to check in with patients at their place of work or another location. These steps are all expected to improve member satisfaction among health plans.

Member portals and user-friendly billing systems are also encouraged. Portals could create a more streamlined manner in answering questions about coverage. A Care Cloud survey found that 73 percent of polled consumers felt that access to electronic health records through patient portals would improve their overall satisfaction. Efficient and easy-to-use billing systems should also assist with patient retention and member satisfaction.

Health insurance companies dedicated to boosting member satisfaction should improve price transparency, communication channels, patient outreach, and their medical billing practices.


Sign up for our free newsletter:

Our privacy policy

no, thanks