Survey Results Support More Health Plan Member Communications

May 1, 2008 ( - Only 45% of health plan members reported they fully understand how to use their coverage and member services, a new survey finds.

A news release from consumer polling agency J.D. Power and Associates about its latest health plan member survey said it found the majority of plan members rate their insurer lowest for the communications and information provided to help them understand their plan. According to the news announcement, enhancing member understanding about critical plan details-such as prescription coverage, co-pays, how to locate physicians, and how to appeal coverage denials-can lead to higher satisfaction ratings for insurers.

align=”left”>The study found that the issues affecting members’ overall plan satisfaction included:

  • Choice of Doctors, Hospitals, and Pharmacies (21%);
  • Information and Communication (17%);
  • Approval Processes (12%);
  • Claims Processing (9%);
  • Insurance Statements (8%); and
  • Customer Service (8%).

align=”left”>”Health insurer performance fluctuates greatly-even among different regional plans from the same insurance company-and this lack of service consistency can present a real challenge for human resources executives attempting to select the best health benefits for their employees working in multiple regions across the country,” said Jim Dougherty, executive director of the healthcare practice at J.D. Power and Associates, in the announcement. “With increasing health care costs and an aging workforce that needs additional services, businesses have less and less tolerance for insurers that aren’t consistently engaging members and helping them manage their own health care and the associated costs. However, we find that those plan members who are most engaged by their insurer through effective communication better understand how to use their plans and have particularly high satisfaction levels. Those higher satisfaction scores translate into better retention rates and more positive recommendations for the plan.”

The survey measured customer satisfaction with 107 health plans in 17 regions throughout the U.S. Details of the results are available here .