Customer satisfaction with health plans is on the decline, and the gap between the highest and lowest performers is getting wider, according to a new report.
J.D. Power released its annual study looking at consumers' attitudes toward commercial health plans, which found that the average satisfaction score for this market is 563 on a 1,000-point scale. But there is notable variation in scores based on geography and plan, with a high of 594 and a low of 523.
The J.D. Power report said this means plan members in different parts of the country are having different experiences and finding varied value in their coverage.
Member experience is a critical differentiator for employers and plan sponsors, with 20% of employers saying they switched plans due to low satisfaction among employees. Plans that separate themselves from the pack have invested in engagement, education and service, according to the study.
In addition, digital platforms offer a key opportunity for plans to improve their customer satisfaction, according to the report. Programs for individuals with chronic conditions, remote monitoring and provider communication tools are all popular with consumers but generally underused by the populations that can benefit.
Doing more outreach and education around these tools could improve satisfaction, according to the report.
“Brand performance gaps in the commercial health insurance market are no longer subtle— they’re widening in ways that directly affect satisfaction, retention and competitive strength,” said Caitlin Moling, senior director of global healthcare intelligence at J.D. Power, in a press release.
“Leading plans are setting themselves apart by delivering clarity, digital convenience and member-first communication," Moling said. "Others are falling behind as trust erodes, digital tools go underutilized and members struggle to understand their coverage.”
Investing in education and outreach could also bear fruit as people who understand their out-of-pocket spending and their provider networks are generally more satisfied with their plans, according to the report. They're also less likely to experience a denied claim or access challenges, which can worsen their experiences.
By comparison, 48% of those who said they did not completely understand their out-of-network benefits had a claim denied, J.D. Power found. And 56% said their first choice doctor was not available in-network.
The study also found that average deductibles are highest for people working at small employers at $2,847. That's 8% higher than midsize employers and 10% higher than large employers, according to the report.