Anticipating the impact of healthcare reform, nearly four in 10 health plan members with employee-sponsored insurance say they would shop for coverage through a health insurance exchange if they had the opportunity, according to the J.D.Power and Associates 2012 U.S. Member Health Plan Study.
According to the Company, now in its sixth year, the study measures member satisfaction among 141 health plans in 17 regions throughout the United States by examining seven key factors: coverage and benefits; provider choice; information and communication; claims processing; statements; customer service; and approval processes.
A majority of health plan members who purchase insurance on their own indicate they would likely use one of the state health insurance exchanges (55 percent), which are conceived, in part, to address their needs. However, a sizable percentage of health plan members who are covered under an employer-sponsored program--39 percent-- also indicate they would shop for insurance through an exchange if it were available.
In addition, the 2012 study finds increased levels of interest in state-sponsored health insurance exchanges, compared with the previous year. In 2012, only 37 percent of health plan members say they would not be likely to use an exchange, compared with 50 percent in 2011 who expected to continue obtaining coverage at work.
"Health insurance exchanges are meant to appeal to individuals who must buy coverage on their own, yet the level of interest among those who obtain health insurance at work could have important implications for the future of employer-sponsored coverage," said Rick Millard, senior director of the healthcare practice at J.D. Power and Associates. "Satisfaction among some health plan members may be low enough that an alternative, direct retail model could become more attractive than traditional wholesale purchasing by employers."
The study also finds substantial interest among health plan members in private health insurance exchanges, in which an employer might provide employees with vouchers for purchasing health insurance independently. Approximately 41 percent of employer- insured health plan members indicate they would use this approach if it were available.
"The private exchange model could further erode reliance on obtaining health insurance at work," said Millard. "Creating new channels for purchasing insurance could trigger more changes. It could mean more attention will be paid to direct purchasers, and also make higher levels of satisfaction critically important for health plans that strive to acquire and retain members."
"Health plans that excel in member satisfaction know how to create simpler benefit designs that members perceive to be consistent and dependable," said Millard. "As health insurance exchanges take hold and consumer shopping for coverage increases, it will become even more critical for plans to communicate in clear and concise ways."
Health plan members in Michigan, the Illinois/Indiana region and Ohio are the most satisfied with their health plan experience, while members in the Mountain region and Colorado are the least satisfied.
Health plans ranking highest in their respective regions are (in alphabetical order): Anthem Blue Cross and Blue Shield of Connecticut; AvMed Health Plans; Blue Cross Blue Shield of Alabama; Blue Cross Blue Shield of Illinois; Blue Cross Blue Shield of Kansas City; Blue Cross Blue Shield of Texas; Dean Health Plan; Geisinger Health Plan; Health Alliance Plan (HAP); Independent Health Association; Kaiser Foundation Health Plan (which ranks highest California, Colorado, the Northwest region, the South Atlantic region and the Virginia-Maryland-Washington D.C., region); Medical Mutual of Ohio; and SelectHealth.
Headquartered in Westlake Village, Calif., J.D. Power and Associates is a global marketing information services company providing forecasting, performance improvement, social media and customer satisfaction insights and solutions. J.D. Power and Associates is a business unit of The McGraw-Hill Companies.
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