My latest Meredith Poll tells me something is broken in the N.C. healthcare system | Opinion [The Charlotte Observer]

Charlotte Observer (NC)

In an era where truth is increasingly subjective and facts are often manipulated, data provides clarity. It’s why I founded Meredith Poll nearly eight years ago — to more thoroughly and objectively examine the issues most important to N.C. voters and ultimately drive their decisions at the ballot box and beyond.

So when the North Carolina Center for Health and Democracy asked me to conduct a poll on consumer attitudes about health insurance, it was a no-brainer. I thought it was critical that as N.C. health experts and legislators continue the conversation about how to improve our state’s healthcare system, they should be fully informed about how people feel about a central component of that system: health insurance.

The objective of our poll was to gain a clearer understanding of North Carolinians’ perspectives and attitudes towards commercial health insurance companies broadly, as well as assess how consumer sentiment is impacted based on people’s actual interactions with their insurer.

When we dug into the data, our findings were dramatic.

While North Carolinians say they are generally satisfied with their insurance provider, less than 10% felt their health insurance company had their best interest in mind.

North Carolinians blame health insurance companies more than any other part of the healthcare system for the rising costs of healthcare. In fact, every demographic group surveyed had health insurance companies as the top reason for these rising costs.

This concern over rising costs is heightened by the fact that the two most important factors that influence consumers’ decision to purchase health insurance plans are monthly premium costs and out-of-pocket expenses. Rising premium costs produce very high levels of dissatisfaction for consumers with almost half reporting being very dissatisfied.

A significant number of North Carolinians reported a higher amount of dissatisfaction with their insurance companies after having a claim denied, a procedure not covered by insurance, or having to go through unnecessary paperwork to get treatment. Almost three-in-four of those who had a claim denied reported feeling dissatisfied or extremely dissatisfied with their insurance company.

Similarly, those who said they had a health procedure not covered by their insurance company or received a surprise bill also saw their dissatisfaction level increase.

Claim denial rates reported by North Carolinians in this poll also outpace national averages based on recent data from Kaiser Family Foundation. On average, KFF found that 18% of claims were denied across the country with 16% being denied because the claim was for an excluded service, 10% for lack of preauthorization, and only 2% percent for medical necessity.

My conclusion from the poll is that something is broken in the N.C. healthcare system at large and in the way insurers engage with customers. It needs to be fixed. I’ve seen friends and family members face serious health situations and get frustrated dealing with their health insurance provider. It is unnecessary stress.

While patients face these trends across the country, North Carolina is unique because of the limited choices for health insurance. For example, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) controls 97% of the individual Affordable Care Act health insurance market in the state. Maybe it isn’t a surprise that, according to the poll, those insured by Blue Cross NC reported an overall satisfaction level of just over 47%. The lack of health insurance options in the state means a lack of competition in prices, premiums and coverage.

State lawmakers should promote policies and practices that encourage competition and ensure that the insurance marketplace has choice and transparency. Insurers should offer legitimate plans that cover care without jeopardizing North Carolinians’ hard-earned dollars with denials, delayed care and complicated appeals.

As we enter a new legislative session, N.C. legislators should take these issues regarding health insurance seriously — not only for patients but for the long-term effectiveness of our entire healthcare system.