Health Plan Customer Satisfaction Stabilizes in Midst of Massive Industry Shifts

Customer satisfaction among commercial health plan members is stable or improving across most areas of the country but overall satisfaction scores for health insurers are still one of the lowest-rated industries evaluated by J.D. Power. According to the J.D. Power 2018 Commercial Member Health Plan Study,SM the key challenge health plans must address is effectively communicating with members at every touch point, with a focus on better equipping members to navigate the healthcare system. New Jersey is among the top 6 regions in terms of satisfactiojn.

“Commercial health plans have been battling a perfect storm of rising costs, payment reforms and consolidation, which has distracted them from focusing on improving overall customer satisfaction in the sector compared with other industries,” said Valerie Monet, Senior Director of U.S. Insurance Operations at J.D. Power. “Amidst the consolidation activity this past year, the one area where top-performing health plans can really set themselves apart in the eyes of their members is to help them better understand how to navigate the healthcare system, including how their plan works and cost-effective access points for care. The key is effective communication.”

Following are some of the key findings of the 2018 study:

  • Satisfaction with health plans lower than most other industries: On an industry basis, commercial member health plan customer satisfaction scores average 712 on a 1,000-point scale, which is 100 points lower than the average score in the top-performing industry group, real estate.
  • Members still struggle to understand how their plan works: In an industry that continues to evolve, members are struggling to keep pace. Fewer than half (47%) of members completely understand how their plan works. A pain point for members is understanding when pre-approvals for medical procedures, services or treatments are needed.
  • Communication is key in setting expectations, driving member trust: Health plan member satisfaction scores are significantly higher when members view their health plan as a trusted partner. Increasingly, the key drivers of member trust are rooted in ongoing engagement with the plan. Noted drivers include using cost estimators or cost-tracking tools provided by the plan and submitting information to the health plan directly, either via an activity tracker or another method.
  • Health plan members want faster, better customer service: Member expectations of customer service are being affected by their experiences with other industries in that, regardless of healthcare’s complexity, members want faster access to care. With a greater number of retail clinics and urgent care locations across America, consumers have more options than ever before, yet satisfaction with choice of clinics and urgent care locations covered by the plan is down year over year. This suggests health plans have an untapped opportunity to better leverage these access points for care.

Study Rankings

Satisfaction is highest among health plan members in these six regions: Maryland (736); Michigan (724); East South Central (723); California (721); New Jersey (720); and Florida (720).

BlueCross BlueShield plans rank highest in 10 regions: East South Central (BlueCross BlueShield of Alabama); Michigan (BlueCross BlueShield of Michigan); New Jersey (Horizon BlueCross BlueShield); Massachusetts (BlueCross BlueShield of Massachusetts); Mountain (Regence BlueCross BlueShield of Utah); Ohio (Anthem BlueCross BlueShield of Ohio); Texas (BlueCross BlueShield of Texas); Heartland (BlueCross BlueShield of Kansas); Southwest (Anthem BlueCross BlueShield of Nevada); and Northeast (Anthem BlueCross BlueShield of Connecticut). Kaiser Foundation Health Plan ranks highest in six regions: Maryland, South Atlantic, California, Virginia, Northwest and Colorado. The following plans rank highest in at least one region: New York (Capital District Physicians Health Plan); Florida (AvMed); Pennsylvania (UPMC Health Plan); Illinois/Indiana (Health Alliance Medical Plans); Delaware/West Virginia/Washington, D.C. (Cigna); and Minnesota/Wisconsin (HealthPartners).

The Commercial Member Health Plan Study, now in its 12th year, measures satisfaction among members of 163 health plans in 22 regions throughout the United States by examining six key factors: coverage and benefits; provider choice; information and communication; claims processing; cost; and customer service. The study also touches on several other key aspects of the experience, including plan enrollment and member engagement. The study is based on responses from 33,342 commercial health plan members and was fielded in January-February 2018.

For more on the study, visit

J.D. Power is a global leader in consumer insights, advisory services and data and analytics. These capabilities enable J.D. Power to help its clients drive customer satisfaction, growth and profitability. Established in 1968, J.D. Power is headquartered in Costa Mesa, Calif., and has offices serving North/South America, Asia Pacific and Europe. J.D. Power is a portfolio company of XIO Group, a global alternative investments and private equity firm headquartered in London, and is led by its four founders: Athene Li, Joseph Pacini, Murphy Qiao and Carsten Geyer.

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