Medicare Advantage Members Report High Plan Satisfaction

October 28, 2015 - Medicare Advantage members confirm greater levels of plan satisfaction than those enrolled in commercial programs, says a 2015 Medicare Advantage Member Satisfaction Study released by J.D. Power.

A well-informed patient who clearly understands the general meaning behind a deductible, is more than willing to renew a policy, speaks highly of plan information to friends and family, and who experiences a well-scrubbed claims process is indeed satisfied, confirms J.D. Power.

A total of 6 factors were measured in terms of overall member satisfaction level based on the responses of over 2,700 Medicare Advantage members – also known as Medicare Part C members: coverage and benefits, provider choice, customer service, information and communication, cost, and claims processing.

Reported levels of “overall satisfaction” among Medicare Advantage members hit 774 on a 1,000 point scale, says J.D. Power within a press release. Such is “significantly higher” in comparison with noted satisfaction levels among commercial health plan members.

“Coverage and benefits is the most influential factor in driving overall member satisfaction with their Medicare Advantage health plan,” J.D. Power states. “Contributing to the high satisfaction with Medicare Advantage is that 46 percent of members strongly agree their health plan is a trusted partner in their health and wellness, which increases overall satisfaction by 177 points.”

Sixty-four percent of members confirm they have enough coverage in relation to the care levels they need, resulting in an over 100-point increase in overall satisfaction levels, says J.D. Powers.

Members confirm their money is being well-spent

“Medicare Advantage health plan members tend to have a more favorable image of their health plan than do members of commercial plans on brand measures of trustworthiness, affordability, reputation and customer-centricity,” says Rick Johnson, Director of the Healthcare Practice at J.D. Power.

“Members pay more to move from Medicare to Medicare Advantage, and the plans and the government do an excellent job demonstrating the value of the Medicare Advantage plan. Members feel the money spent is worth it,” Johnson adds.

“People generally like to have a primary care doctor that they know and trust, and Medicare Advantage plans provide that for the vast majority of members,” explains Johnson. “Having to switch providers because they are dropped from a plan adds a level of stress and a feeling of having to start over,” he adds.

“Continuity in plan networks is a strength of Medicare Advantage plans, with 73 percent of members indicating their doctors and 74 percent indicating their hospitals were not dropped from their plan’s network during the past year,” J.D. Power maintains.

“That creates loyalty and trust, as the average doctor-member relationship is 8.6 years and 92 percent of members agree their doctor is a partner in their medical care.”

4 of the study's key findings on maintaining high satisfaction levels

• Among Medicare Advantage health plan members, the average wait time for an appointment with their primary care physician is 7.7 days, while wait times for a specialist appointment average 14.7 days, both comparable with wait times experienced by commercial health plan members. 
• Satisfaction improves customer loyalty and advocacy. Among customers who are delighted (overall satisfaction 901 or higher) with their Medicare Advantage health plan, 89 percent say they “definitely will” renew their policy, and 88 percent say they “definitely will” recommend their plan to family and friends. Loyalty drops to 72 percent and advocacy to 64 percent among member who are pleased (satisfaction 751-900).
• Medicare Advantage members are more likely to completely understand how their plan works — including annual deductibles, out-of-pocket expenses and which doctors are covered — than members of commercial plans.
• Two-thirds (66%) of members indicate that their doctor submitted a claim on their behalf in 2014, while only 3 percent of members submit a claim themselves. Only 10 percent of doctor-submitted claims are denied, compared with 23 percent for member-submitted claims. When a member has a claim denied, overall satisfaction drops to 661 from 789.

Kaiser Permanente is J.D. Power’s power plan

Kaiser Permanente — involved in a “human error” data breech several years ago involving erroneously sent email attachments — was the study’s highest ranked plan with a reported score of 842.

As HealthITAnalytics.com reported, 29 Kaiser Permanente, with over 600,000 patient members in the Mid-Atlantic region and 9 million patient divisions nationwide, received the highest level of NCQA patient-centered medical home (PCMH) recognition earlier this year.

J.D. Power lists the “industry average” as 774. Other leading organizations listed with their accompanying score include:

• Highmark (773): claimed $1.4 million in unallowable post-retirement benefits last year
• UnitedHealthcare (752): recently distributed nearly $3 million in bonus payments to hundreds of physicians
• Cigna (751): rejected Anthem’s (732) “woefully skewed” nearly $54 billion proposal last June
• BlueCross BlueShield of Michigan (748): announced $200,000 in Medicaid Beneficiary care access grants last February
• Aetna (746): acquired Humana (759) for $37 billion earlier this year to help moderate healthcare costs