Satisfaction with commercial health plans is on the decline, with members expressing more frustration with customer service and communication from their insurers, according to J.D. Power's 2023 Commercial Member Health Plan study.
Becker's sat down with eight leaders at plans top-rated by their members to ask what members want from their plans, and how their expectations are evolving.
Technology is making customer service easier — but healthcare is getting more complicated, leaders said. Members want help navigating the system, and quick and easy resolution to their problems.
Here's what eight executives had to say about what members want most now:
Margaret Anderson, senior vice president and chief sales and marketing officer at Health Alliance Plan, said 10 to 15 years ago, consumers accepted the healthcare system to be slow and difficult to navigate. Now, members value fast service and quick resolution to issues, Ms. Anderson said.
"Over the last 10 years, we've seen a significant shift, where people are paying a lot of money for their healthcare, both in terms of premium costs through their paychecks, and once they go to access care, many people have a high cost share they have to pay out of pocket," Ms. Anderson said. "If I'm paying that money, where's the value that's coming back? What we're seeing is there is a dollar value and value to members in having customer service and being satisfied with their plans."
John Bennett, MD, CEO of Capital District Physicians Health Plan, said members want to feel like their health plan has their back.
"I have had members tell me that 'I got really ill, and I needed this help, and I always felt like CDPHP had my back.' They also want a hassle-free experience. They need clarity about what their benefits are. They need clarity about what the cost of things are," Dr. Bennett said.
Gratia Carver, vice president and chief experience officer at BCBS Kansas City, said she keeps in mind that members are comparing their experiences with insurance to fast, easy processes like shopping on Amazon.
"What are we doing to make sure that we create a better, easier, seamless experience — which aligns to our corporate mission and strategy? It helps us focus on what we need to be doing internally to help our members, especially navigating the complex healthcare system in the U.S. I think that speaks to the change in [expectations in] the last decade or so, because things in other sectors of consumers' lives are getting easier."
Jacqueline Lindeman, business development program director at Kaiser Foundation Health Plan of Colorado, said members' desire for convenient care options has grown over the past 10 years.
"Our organizations really try to evolve to meet their needs and expectations by offering that wide variety of care offerings, whether they want to see us in-person or virtually. We've been really focused on meeting them for convenient, accessible care," Ms. Lindeman said.
Nicholas Moriello, segment president of Highmark BCBS Delaware, said the healthcare system is "complicated and fragmented, to say the least."
Highmark's Living Health program is trying to tackle some of the industry's most fundamental problems, Mr. Moriello said, to improve outcomes and experiences for members.
"Working hand in hand with physicians and clinicians and caregivers who are under more stress than ever — all the various expense challenges, workforce shortages. All of that is resulting in an upward spiral of healthcare costs that we're looking to impact positively," Mr. Moriello said.
Christina Ott, chief growth officer at Quartz Health Plan, said consumers are looking for ease of use.
"As leaders, we can work to find the ways we can make both the journey easier for the individual to get access to the information they need, easier to find out who they should talk to, and not get caught in a pain point or friction point out of the experience," Ms. Ott said.
"We know healthcare is complex, so as a provider-sponsored plan, having that alignment and viewpoint from both the member as the insurance card holder and the member who is the patient helps us solve problems that are hard to solve," she added.
Steven Tringale, president of Mass General Brigham Health Plan, said members want administrative simplification — something every health plan can be doing better.
Members also want innovative benefit design, Mr. Tringale said.
"We think those are the kinds of things members are looking for, rather than just traditional payment and coverage for fee-for-service healthcare, which is disjointed and doesn't support continuity of care. We want our care to focus on what makes the most sense for the member, and to package it in a way that is going to improve both the experience and the clinical outcome."
Martha Wofford, CEO of BCBS Rhode Island, said members need help navigating the healthcare system.
"It's so much to navigate, and I think our healthcare system has gotten increasingly fragmented," she said.
Health plans can be expensive, so members need to see value for their money, something BCBS Rhode Island works to do, Ms. Wofford said.
"I think we have to make sure that they understand the benefits that they bought and they're taking full advantage of them, and that they're getting value for their dollar. And we have to keep working night and day on the affordability issues to keep medical costs in check, because it just keeps going up," she said.