Satisfaction with commercial health plans is on the decline, especially among younger generations, according to J.D. Power's 2023 Commercial Member Health Plan study.
J.D. Power surveyed 32,656 members of 147 commercial health plans in 22 regions. The results were published May 31.
Becker's caught up with eight leaders at plans rated best in their region by their members about their approach to customer service and care. Integrated care, empathetic customer service and convenient options like telehealth were some of the key aspects executives highlighted.
Here's what they had to say:
Blue Cross Blue Shield of Kansas City balances empathetic interactions with members and taking care of its employees, Gratia Carver, vice president and chief experience officer, said.
"This is a hard job," Ms. Carver said. "People aren't calling in to say 'Hey, love you guys.' They're taking care of issues. So we need to make sure we're taking care of our people as well."
To be customer-centric, organizations have to put their money where their mouths are, Ms. Carver said.
"Culture only changes with behavior, and the way you get behavior, oftentimes, is incenting for it," Ms. Carver said. "It has to be built into the DNA of your organization."
Blue Cross Blue Shield of Rhode Island reaches its members through five retail storefronts and a mobile "Big Blue Bus," Melissa Cummings, vice president and chief customer officer, said.
"I think it's such an important way that we put ourselves in the communities that we serve — real bricks and mortar, real commitment to the people that are here in the state. We do sales and service, navigation, there are nurse case managers, pharmacists. We have a whole host of daily programming that looks like fitness, education, prevention, cooking demonstrations. It's a social network of a different sort, and one that we're really proud of," Ms. Cummings said.
Capital District Physicians Health Plan wants to give members a customer service experience that will "knock their socks off," CEO John Bennett, MD, said.
"What I would tell any healthcare organization, provider or payer, is if you want to take care of your people, you must truly, authentically, deeply care for them," Dr. Bennett said.
The plan will co-locate its headquarters with Community Care Physicians in a new 263,000 square-foot medical facility in the Albany, N.Y. area.
"I guarantee I will be walking around the clinical part of the building more than I'll be walking around the insurance part. We want to give you a totally blown away experience. We'll have a pharmacy, full lab, imaging, radiation therapy, and adjacent to it will be an ambulatory surgical center. It's that seamless customer experience that I think is a huge value," Dr. Bennett said.
Health Alliance Plan's secret sauce is its Detroit-based workforce, Margaret Anderson, senior vice president and chief sales and marketing officer, said.
"We really do have a workforce that approaches the work with both their hearts and minds when it comes to how we can help employees navigate the healthcare system," Ms. Anderson said.
Another differentiator for Health Alliance Plan, Ms. Anderson said, is its HMO plan, which allows members to see specialists without referrals, and its data-driven customer service.
"We have specific strategies in place to learn from data, which shows us when members have abrasions — accessing the healthcare system, helping people get appointments, listening to their needs and offering up solutions that will help them immediately," Ms. Anderson said.
Highmark Blue Cross Blue Shield of Delaware is continuously engaged with stakeholders across the healthcare system, segment president Nicholas Moriello said.
"We've got dedicated service teams to help navigate a really complicated healthcare system, broad support to our folks providing the care and meeting clinicians where they are," Mr. Moriello said.
His advice to other organizations: Center members and clinicians.
"When you keep the clinician and person at the center of all that you do, look for those partnerships, and look for the relationships that can be built to collaborate and align and work together to achieve more," Mr. Moriello said.
Kaiser Foundation Health Plan of Colorado has spent the past year focused on three things: patient experience, keeping premium and care costs affordable and helping members find care both virtually and in-person, Jacqueline Lindeman, business development program director, said.
"We're really committed to delivering high-quality and affordable integrated care and coverage in a model that I'd say is difficult to replicate," Ms. Lindeman said. "I think what makes us unique is really taking that member-centric approach — keeping the member at the center of everything we do has really enabled us to be the most successful."
Mass General Brigham Health Plan's strength is its full integration with Somerville, Mass.-based Mass General Brigham, plan President Steven Tringale said.
"Our perspective on the member experience includes not just some typical components of a health plan — billing, enrollment credentialing, delivery system, access — but how that care actually gets provided, what the important components of that care are," Mr. Tringale said.
The plan is a healthcare company, not just an insurer, Mr. Tringale said.
"We need to focus on what is the long-term benefit for the member, not just what's the short-term benefit for the insurer," he said. "It's to communicate, communicate, communicate both from a high tech and high touch basis, not only with the members, but with our own workforce and employees, so that they understand why we're doing what we're doing."
Quartz Health Solutions has worked to move interactions with members from transactional to relational, Chief Growth Officer Christina Ott said.
"I think the health insurance industry has trained customers to be passive, or to expect a reactive experience," Ms. Ott said. "We've really been committed to show a different aspect of the way that we interact. When our members contact us, it's usually at a point when they're scared, or unsure, or confused about something dealing with their loved ones and their family. For us, we try to anticipate that and be proactive in showing them that we care."
Quartz, based in Wisconsin, uses data to anticipate members needs but also conducts focus groups to get qualitative feedback from members.
"I think sometimes for health insurance, we don't want to hear it. But as I've worked with our teams and worked with the various stakeholders to hear it, it foundationally gets you to deliver and meet their needs," Ms. Ott said.