Infographic: Health Plan Member Satisfaction - The Current State

The state of health plan member satisfaction reveals significant room for improvement based on feedback from over 2,800 healthcare consumers. Key findings indicate that 4 out of 5 consumers believe adherence to their communication preferences would enhance their overall satisfaction with their health plans. Notably, 55% of respondents are less than fully satisfied with how care managers use Social Determinants of Health (SDOH) data to deliver personalized services.

Key Insights:

• Communication Preferences: 88% agree that if care managers use members' preferred communication channels, satisfaction would increase. Similarly, 82% believe the same applies to health plans.
• Generational Differences:
  • Younger generations (18-34) are 2-3 times more likely to trust retailers and 3-4 times more likely to blame doctors for high healthcare costs compared to older generations.
  • Middle-aged consumers (45-54) primarily blame health insurance companies, while older generations (55+) are 2 times more likely to blame pharmaceutical companies.
• Trust and Perception:
  • 70% of consumers trust their health plans to administer their insurance.
  • 40% attribute the high cost of healthcare to insurance companies.

Benefits of Improved Member Satisfaction:

• Personalization:
  • Care managers should adhere to communication preferences, assist with medication management, and support referrals to social services.
  • Health plans need to provide incentives for healthy behaviors, easy access to health records, and tools for finding cost-effective care.
• Competitive Advantage:
  • Omni-channel engagement and modernized member experiences are essential as tech-savvy market entrants like CVS, Walmart, and Amazon raise consumer expectations.
• Regulatory Impact:
  • Regulatory bodies now emphasize member satisfaction in performance measures, with CMS doubling its weight in Star Ratings.

Recommendations for Health Plans:

1. Remain Agile and Adaptable: Navigate the evolving regulatory landscape with flexibility and precision.
2. Automate Processes: Streamline operations wherever possible to enhance efficiency.
3. Lead with Modernization: Innovate and stay ahead of the competition by continually updating practices.
4. Support Value-Based Care: Focus on outcomes and patient-centered care.
5. Scale Personalization: Tailor member engagement efforts to meet individual needs effectively.

By focusing on these areas, health plans can significantly improve member satisfaction, ultimately leading to better health outcomes and a stronger competitive position in the market. For a deeper understanding and actionable insights, explore the full report on the current state of health plan member satisfaction.