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Empowering Health Plans to Satisfy Members: Insights from the 2023 HealthEdge Consumer Survey

In the dynamic world of healthcare, consumer expectations are rapidly evolving. The rise of retail experiences has empowered healthcare consumers with higher expectations, prompting health plans to rethink their strategies to ensure member satisfaction.

In response, HealthEdge conducted an independent research study of more than 2,800 insured individuals in the United States to gain valuable insights into consumer preferences, perceptions, and expectations. The 2023 study reveals crucial findings that can help health plans adapt and thrive in today’s competitive landscape.

Snapshot of Key Findings

The study uncovered several significant findings that hold vital implications for health plans:

  1. Member Satisfaction: Only 45% of healthcare consumers report being fully satisfied with their health insurance provider. Interestingly, member satisfaction levels increase to 56% among those with assigned care managers. The answer to closing this satisfaction gap lies in delivering personalized member experiences – which is no easy feat.
  2. Social Determinants of Health (SDOH): While members who have a care manager report higher satisfaction levels, care managers still have significant opportunity to better leverage available SDOH data to deliver personalized, relevant services and address members’ individualized needs.
  3. Communication Preferences: An overwhelming 82% of consumers report higher satisfaction when payers communicate with them in their preferred ways. Adopting omni-channel communication strategies is crucial for enhancing access, convenience, and engagement.
  4. Improving Member Satisfaction: The survey identified two key actions for improving member satisfaction: enhancing customer service and increasing access to self-service tools. Equipping customer service representatives and care managers with data and tools for personalized care is essential, as is empowering members to take a more active role in their healthcare journeys.
  5. Trust in Health Plans: Despite increasing competition from non-traditional players, health plans remain the most trusted source among 70% of respondents for administering health insurance. However, generational differences affect trust levels, highlighting the importance of accommodating each generation’s needs.
  6. Transforming Perceptions: 40% of respondents blame health insurance companies for the high cost of healthcare. To change this perception, health plans must be perceived as partners in care rather than just payers of care.

Three Reasons Why Member Satisfaction Matters More Than Ever Before

  1. Choice: Historically, healthcare consumers had limited choices. Many simply accepted their employer provided benefits without question, as most employers covered 100% of medical expenses. Millions of Americans did not have health insurance. Medicare was the primary health plan for the majority of seniors. Most benefit plans left little financial burden on the consumer, and as a result, the average healthcare consumer didn’t think twice about the high cost of healthcare. Today, healthcare consumers have more choices than ever before. There are nearly 4,000 Medicare Advantage plans from which seniors can choose, with the average beneficiary having more than 39 different options in their coverage area.
  2. Competition: Market choice drives competition, and the competition among health plans has never been greater. Health plans that operate on outdated technology are unable to adapt to changing market conditions or deliver the innovative solutions today’s market requires. As more non-traditional players like Amazon, CVS, and Walmart enter the market and continue to raise the bar on consumer experience, health plans must match this new wave of tech-savvy competitors with modern care management and member engagement platforms.
  3. Criteria: New and expanding government regulations continue to put pressure on health plans to improve transparency and the member experience. In fact, the Centers for Medicare & Medicaid Services (CMS) doubled the weight of member satisfaction scores for the 2023 rating year. The increase means member satisfaction has a larger impact on performance metrics that affect health plan bottom lines.

Practical Guidance for Health Plans

To address growing consumer expectations and remain competitive, health plans should focus on innovation backed by modern technology. Implementing modern platforms, deploying digital member engagement tools, and empowering care management teams can significantly enhance member satisfaction and improve the overall healthcare experience.

The 2023 HealthEdge consumer satisfaction survey report highlights the urgency for health plans to prioritize member satisfaction in today’s competitive landscape. By leveraging modern technology and adopting innovative strategies, health plans can meet consumer expectations, remain competitive, and prepare for the generations of members to come. As healthcare continues to evolve, empowering the future of healthcare lies in delivering personalized, transparent, and convenient experiences to consumers. The time to act is now.

Visit the HealthEdge website to access the full research report or watch a recording of the recent AHIP webinar where HealthEdge clinical and business leaders discuss the survey findings.