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J.D. Power and Associates Reports: Satisfaction with Health Plans Varies Dramatically From Region To Region, Largely Due to Poor Communication From Insurance Providers
Date:4/30/2008

More Than 50 Percent of Members Say They Don't Fully Understand the Details

of Their Health Insurance Plan

WESTLAKE VILLAGE, Calif., April 30 /PRNewswire/ -- Health plan performance varies widely among some insurers across the U.S., yet contacting plan members regularly and increasing their understanding of plan details can lead to more consistent and positive satisfaction ratings, more renewal business and additional sales of services to members, according to the J.D. Power and Associates 2008 National Health Insurance Plan Study(SM) released today.

(Logo: http://www.newscom.com/cgi-bin/prnh/20050527/LAF028LOGO-a)

Now in its second year, the study measures member satisfaction among 107 health plans in 17 regions throughout the U.S. by examining seven key factors: coverage and benefits; choice of doctors, hospitals and pharmacies; information and communication; approval processes; claims processing; insurance statements; and customer service.

The study finds that the majority of health plan members rate their insurer lowest for the communications and information that are provided to help them understand their plan. Only 45 percent of members reported they fully understand how to use their health insurance coverage and member services. Enhancing member understanding with critical plan details -- such as prescription coverage, co-pays, how to locate physicians and how to appeal coverage denials -- can lead to higher satisfaction ratings for insurers.

"Health insurer performance fluctuates greatly -- even among different regional plans from the same insurance company -- and this lack of service consistency can present a real challenge for human resources executives attempting to select the best health benefits for their employees working in multiple regions across the country," said Jim Dougherty, executive director of the Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

Highmark Blue Cross Blue Shield 784 5

Highmark Blue Shield 773 4

Blue Cross of Northeastern Pennsylvania 771 4

Pennsylvania/Delaware Region Average 753 3

Capital Blue Cross 749 3

Independence Blue Cross 745 3

BlueCross BlueShield of Delaware 727 2

Aetna (Pennsylvania) 723 2

HealthAmerica of Pennsylvania, Inc. 711 2

South Atlantic Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

Kaiser Health Plan of Georgia 746 5

Aetna Health (Georgia) 743 4

BlueCross BlueShield of North Carolina 740 4

United Healthcare of Georgia 733 4

CIGNA HealthCare of North Carolina 726 4

BlueCross BlueShield of South Carolina 722 3

South Atlantic Region Average 722 3

BlueCross BlueShield of Georgia 720 3

Included in the South Atlantic Region are: Georgia, North Carolina and South Carolina.

Texas

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

Humana 753 5

CIGNA 747 4

BlueCross BlueShield 736 4

Texas Region Average 729 3

United Healthcare 728 3

Aetna 726 3

Virginia-Maryland Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

CareFirst BlueCross BlueShield 740 5

Kaiser Health Plan 739 5

Anthem Health Plans of Virginia 734 3

Virginia/Maryland Region Average 733 3

Aetna 730 3

United Healthcare of the Mid-Atlantic 711 2

Factors contributing to Overall Health Plan Satisfaction

Coverage and Benefits 26%

Choice of Doctors, Hospitals and Pharmacies 21%

Information and Communication 17%

Approval Processes 12%

Claims Processing 9%

Insurance Statements 8%

Customer Service 8%

NOTE: J.D. Power and Associates qualifies its sample for the 2008 National Health Insurance Plan Study through enrollment data from an independent source. Plans that do not report enrollment data by state are not included in the study. Plans whose commercial HMO, PPO and POS enrollment was less than 250,000 members were also not included in the sampling for the study.

About J.D. Power and Associates

Headquartered in Westlake Village, Calif., J.D. Power and Associates is a global marketing information services firm operating in key business sectors including market research, forecasting, performance improvement, training and customer satisfaction. The firm's quality and satisfaction measurements are based on responses from millions of consumers annually. For more information on car reviews and ratings, car insurance, health insurance, cell phone ratings, and more, please visit JDPower.com. J.D. Power and Associates is a business unit of The McGraw-Hill Companies.

About The McGraw-Hill Companies

Founded in 1888, The McGraw-Hill Companies (NYSE: MHP) is a leading global information services provider meeting worldwide needs in the financial services, education and business information markets through leading brands such as Standard & Poor's, McGraw-Hill Education, BusinessWeek and J.D. Power and Associates. The Corporation has more than 280 offices in 40 countries. Sales in 2007 were $6.8 billion. Additional information is available at http://www.mcgraw-hill.com.

Media Relations Contacts:

Jeff Perlman Syvetril Perryman

Brandware Public Relations J.D. Power and Associates

Agoura Hills, Calif. Westlake Village, Calif.

(818) 706-1915 (805) 418-8103

jperlman@brandwaregroup.com syvetril.perryman@jdpa.com

healthcare practice at J.D. Power and Associates. "With increasing healthcare costs and an aging workforce that needs additional services, businesses have less and less tolerance for insurers that aren't consistently engaging members and helping them manage their own health care and the associated costs. However, we find that those plan members who are most engaged by their insurer through effective communication better understand how to use their plans and have particularly high satisfaction levels. Those higher satisfaction scores translate into better retention rates and more positive recommendations for the plan."

Study results by region are:

Arizona-Utah Region

BlueCross BlueShield of Arizona ranks highest, receiving a satisfaction index score of 763 on a 1,000-point scale.

California Region

Kaiser Foundation Health Plan of California ranks highest with 755.

Colorado Region

Kaiser Foundation Health Plan of Colorado ranks highest with 748.

East South Central Region

BlueCross BlueShield of Alabama ranks highest with 759.

Florida Region

BlueCross BlueShield of Florida ranks highest for the second consecutive year with 751.

Heartland Region

Ranking highest in the Heartland region is Wellmark BlueCross BlueShield of Iowa with 742.

Illinois-Indiana Region

BlueCross BlueShield of Illinois ranks highest, earning a score of 729.

Michigan Region

Health Alliance Plan of Michigan ranks highest with 772.

Minnesota-Wisconsin Region

HealthPartners ranks highest with 768.

New England Region

Anthem BlueCross BlueShield of Connecticut ranks highest with 772.

New York-New Jersey Region

United Healthcare (New Jersey/New York) ranks highest with 749.

Northwest Region

Group Health Cooperative ranks highest with 778.

Ohio Region

Humana of Ohio ranks highest in customer satisfaction with 748.

Pennsylvania-Delaware Region

Highmark Blue Cross and Blue Shield ranks highest with 784, which marks the highest score across all regions included in the study.

South Atlantic Region

Kaiser Foundation Health Plan of Georgia ranks highest with 746.

Texas Region

Humana of Texas ranks highest with 753.

Virginia-Maryland Region

CareFirst BlueCross BlueShield ranks highest with 740.

The 2008 National Health Insurance Plan Study includes responses from 37,060 members of large commercial health plans. Members were surveyed online in November and December 2007. Criteria for inclusion were plans with approximately 250,000 members across all commercial products, excluding Medicare and Medicaid.

For more information on the performance of national health insurance plans, visit http://www.jdpower.com/healthcare/ratings/health-plan-ratings/.

Member Satisfaction Index Ranking

Arizona-Utah Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

BlueCross BlueShield of Arizona 763 5

SelectHealth 762 5

United Healthcare (Western States) 726 3

Arizona/Utah Region Average 723 3

Aetna (Arizona) 722 3

Regence BlueCross BlueShield of Utah 696 2

California

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

Kaiser Health Plan 755 5

California Region Average 719 3

CIGNA 710 3

Blue Shield 704 2

PacifiCare 701 2

Blue Cross 698 2

Aetna 696 2

Health Net 684 2

Colorado

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

Kaiser Health Plan 748 5

CIGNA 729 4

Colorado Region Average 711 3

United Healthcare 707 3

Anthem BlueCross BlueShield 680 2

East South Central Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

BlueCross BlueShield of Alabama 759 5

CIGNA of Tennessee, Inc. 749 4

Blue Cross Blue Shield of Tennessee 737 3

Anthem Blue Cross Blue Shield of Kentucky 736 3

East South Central Region Average 735 3

Humana of Kentucky 733 3

United Healthcare is included in the study, but not ranked due to small sample size.

Included in the East South Central Region are: Alabama, Kentucky, Mississippi and Tennessee.

Florida

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

BlueCross BlueShield 751 5

CIGNA 745 4

Florida Region Average 733 3

Aetna 719 2

Humana 712 2

United Healthcare 708 2

Heartland Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

Wellmark BlueCross BlueShield of Iowa 742 5

United Healthcare of the Midwest, Inc. 740 5

BlueCross BlueShield of Nebraska 740 5

BlueCross BlueShield of Kansas 733 3

Heartland Region Average 731 3

BlueCross BlueShield of Kansas City 729 3

BlueCross BlueShield of Missouri 718 2

Included in the Heartland Region are: Iowa, Kansas, Missouri and Nebraska.

Illinois-Indiana Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

BlueCross BlueShield of Illinois 729 5

Anthem BlueCross BlueShield of Indiana 727 5

CIGNA of Illinois, Inc. 719 3

Illinois/Indiana Region Average 719 3

Humana of Illinois 716 3

Aetna (Illinois) 716 3

United Healthcare of Illinois, Inc. 692 2

UniCare 676 2

Michigan

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

Health Alliance Plan 772 5

BlueCross BlueShield 754 3

Michigan Region Average 753 3

Priority Health 737 2

Aetna 712 2

Minnesota-Wisconsin Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

HealthPartners 768 5

BlueCross BlueShield of Minnesota 746 4

Minnesota/Wisconsin Region Average 729 3

Medica Health Plans 711 2

Humana of Wisconsin 711 2

United Healthcare of Wisconsin, Inc. 698 2

Anthem BlueCross BlueShield of Wisconsin 697 2

New England Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

Anthem BlueCross BlueShield of Connecticut 772 5

Harvard Pilgrim Health Care 771 5

BlueCross and BlueShield of Massachusetts 751 4

Tufts Associated Health Plans 743 4

BlueCross BlueShield of Rhode Island 743 4

New England Region Average 734 3

Anthem BlueCross BlueShield of Maine 725 3

United Healthcare of New England 707 2

Health Net 695 2

Included in the New England Region are: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont.

New York-New Jersey Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

United Healthcare 749 5

Empire BlueCross BlueShield 742 5

BlueCross BlueShield of Western New York and

Blue Shield of Northeast New York 742 5

Excellus BlueCross and BlueShield 735 4

HIP Health Plan of New York 732 3

New York/New Jersey Region Average 727 3

MVP Health Care 721 3

Horizon BlueCross BlueShield 710 2

Aetna 708 2

Group Health Incorporated 701 2

Oxford 682 2

Northwest Region

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

Group Health Cooperative 778 5

Premera Blue Cross 765 4

Regence BlueShield of Washington 738 3

Northwest Region Average 735 3

Regence BlueCross BlueShield of Oregon 733 3

Providence Health Plan 733 3

Kaiser Health Plan 732 3

Blue Cross of Idaho 695 2

Regence Blue Shield of Idaho is included in the study, but not ranked due to small sample size.
Included in the Northwest Region are: Idaho, Oregon and Washington.

Ohio

(Based on a 1,000-point scale)

J.D. Power.com

Power Circle

Provider Index Ratings

Score For Consumers

Humana 748 5

Medical Mutual 737 4

United Healthcare 736 3

Aetna 735 3

Ohio Region Average 735 3

Anthem BlueCross BlueShield 733 3

AultCare is included in the study, but not ranked due to small sample size.

Pennsylvania-Delaware
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SOURCE J.D. Power and Associates
Copyright©2008 PR Newswire.
All rights reserved

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