Kaiser Foundation Health Plan is the highest ranked Medicare Advantage plan based on overall satisfaction and Centene is the lowest out of 10 plans, a study released today found. The report is from J.D. Power, a consumer research, data and analytics firm.
The annual study, now in its eighth year, measures member satisfaction on six factors: coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. The report is based on responses from 3,094 members of MA plans between May and July.
Behavioral Health, Interoperability and eConsent: Meeting the Demands of CMS Final Rule Compliance
In a webinar on April 16 at 1pm ET, Aneesh Chopra will moderate a discussion with executives from DocuSign, Velatura, and behavioral health providers on eConsent, health information exchange and compliance with the CMS Final Rule on interoperability.
The industry average of customer satisfaction reached 809 on a 1,000-point scale in 2022, up three points from 2021 and up 15 points over the last five years. Kaiser is at 844 points. Humana is ranked second with 824 points and Highmark is ranked third with 811. Centene, in last, has 773 points.
These rankings are relatively similar to last year’s report: Kaiser was in first with 846 points and Highmark was in second with 834 points. Humana was tied for third with Cigna at 822 points. Centene was still in last with 769 points.
While overall customer satisfaction with MA plans have increased in the last year, there are still some areas where plans are falling short, including mental health and substance abuse disorder services, J.D. Power said. Only 38% of Medicare Advantage members said they have enough mental health coverage. For substance use disorder services, only 27% said they have enough coverage.
That’s concerning given that about 1.7 million Medicare beneficiaries have a diagnosed substance use disorder and one in four have a mental health condition, according to the National Library of Medicine and The Commonwealth Fund.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“For some health plans, coverage can be improved,” said Christopher Lis, managing director of global healthcare intelligence at J.D. Power, in a news release. “For others, increasing customer understanding of mental health benefits may be the bigger opportunity as beneficiaries might be aware that some coverage is available but may not fully understand which services and medications are covered. But coverage does not always guarantee access, as finding providers who accept Medicare may be a challenge in some areas.”
Lis offered a four-tiered approach to improving these services. First, health plans can increase member engagement so patients are aware of all the support services available. Second, plans can work to expand the number of mental health professionals that are in-network. Third, patients with severe illness need to be prioritized for timely in-person treatment with the right specialists. Lastly, plans need to implement better ways to care for patients with milder conditions, such as through telehealth or app-based services.
“With this kind of tiered approach, we can focus the right resources on the right patients, thereby limiting the burden on mental health professionals and minimizing extensive wait times for patients with urgent mental health needs,” he said.
Other findings in the study include:
- Satisfaction in substance use and mental health coverage is a stark contrast from members who said they have enough coverage for routine diagnostics, at 91%, and those who have enough for preventive and wellness services, at 89%.
- Although consumers have had positive experiences with telemedicine, usage declined among MA members. Only 24% of them used telemedicine in the last year, compared to 35% in 2021. However, of those who used it, 48% said they would use it again, up 5 percentage points from last year.
- Portals are gaining popularity, with 82% of MA members registered for their health plan’s member portal, up four percentage points from last year. However, 14% of this group have registered but never logged in.
Photo: zimmytws, Getty Images
