Employers’ Views of Health Insurers

PriceWaterhouseCoopers has an internal Health Research Institute which puts out some useful surveys and studies.  A recent one described the results of a recent survey of large and small employers on their perceptions of their health insurers.  (PWC Study) About 100 large companies, with an average of 11,000 employees, and 130 small companies with a workforce of less than 200 persons were surveyed.  They were asked questions regarding several aspects of their health plans, from financial cost to administrative capabilities to clinical facets such as wellness and care management.  Overall, satisfaction has declined from the previous survey.

Generally, both small and large employers are most satisfied with claims payment accuracy and timeliness, the level of administrative fees and capabilities for online payments and eligibility.  Small employers are less satisfied than large ones with the level of provider discounts, which is to be expected since large employers tend to be self-funded, using the insurer for largely administrative and care management capabilities, and get the more complete benefit of provider discounts than do the largely fully-insured small employers.  Among both large and small employers, the least satisfaction is with health risk profiling efforts, personal health records and online comparison tools.

PWC also asked the employers what areas were most important to them and dissatisfaction tended to be higher in the areas that were most important.  This suggests there is a gap between employers’ expectations and health insurers’ performance in these areas.  The survey is a useful tool for health plans which haven’t already heard from their customers that they need to do better on certain facets of their offerings.  While employers may be frustrated with aspects of the insurers’ services, they need to understand that often regulations and provider contracts inhibit a plan’s ability to deliver services in a manner they believe would most benefit the employer.  An example is certain HIPAA and disability law restrictions on wellness programs.  Employers and health plans should work together to address these issues.