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Medicare Advantage Member Satisfaction

By November 4, 2015Commentary

An important component in CMS’ rating of Medicare Advantage plans is patient satisfaction and it is obviously important to the plans for marketing and growth purposes.  In general Medicare Advantage plans appear to deliver better quality care than does the fee-for-service program; is that reflected in beneficiaries satisfaction ratings?  A J.D. Powers survey examined the satisfaction perceptions of 2731 Medicare Advantage members across the country.   (J.D. Powers Survey)  Six factors were assessed:  coverage and benefits, which 24% said was the most important factor in their rating; provider choice, 18% ranking it most important; customer service, 16%; information and communication, 16%; cost, 15%; and claims processing, 11%.  Overall satisfaction was scored on a 1000 point scale.

Average satisfaction was 774, which is higher than that expressed by commercial plan members, at 679.   One good sign for the plans is that nearly half the respondents agreed that their health plan was a trusted partner in meeting their health needs.  64% said that they had adequate coverage for their health needs through the MA plan.  Network composition is also a major concern, with the average member having an 8.6 year relationship with their physician and 92% saying their doctor is an important partner in their medical care.  Surprisingly, however, only 73% said their doctor was not dropped from their plan in the last year and 74% said their primary hospital wasn’t.  That is a significant minority who did experience a loss of provider access.  With the focus on narrower and/or “high-performance” networks as a cost-control technique, more disruption may lie ahead.

Wait times averaged 7.7 days for a primary care physician visit and 14.7% for a specialist visit.  As expected, members with the highest satisfaction are more likely to stay with their plan in the coming year and to recommend it to others.  While only a small number of claims tend to be denied, when they are satisfaction drops substantially.  Kaiser plans had the highest satisfaction rating, at 842.  That pulled the industry average up a lot, to 774, with the next highest plan being Highmark at 773, then Humana at 773 and United Healthcare at 752.  Among large plans, Anthem brings up the rear at 732.  Overall, not a bad performance.

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