Consumers more satisfied with Medicare Advantage than commercial plans
Satisfaction among Medicare Advantage customers is 87 points higher than among customers of commercial member plans.
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Even as the hospitals and health systems continue to battle with Medicare Advantage programs over reimbursement rates, customer satisfaction with MA plans is significantly higher than with commercial member health plans, according to the J.D. Power 2024 U.S. Medicare Advantage Study.
It found the most important factors driving customer satisfaction with Medicare Advantage plans are ease of finding care, low out-of-pocket costs and provider choice.
According to Christopher Lis, managing director of global healthcare intelligence at J.D. Power, MA plans' outperformance of commercial plans can be attributed to the top five drivers of satisfaction in the MA shopping experience: preferred in-network doctors, adequate prescription drug coverage, preferred in-network hospitals and facilities, previous experience with a health plan, and the existence of a copay.
WHAT'S THE IMPACT?
Access to care and provider choice emerged as the key drivers of customer satisfaction. Overall customer satisfaction with Medicare Advantage plans is 652 (on a 1,000-point scale), and ease of finding care, low out-of-pocket costs and provider choice were what mattered most to consumers.
Satisfaction among Medicare Advantage customers is 87 points higher than among customers of commercial member plans. The largest gaps in customer satisfaction in specific aspects of the customer experience are: "helps me to save time or money" (+128 points), "ease of doing business" (+93), "level of trust" (+92) and "product/coverage offerings meet my needs" (+90).
The top-performing regional plans set the pace for customer satisfaction, the report found. While average overall satisfaction scores are highest among national health plans, the top-performing individual regional Medicare Advantage plans – UMPC For Life, Highmark Blue Cross Blue Shield, Independence Blue Cross, Geisinger Gold and Priority Health Medicare – significantly outperform the top-performing national plans.
Kaiser Permanente ranks highest in overall customer satisfaction with Medicare Advantage plans in California, with a score of 666. Alignment Health Plan (665) ranks second, and SCAN Health Plan (652) ranks third.
UnitedHealthcare ranks highest in overall satisfaction with MA plans in Florida, with a score of 689, and in Georgia and Illinois, with scores of 671 and 677, respectively. The insurer also ranks highest in North Carolina, with a score of 690.
Other plans with high MA satisfaction scores include Anthem Blue Cross and Blue Shield (the highest-ranking plan in Ohio, with a score of 663); UPMC For Life (tops in Pennsylvania, with a 699); Excellus BlueCross BlueShield (tops in New York, with 654).
THE LARGER TREND
Recent quarterly reports from the large insurers show Medicare Advantage profitability is on the decline. The headwinds, executives said during recent earnings calls, have been due to greater than expected utilization of benefits and lower than expected reimbursement from the government.
Adding to MA's margin challenges are providers who are making the decision to cut their ties with MA plans, rather than deal with delays in prior authorization and claims payments.
Despite that, the highest gross margins among insurers come from Medicare Advantage, which boasted gross margins per enrollee of $1,982 on average by the end of 2023, compared to $1,048 in the individual market, according to a recent KFF analysis of insurers' financial performance.
When KFF examined gross margin trends in Medicare Advantage last year, it found that while MA margins reverted back to pre-pandemic levels in 2021, those margins were still double those seen in other markets.
ON THE RECORD
"As the 2025 Medicare open enrollment period rapidly approaches, there are several important factors that Medicare-eligible seniors should consider when evaluating health insurance options for the coming year," said Caitlin Moling, senior director of global healthcare intelligence at J.D. Power. "Current health status; access to preferred doctors and facilities; access to healthcare in specific regions/locations; and out-of-pocket costs are just a few of the key variables that can weigh heavily on the customer experience with Medicare Advantage plans. The more consumers know about what kinds of care they're likely to need and the detailed coverage their health plan provides going into a contract, the better the experience they will likely have during the course of their relationship with that plan."
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
