Managed Care - September 2008 - (Page 46)

Plan representatives answer questions and solve problems Importance and satisfaction — mean score by health insurer Tricare/military Kaiser Permanente AARP BCBS of Illinois BCBS of Michigan Humana Other health plan Highmark Coventry Blue Cross & Blue Shield Assoc. Medicaid Health Care Services Corp. Medicare CareFirst BCBS WellPoint Anthem Aetna PacifiCare/Secure Horizons UnitedHealthcare — Net Medicare and Part D Cigna UnitedHealthcare 2 3.25 3.20 3.16 3.11 3.09 3.06 3.06 3.05 3.04 3.04 3.04 3.03 3.03 3.01 3.01 3.01 2.99 2.98 2.97 2.97 2.96 2.92 3.43 3.51 3.44 3.54 3.53 3.52 3.52 3.50 3.51 3.51 3.54 3.52 3.40 3.40 3.50 3.52 3.50 3.52 3.51 3.57 3.54 3.53 health plan’s obligations and the fact that the employer is responsible for many of the plan policies. Insurers must make an effort to educate consumers about benefits packages, but that doesn’t mean throwing a mountain of data at someone. “Some of the booklets I’ve seen have been pretty straightforward,” says Wilson. “‘Here’s what you have. Here are the options you have.’ Others are just too much. I get this book from my insurer that’s about 150 pages thick. I can’t understand the legalese. It all comes back to: How easy is the plan to use and can I easily understand the information that is sent to me?” Resolution of denied claims/appeals Importance and satisfaction — mean score by health insurer Tricare/military Kaiser Permanente BCBS of Illinois AARP BCBS of Michigan PacifiCare/Secure Horizons CareFirst BCBS Medicaid Humana Medicare Health Care Services Corp. Other health plan Blue Cross & Blue Shield Assoc. Highmark WellPoint Anthem Coventry Aetna Medicare and Part D UnitedHealthcare — Net Cigna UnitedHealthcare 2 3.14 3.07 3.07 3.06 3.02 3.01 3.01 3.00 3.00 2.99 2.99 2.98 2.96 2.95 2.95 2.94 2.93 2.93 2.92 2.89 2.85 3.40 3.28 3.32 pends on how quickly the plan takes care of it, and if it doesn’t, that’s when consumers hear about it.” Things like “having courteous and helpful plan representatives” have to do with customer service, a vital component to any plan in the consumer age. “Plans will argue that the employer sets the cost, but customer service is something that they have 100 percent control over,” says Wilson. “When you pick up the phone and call your plan, do you get right through to a person or do you land in what I like to call voice jail, that unending loop of prompts? I’ve seen some really bad systems and there are others that are very customer oriented.” Of course, much disappointment among consumers might be avoided if they understood the There’s a gap The fact that the importance rating by members on whether plan represen3.54 3.46 tatives answer questions and solve prob3.54 3.53 lems is relatively higher than the satis3.58 faction ratings means there is a gap 3.44 3.52 between members’ expectations and 3.48 3.54 quality. 3.53 “The difference between importance 3.56 3.60 and satisfaction ratings appears to be 3.55 3.54 greater for customer service areas since 3.57 these are areas under direct control by 3.56 3.52 the plans,” says Wilson. “I contrast this 3.54 3.58 when we look at measures of satisfac3.57 tion versus importance with pharmacy benefits, for example. What we see in the 40 issues or so we measure on pharmacy is that most people are more satisfied in relation to their importance rating expectations for the pharmacy. This means that in terms of what’s important to plan members, the expectations are higher but the delivery is less satisfying.” Health plans not only must contend with each other in the marketplace as well as demands placed on them by purchasers, but also with the high expectations of consumers, says Wilson. “Expectations for health insurance issues are very high across the board. And plans must ultimately meet the needs of the member in order to minimize the number of dissatisfied and unhappy employees.” Keep that in mind. MC 46 MANAGED CARE / SEPTEMBER 2008

Table of Contents Feed for the Digital Edition of Managed Care - September 2008

Managed Care - September 2008 Editor’s Memo Contents Legislation & Regulation News and Commentary Medication Management Compensation Monitor Archimedes Lends Hippocrates a Hand Some Other Predictive Modeling Programs Messing With Medicare Advantage The Trouble With MAC MedPAC’s Suggestions Sound Familiar The Leader in Patient Satisfaction Formulary Files Plan Watch Tomorrow’s Medicine Ad Index Outlook

Managed Care - September 2008

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