55% of Healthcare Consumers are not Fully Satisfied with their Health Insurance

Survey of 2,800 health plan beneficiaries reveals members want more personalized care

New research released today by next-generation healthcare SaaS company HealthEdge reveals that only 45% of healthcare consumers are fully satisfied with their health insurance. In a survey of more than 2,800 participants, an overwhelming 55% of beneficiaries want more from their health plan — signaling shortcomings in payers’ ability to provide personalized care.

Survey data represents all different types of health plans, with participants mirroring the diverse populations today’s plans serve. When asked what health plans can do to improve member satisfaction, these five responses ranked highest:

1. Incentives and rewards for healthy behaviors
2. Easy access to health records
3. Access to providers who offer care based on member preferences and personal traits
4. Good customer service
5. Tools or information to help members find less costly care

As the always-on, highly personalized digital convenience of modern retail shapes the expectations and purchasing decisions of today’s healthcare consumers, the quality of health plans’ self-service tools and the effectiveness of their customer service grow increasingly critical. Healthcare consumers have more choices than ever before, and competition among health plans has never been steeper.

“Market dynamics are creating a perfect storm for payers — one that requires a renewed focus on personalizing member experiences and improving member satisfaction. Forward-thinking health plans are adopting modern technology solutions that enable greater access to meaningful data, omni-channel engagement capabilities and more personalized care management strategies to meet the onslaught of challenges in today’s healthcare landscape,” said Christine Davis, senior vice president of Marketing at HealthEdge.

In 2023, high satisfaction in healthcare delivery requires timely access to relevant member data. Next-generation technology for core administration, care management and member engagement provides plans with an essential digital foundation to create the experience today’s members demand. Modern care management platforms enable care managers and providers to tailor care plans to member needs. Care teams with access to data on social determinants of health — such as housing instability, food insecurities and transportation barriers — can identify risks and connect members to the support they need to follow care plans and live healthier lives. Payers with advanced core processing have the agility to configure benefit plans that meet the unique needs of the populations they serve. With digital member engagement capabilities, plans can empower members to take an active role in their own healthcare journey, understand their financial responsibilities and make informed choices. This digital transformation leads to lower costs, higher quality and better outcomes, improving healthcare for payers, providers and patients.

The survey also uncovered key differences among generational and line of business consumer segment responses. Dual-eligible plans, designed for people who qualify for both Medicare and Medicaid, appear to have the highest member satisfaction. Responses suggest 18–24-year-olds are four times more likely than other age groups to prefer communicating with health plans in digital ways, such as texting and mobile app messaging. “For this on-the-go, mobile-everything population, convenience isn’t an option — it’s a necessity,” Davis said. Responses from participants age 65 and up imply older members prefer outreach through more traditional channels, such as phone calls and emails.

A full report of survey findings lends guidance on how payers can leverage technology to transform the member experience so patients see health plans as partners in care.

About HealthEdge

Innovating a world where healthcare can focus on people, HealthEdge® is driving a digital transformation through transaction automation and real-time business and clinical engagement among payers, providers and patients. The next-generation healthcare SaaS company provides an integrated ecosystem of advanced solutions for core administration (HealthRules® Payer), payment integrity (Source), care management (GuidingCare®) and member experience (Wellframe) that empower health plans to accelerate business, reduce costs and improve outcomes. Follow HealthEdge on Twitter or LinkedIn.

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