Despite an industry-wide transition to value-based payment models that incentivize preventive care and proactive communication between health plans and members, commercial health plans are missing the mark when it comes to patient engagement, according to the J.D. Power 2023 U.S. Commercial Member Health Plan Study.
Customer satisfaction with commercial health plans is particularly strained among members of Gen Y and Gen Z, driven largely by poor customer service and communication scores. Similarly, members with the lowest self-reported health status are most likely to experience communications challenges with their health plans.
According to Christopher Lis, managing director, global healthcare intelligence at J.D. Power, the move to value-based care hinges on the idea that payers and providers can drive better outcomes, at a lower cost, by improving patient engagement. But many commercial health plans are finding it difficult getting the right information and support to patients.
Moreover, in patients with self-reported health status of ‘poor and fair,’ only 17% were assigned to a case manager,” said Lis. “Yet for these patients with oftentimes complex health conditions, seeing multiple providers and taking several prescriptions, care fragmentation leads to poor health outcomes and higher spending in the very population that needs coordinated care the most.
