One of the ways that the Affordable Care Act will transform health insurance shopping is by standardizing much of the benefits offered among health plans. This standardization will increase the importance of quality comparisons in the purchase decision process since benefit differences will decrease. However, when HealthPocket’s InfoPoll asked consumers about what would determine their health plan choice if health insurance plans offered the same benefits, ratings of customer satisfaction and quality were the least frequently chosen factor.
HealthPocket’s InfoPoll surveyed 900 adults across the U.S. and found respondents chose “low monthly premium” as the deciding factor for health insurance selection three times more often than ratings for customer satisfaction and quality. Despite the primacy of premium over ratings in shopping intentions, consumers would benefit from considering quality among health plans. For example, a low monthly premium has less relevance if the quality of the health plan and its network of doctors is below average. Additionally, it cannot be reasonably assumed that an expensively priced health plan implies higher quality due to the higher premium amount.
With respect to the neglect of quality in health plan shopping, the potential for negative consequences may increase for consumers in 2014. Given health reform’s expanded benefit requirements and constraints on allowable overhead expenses, an increasing number of health insurance plans are trying to reduce costs with narrower healthcare provider networks serving more patients with fewer doctors and hospitals. These narrow networks may be problematic for those with complicated medical issues or chronic conditions1 unless a narrow network plan network had been consciously chosen based on its expertise caring for a condition.
In 2009, the Center for Studying Health System Change commented “health care price and quality transparency in the United States for the most part remains a product in search of a buyer.”2 HealthPocket’s InfoPoll’s results would suggest that this is still the case in 2013. However, respondents may have cited customer satisfaction and quality ratings so infrequently because many consumers are unaware that quality ratings exist for health plans. Currently, health insurance reviews are used by a minority of consumers. A 2012 Health Research Institute survey found that only 16% of those surveyed had read, used, or written a review on an insurance company.3
One major change commencing in 2014 could alter the importance the public places on health plan quality in the individual health insurance marketplace. Health plans will no longer be able to reject applicants or charge them higher premiums based on their health conditions. Absent of worries about health-related application rejections or premium increases, consumers who are dissatisfied with their health plan’s quality will have fewer obstacles to plan switching.
HealthPocket’s InfoPoll also revealed that brand loyalty would be the determining factor in only one out of five respondents’ health plan selection. This may be especially troubling news for well-known brands in the health insurance market who can charge higher premiums due to superior brand perceptions among consumers. If a consumer cannot be trusted to stick with “a brand I know and trust,” then side-by-side comparisons in health exchanges and other online marketplaces as well as the commoditization of health plan benefits may force changes on the marketing strategies of big brands. The use of quality ratings could also undermine the market advantage of big brands but, at this stage of healthcare consumerism in America, the current usage level of rating data poses no threat to established health insurance brands.
Given the importance of quality in health insurance shopping, HealthPocket’s health plan comparison tool includes Quality Scores for health plans. HealthPocket’s Quality Score combines a plan’s quality ratings from unbiased government and nonprofit data along with HealthPocket’s own analysis of a plan’s financial value as compared to competing health plans available within the local market. The HealthPocket Quality Score examines a variety of factors including clinical quality measures on treatment and preventative care, premiums, cost-sharing (e.g. deductibles, co-pays), and customer satisfaction.
Results are based on 900 responses to an online survey conducted from May 22, 2013 to May 24, 2013. Respondents were asked “If health insurance plans in your area all offered the same benefits, which of the following factors would determine your plan choice?” Respondents had the option of choosing only one of the following answers: "Low Monthly Premium," "Plan Acceptance By My Doctors," "A Brand I Know and Trust," "My Exposure to Out-of-Pocket Costs," and "Customer Satisfaction & Quality Ratings." The order of these options was randomized across respondents. The survey was displayed within a network of over 100 different news web sites and other content sites. Demographic inferencing and methodology to acquire survey respondents who approximate national statistics on age, gender, income, and region was performed by technology administered by Google. Race, education, and health insurance status were not examined. Margin of error across the responses is estimated at +3.2%/ -3.0%.
This survey analysis was completed by Kev Coleman, Head of Research & Data at HealthPocket.com. Correspondence regarding this study can be directed to Mr. Coleman at firstname.lastname@example.org.
Feedback and questions are welcome but, given the volume of email, personal responses may not be feasible.
1 Julie Appleby. “HMO-Like Plans May Be Poised To Make Comeback In Online Insurance Markets” Kaiser Health News (January 22, 2013). Accessed May 24, 2013. http://www.kaiserhealthnews.org/stories/2013/january/23/hmo-limited-networks-comeback-in-exchanges.aspx
2 Paul B. Ginsburg and Nicole M Kemper. "Health Care Quality Transparency: If You Build It, Will Patients Come?" Center for Studying Health System Change Commentary No. 4. (July 2009). Accessed May 24, 2013. http://www.hschange.com/CONTENT/1072/
3 "Scoring healthcare: Navigating Customer Experience Ratings," Health Research Institute (April 2013): 2. https://www.pwc.com/us/en/health-industries/publications/assets/pwc-hri-scoing-healthcare-chart-pack.pdf
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