Health Plan Member Satisfaction is Reduced In Less Competitive Markets

Advocates of the proposed Anthem-Cigna and Aetna-Humana health insurance mergers argue that, in the long run, the acquisitions will benefit consumers, health care providers, and insurance markets. They say consumers will gain from the mergers and members of the health plans will become satisfied with their care. This argument is vital for the merging parties because the recent value-based care initiatives taking places at the Centers for Medicare and Medicaid Services emphasize patient engagement and patient satisfaction.

However, a recent study casts doubt on claims that the mergers will result in increased member satisfaction. This new report, from J.D. Power, called the J.D. Power 2016 Member Health Plan Study, concludes that greater, not less, competition between insurance companies is what leads to higher health plan member satisfaction and patient engagement.

The J.D. Power study analyzes member plan satisfaction among 135 health insurance plans throughout 18 regions, using six characteristics: provider choice, medical claims processing, pricing of health plans, customer service, communication, and information access. Member plan satisfaction was low in 2014 when the Affordable Care Act’s health insurance exchanges were introduced, but it has since increased. The report found that member plan satisfaction with regards to communication, information access, and pricing was reduced in regions where one health plan possesses over 50% of the market share.

J.D. Power concluded that health plan member satisfaction and patient engagement is higher in areas where insurers have greater competition. Consumer beneficiaries want better customer service, access to information about health care, better communication, and affordable prices, and they also want increased consumer choice. These findings suggest that competition is necessary for increased patient and plan member satisfaction, and since the Anthem-Cigna and Aetna-Humana mergers will reduce the number of national insurers from five to three, they will harm competition in the health insurance industry.

In recent months medical organizations, consumer groups, and legislators have been expressing various concerns about these mergers. Evidence that these concerns are warranted is mounting, not diminishing. The report is yet another indication that antitrust authorities should thoroughly examine the acquisitions and carefully evaluate their impact before making a decision.