- Most Medicare Advantage beneficiaries are satisfied with their insurance, but only 31% said their plans made it easy for them to find care, according to a study from J.D. Power.
- Overall customer satisfaction with MA plans was 652 on a 1,000 point scale, which is in the good-to-great range in the study’s MA index model. Trust and the ability to resolve problems or complaints were factors most highly correlated with members' likelihood of renewing their plans, according to the study.
- One shortcoming of many MA plans was utilization of digital health, with just 34% of respondents saying they used two or more digital tools offered by their plans. On average, customer satisfaction scores were 158 points higher when beneficiaries said it was easy to find care and 62 points higher when they used two or more digital tools.
MA plans, where the government contracts with private insurers to offer Medicare coverage, have become increasingly popular with seniors over the past decade. More than half of eligible Medicare beneficiaries were enrolled in MA plans this year.
Other surveys have found enrollees were satisfied with their coverage, with beneficiaries saying they liked their plans because they covered their preferred providers, had affordable premiums and offered cost-effective coverage for prescriptions.
The J.D. Power study found MA plans performed best on trust, ease of doing business and meeting members’ coverage needs.
“Most Medicare Advantage plans are performing well on the basics, yet there are opportunities for improvement in the areas of ease of finding care, care coordination and innovation around digital self-service,” Christopher Lis, managing director for global healthcare intelligence at J.D. Power, said in a statement.
One study found many MA enrollees could be losing access to mental healthcare because nearly two-thirds of psychiatrist networks in MA were narrow, containing fewer than 25% of providers’ a network’s service area.
A report from the HHS’ Office of the Inspector General published last year found 13% of prior authorization requests denied by MA organizations would have been approved under traditional Medicare, while 18% of denied payment requests met Medicare coverage rules.
In April, the CMS finalized a rule that cracks down on MA denials, requiring plans to comply with national and local coverage determinations and general coverage and benefit conditions included in traditional Medicare regulations, which goes into effect in the 2024 plan year.