- A slight majority of U.S. employers like their health plans, but most aren't pleased with what their payers are doing to move the needle on cost, quality and transparency, according to a new survey conducted by the nonprofit Leapfrog Group.
- The survey of more than 170 employers representing some 4 million covered lives found employers that contracted with Cigna were happiest on what their plan was doing to move toward value and those contracting with CVS Health-owned Aetna were most satisfied with its focus on quality. UnitedHealthcare got the lowest ratings in both arenas. A spokesperson for the payer told Healthcare Dive it is "proud of the progress we are making, but also recognize we can always be better. So we appreciate insights from third party surveys" to work on affordability and health outcomes.
- Overall, employers rated their plans a 2.57 grade point average, or a C+, on their ability to direct employees to high-quality healthcare. Blue Cross Blue Shield plans got the highest GPA: 2.59. Cigna got a 2.5, Aetna got a 2.47 and UnitedHealthcare got a 2.29.
A little more than half (58%) of employers told Leapfrog they were generally satisfied with their health plans. But the results show payers still have a ways to go in pleasing their employer clients, and the more than half of Americans receiving coverage through their job, as healthcare costs continue to skyrocket.
Just over half of employers say their plan is working with them to lower costs. UnitedHealthcare, the largest commercial payer in the U.S., ranked lowest, with only 43% of their employers satisfied. Cigna scored highest on lowering costs and improving quality, with 58% and 79% employer satisfaction, respectively. Employers were generally more pleased with what their plans were doing to better quality.
Only 29% of employers overall said they were satisfied with their plan's transparency in price and quality to help employees choose between providers. Aetna was ranked highest with 29% approval, while BCBS plans only had 21% satisfaction.
Leapfrog researchers called the results "discouraging," though there are myriad public and private efforts to force more transparency into the opaque sector. A court decision that would force payers and providers to reveal their private negotiated rates to help consumers shop for care is currently being appealed by the American Hospital Association.
The healthcare industry has also been shifting away from fee-for-service payment models that incentivize providers to deliver greater volume, not better quality. Many large, self-funded companies have pushed for alternate payment models, such as bundled payments, centers of excellence and direct contracting with providers, which removes the payer from the equation altogether.
About a fourth of employers told Leapfrog they use an APM, but most aren't satisfied with what their plan is doing to move away from the fee for service. A third of employers with Aetna said they were satisfied with the payer's APMs, compared with only a fifth of respondents using a BCBS plan.
The Leapfrog survey also found employers widely think payers put the preferences of in-network providers above their own needs. About a third of Cigna and Aetna clients think their plans put them first. That plummeted to just 14% for UnitedHealthcare's employer clients.