When it comes to consumer goods like appliances and cars, many of us consult third party reviews to help us decide whether we’re getting a good value for the price of the item.
That similar approach appears to be lacking when it comes to health coverage decisionmakers in choosing a health plan. Studies show that employers do little research into the quality of the health plan they’re purchasing for their employees’ health coverage.
A survey by the Associated Press and the National Opinion Research Center showed while 6 in 10 employers offering health insurance say quality ratings are an important factor when choosing a plan, most are unfamiliar with independent sources of quality data. Only 7 percent of employers that offer health insurance use objective quality information from sources tested in the survey; 89 percent do not use or are unfamiliar with any of the objective sources tested.
What does this mean to an employer?
Health plan premiums are certainly a concern for employers when choosing their employees’ health plan. However, employers should also be asking themselves how the health plan helps providers deliver care. Chronic medical conditions not only result in lost wages and out-of-pocket costs for the employee, but they also can impact employer costs caused by lost productivity and absenteeism.
Proper management and control of chronic conditions saves money, too: heart attack or stroke can cost in the range of $8,000 to $14,000 per month in medical costs, not including costs associated with absenteeism, and presenteeism.
Assessing health plan quality
Third-party assessments of health plans are available in summary form online. Some of the organizations include reviews of health plan quality, customer satisfaction, and how well a health plan helps address chronic conditions or encourages preventive care.
The National Committee for Quality Assurance
One of the most widely used assessments of health plan quality is issued by the National Committee for Quality Assurance (NCQA), which began assessing health plan performance regarding patient care and member satisfaction in the mid-1990s.
The NCQA publishes its online NCQA Health Insurance Plan Ratings, which includes an assessment of more than 1,000 health plans based on clinical quality, member satisfaction, and its Accreditation Survey results. It provides rates each plan on a 5-point scale in three categories: Consumer Satisfaction, Prevention and Treatment.
New York Consumer Guide to Health Insurers
The New York Consumer Guide to Health Insurers is published by the New York State Department of Financial Services (DFS) to inform consumers of the health insurance products offered in New York and how they work, and to help them choose a health insurance company based on quality of care and service. The complete guide is online.
The Consumer Guide rates health plans using its own quality information, complaint statistics and data from the Consumer Assessment of Health Plans Survey (CAHPS), which is a series of surveys that rate patients’ experience of care.
Together, quality and satisfaction surveys help paint a picture for employers assessing whether they’re getting the most value out of their health plans for themselves and their employees. It’s good business practice to look beyond premium and into the drivers and causes of health care costs, and how well a health plan is working to address those drivers.
