Kaiser Permanente tops J.D. Power Medicare Advantage plan survey for 5th straight year

Kaiser Foundation Health Plan ranks highest in Medicare Advantage member satisfaction for a fifth consecutive year, according to the J.D. Power 2019 Medicare Advantage Study released June 20.

With a score of 833, Kaiser outperforms all other plans across four of the six factors that comprise the overall satisfaction index. Highmark (818) ranks second and Humana (803) third (see chart below). The industry average was 795.

The study, now in its fifth year, measures member satisfaction with Medicare Advantage plans—also called Medicare Part C or Part D—based on six factors (in order of importance):

  • coverage and benefits (29%)
  • provider choice (17%)
  • cost (15%)
  • customer service (15%)
  • information and communication (12%)
  • billing and payment (12%)

 

With enrollment in Medicare Advantage plans nearly doubling over the past decade—now reaching roughly 20.4 million Americans—health plans have been able to maintain consistently high levels of overall customer satisfaction.

The J.D. Power study found overall satisfaction with MA plans has increased slightly this year.

“Approximately 10,000 people turn 65 every day in America and many are choosing Medicare Advantage plans helping private plan membership grow nearly 10% between 2018 and 2019,” said James Beem, Managing Director, Global Healthcare Intelligence at J.D. Power. “That’s 1.6 million beneficiaries being added to a relatively small number of health plans in a very short time frame. Even though health plans have been delivering a remarkably consistent customer experience, there is still room for improvement in the form of lowering costs for seniors, proactive communication around explanation of benefits and helping members coordinate healthcare.”

Key findings

Following are some of the key findings of the 2019 study:

  • Satisfaction gap narrows between PPO and HMO Plans: While overall customer satisfaction with Medicare Advantage plans is up 1 point (795 on a 1,000-point scale) from 2018, the gap in overall satisfaction between HMOs and PPOs is narrowing. In 2019, the gap is 10 points (804 for HMOs vs. 794 for PPOs), whereas in 2017, the gap was 20 points (810 for HMOs vs. 790 for PPOs).
  • Member tenure has positive effect on satisfaction: Overall customer satisfaction is highest (822) among Medicare Advantage plan members who have been with the same plan between 9-11 years. However, 59% of plan members say they’ve been with their current provider for less than five years.
  • Cost is most frequent driver of switching: Among Medicare Advantage plan members who choose to switch plans, the most common reason is cost-related. However, those who switch plans for cost-related reasons alone have satisfaction scores that are considerably lower (777) than those who switch for cost- and non-cost-related reasons (808).
  • Information and communication offer opportunity for improvement: Aside from cost, the lowest-rated attributes in the study are consistently those related to information and communication. Fewer than 9% of Medicare Advantage plan members say they’ve experienced all three of the study’s key performance indicators related to effective communication.

The 2019 Medicare Advantage Study is based on the responses of 3,233 members of Medicare Advantage plans across the United States. It was fielded from January through March 2019.

For more information about the 2019 Medicare Advantage Study, visit https://www.jdpower.com/business/resource/us-medicare-advantage-study.

21 COMMENTS

  1. They are the only company having a top 5-Star Rating for their hospitals in California for both Medicare and individual plans.

    Their Medicare plans have 5-Star Ratings, the only company I know of with that rating here in California.

    Medicare rates companies in 75 departments. Kaiser controls all 75 since they own the clinics and hospitals and the doctors are their employees. Most other companies writing Medicare policies only control @ 20 departments or less!

    Kaiser has either a hate or love relationship with patients. It's extremely difficult to compete with them even though they have the most expensive Medicare plan in California. They charge for everything whereas most companies have $0 copays for the same thing.

    As soon as I find out someone turning 65 is on Kaiser, I ask: Are you happy with your coverage? If they answer yes I reply, I guess you are going to stay with Kaiser for your Medicare? Almost always, the answer is yes. I'll tell them about the copays Kaiser charges and once in a while someone will want a comparison.

  2. mickeyma

    Kaiser has either a hate or love relationship with patients. It's extremely difficult to compete with them even though they have the most expensive Medicare plan in California. They charge for everything whereas most companies have $0 copays for the same thing.

    When I was writing U65 health insurance I had a handful of clients with them. Their plans were competitive then (before Obamacare). Had the best maternity benefit of any other carrier.

    Women usually fought enrolling in the plan but once they were in it was like the mob. The couldn't leave even if they want to.

    They really have a slick health care system. I told folks it was like joining the Army.

    Play by their rules and you will love it. Otherwise, forget about even joining the club.

    Most of the folks I encounted that hate KP have never had the coverage. They just hate HMO's because of bad press.

    I don't like them either but KP is an exception. Put my daughter on one of their plans while she was in college. Kept it for 5 or 6 years including past graduation. She kept it until she got a job with group insurance.

    One of her choices was KP and she picked it.

  3. LostDollar

    Do the California Kaiser clinics take the Kaiser medigap plans?

    Kaiser California does not have any Medigap plans. Only MAPD called Senior Advantage. Kaiser California does no accept any outside coverage (except if they are closest facility in emergency/urgent situations). It's possible they may accept a Kaiser Medigap plan from another state's Kaiser as they have begun reciprocating coverage between the Kaisers in different states.

    Kaiser California does not allow agents to sell their MAPD plan. Direct to the public only.

  4. Dave020

    Kaiser California does not have any Medigap plans. Only MAPD called Senior Advantage. Kaiser California does no accept any outside coverage (except if they are closest facility in emergency/urgent situations). It's possible they may accept a Kaiser Medigap plan from another state's Kaiser as they have begun reciprocating coverage between the Kaisers in different states.

    Kaiser California does not allow agents to sell their MAPD plan. Direct to the public only.

    Same here for Medicare. No Medigap. KP staff see only KP members.

    A few years ago they agreed to pay brokers a "finders fee" but it came with a lot of strings. I never pursued it. Don't know any brokers here that did.

    Only thing I ever wrote with them was IFP and small group.

  5. somarco

    Same here for Medicare. No Medigap. KP staff see only KP members.

    A few years ago they agreed to pay brokers a "finders fee" but it came with a lot of strings. I never pursued it. Don't know any brokers here that did.

    Only thing I ever wrote with them was IFP and small group.

    IFP? Insurance For Pirates?

  6. ExProgrammer

    IFP? Insurance For Pirates?

    Only in Pittsburgh.

    This forum introduced me to the IFP acronym years ago when there were more U65 health insurance agents around. For some reason I think it is/was a CA thang.

    Individual and Family Plans

  7. mickeyma

    Yes, Kaiser clinics and doctors and hospitals accept the Kaiser Medicare plan.

    You might want to read his question again. He asked if they accepted MEDIGAP plans, not Medicare plans. Kaiser DOES NOT accept Medigap plans. Not even the ones they sell.

  8. somarco

    Same here for Medicare. No Medigap. KP staff see only KP members.

    A few years ago they agreed to pay brokers a "finders fee" but it came with a lot of strings. I never pursued it. Don't know any brokers here that did.

    Only thing I ever wrote with them was IFP and small group.

    Yep, it was too much work for a small fee of $100. I've found you either love Kaiser or you hate it. And it usually correlates with how close a person is to one of their big facilities. By and large, I find the majority of people want more choice than what Kaiser has to offer. At least here in Georgia.

  9. JD Power is a paid award, companies pay a hefty amount for them to do "surveys" on behalf of the company. The rating is meaningless. It's a marketing company. Same reason that Chevrolet get's all the JD Power awards while their reliability has been sinking.

  10. sman

    Yep, it was too much work for a small fee of $100. I've found you either love Kaiser or you hate it. And it usually correlates with how close a person is to one of their big facilities. By and large, I find the majority of people want more choice than what Kaiser has to offer. At least here in Georgia.

    I was also offered a $100 referral fee by KP in Colorado but not if the applicant was already enrolled in a U65 KP plan. I passed because the only people who have ever been interested in the KP MA plans were those who already their members.

  11. mickeyma

    Kaiser does NOT offer Medigap plans in California

    We aren’t talking about just California. Additionally, the question asked was does Kaiser take Medigap? Not their Medigap, but just Medigap in general. You said yes, but some of us believe you misread the question.

    But they do offer Medigap in Washington. And those enrolled cannot receive care at Kaiser facilities. Nor can anyone else with a Medigap plan from any company. The only plans they accept are their own Medicare Advantage plans (for people on Medicare).

  12. mickeyma

    But they do offer Medigap in Washington

    How would I know. I'm only licensed in Calif. If you want to know if they offer Medigap plans in Washington, check it out.

    I give up Mickey. Obviously you aren’t comprehending what is being said.

  13. sman

    No. They can’t go to Kaiser at all.

    Wow! Got it. So they don't take medicare patients. So if a Kaiser member comes down with a rare disease and wants to go to Mayo Clinic or a specialized treatment center they would be stuck.

  14. It appears there are folks on this thread that are not familiar with the way HMO's work, and in particular, KP HMO.

    KP is a closed panel HMO. Google the term if you don't know what that is.

    They also contract with outside vendors which mmics an IPA model. Google that as well but don't get sidetracked by beer with the same name.

    KP hospitals and clinics will only treat members covered by KP policies (individual, group, Medicare). Non-members will NOT be treated at KP owned facilities.

    If KP members require specialized care that is not available in house they will be referred to an approved contractor.

    On occasion KP will honor claims incurred outside their network.

    If a member has an emergency and is not near a KP facility they may seek care from the closest provider.

    And sometimes a member needs care that cannot be handled in house or by contracted providers. In those rare situations KP will approve a treatment plan and negotiate reimbursement in advance.

    There is a very good reason why some agents encourage prospects to consider original Medicare and a supplement plan vs an MA plan, especially when the prospect is looking at an HMO model.

    No networks.

    No referrals.

    No pre-approval

    No surprises.

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