UPMC Health Plan scored highest among local health plans in overall patient satisfaction, according to a study by J.D. Power and Associates, well ahead of Highmark Inc. and the national carriers that are a growing presence in the Western Pennsylvania health insurance market.
Based on online surveys regarding members' experience with their health plan, UPMC Health Plan scored 735 of a possible 1,000 points, followed locally by Cigna with 706 points, Highmark Blue Cross Blue Shield with 703, Aetna with 701, United Health Care with 684 and HealthAmerica/HealthAssurance with 660 points.
Statewide, Geisinger Health Plan in Danville, Montour County, scored best overall with 739 points.
Pennsylvania's health plans were reviewed as part of the seventh annual J.D. Power national study, which was based on responses from 33,000 people enrolled in 136 health plans.
The health plan members were asked almost 100 questions about dealing with different health plans, from how many times they had to explain their situation before getting action to how often claims were denied, said Rick Millard, the Rochester, N.Y.-based study director for the survey and J.D. Powers' practice leader for health care. The complete results are available only to J.D. Power subscribers.
Both UPMC Health Plan and Highmark are coming off down years in the study, with UPMC scoring 711 last year and Highmark receiving a total of 705 points. Mr. Millard speculated the lower scores may have been attributable to the turmoil a year ago as it was unclear if Highmark and the UPMC health system would renew or extend their contract.
This year, "Highmark does not appear to have rebounded as UPMC has," he said.
Diane Holder, president and CEO of UPMC Health Plan, said their J.D. Power listing as number two of 11 plans in the state "affirms that we are doing the right things, and that we are committed to continuing to do so, to best serve our members."
Mr. Millard said both Geisinger and UPMC Health Plan likely benefitted because they are integrated health care delivery systems that combine both a provider network and a health plan.
"In integrated systems, coverage and benefits are more standardized and are a bit easier for members to understand," he said.
Highmark is currently building its own integrated delivery system, having just finalized its affiliation with Jefferson Regional Health System in Jefferson Hills and awaiting final state insurance department approval to acquire the West Penn Allegheny Health System.
Highmark spokeswoman Leilyn Perri noted that the insurer recently launched a redesigned website that helps members get easy access to coverage and provider information. That follows a new explanation of benefits forms and the myCare Navigator service, which helps members find physicians, transfer medical records and coordinate getting second opinions.
"Highmark is continually working with and speaking to our members to help improve the member experience," she said.
Steve Twedt: email@example.com or 412-263-1963.