Health plans cited as a barrier to the delivery of high-quality patient care. Poll results further spotlight physician concerns about impact of consolidation among the nation’s big five health insurance plans
Nashville, TN (PRWEB) October 28, 2015
Physicians broadly mistrust health insurance companies and say they even interfere with physicians’ ability to provide high-quality patient care, according to new results from the ReviveHealth Payor Trust Index (SM), which polled more than 600 primary care and specialist physicians across the country.
Physicians said they have the least trust in UnitedHealthcare (United) and Humana and the most trust in local Blue Cross Blue Shield Plans. Likewise, physicians deemed local BlueCross BlueShield plans best at enabling the delivery of high-quality care, and indicated United was the worst.
Trust was measured based on such things as physicians’ perspectives on a health plan’s efforts to honor its commitments, honestly and accurately represent itself and its intentions, and to not routinely take advantage of physicians. The No. 1 factor cited by physicians’ as influencing their opinions about whether health plans help or hurt the delivery of high-quality care: more coverage and fewer claims denials versus poor coverage and more claims denials.
"What these findings tell me, is that things will be more challenging for everyone, especially physicians, as plans flex their muscles in this new environment of health reform and consolidation of the nation’s largest players and payers,” said Paul H. Keckley, national health policy expert and managing director for the Navigant Center for Healthcare Research and Policy Analysis. Keckley also serves as a member of the ReviveHealth Sounding Board.
That opinion was seconded by fellow ReviveHealth Sounding Board member Nathan S. Kaufman, managing director of Kaufman Strategic Advisors and an expert in payor-provider relationships, who said the physician mistrust of health plans revealed in the latest Payor Trust Index will likely only get worse with the mega-merger deals of the nation’s largest health plans now under review by the Department of Justice (DOJ).
“The Affordable Care Act and other market forces have restricted growth in insurance premiums. Now more than ever, healthcare has become a zero sum game,” said Kaufman. “Market power continues to be the primary driver of how healthcare dollars are distributed. If physicians think health plans are difficult to deal with now, just imagine negotiating with a company comprised of two of the largest, least-trusted ones, which is what we’re looking at right now with the planned mergers involving Humana, Anthem and others.”
Physicians and politicians alike are speaking out against the $100 billion in blockbuster mergers being reviewed by the DOJ, citing harm to consumers, price-setting that forces physicians out of business, and the potential undermining of a central goal of the Affordable Care Act, increased competition.
Under review are Anthem’s proposed takeover of Cigna and Aetna’s acquisition of Humana, deals that would reduce the number of major, national health plans from five down to three. The American Medical Association has weighed in against the mergers as has the nation’s largest state physician group, the Texas Medical Association.
The Payor Trust Index was first established last year by ReviveHealth and research partner Catalyst Healthcare Research as part of the healthcare marketing communication firm’s nine-year annual survey of health system executives’ opinions of what it’s like to do business with the nation’s largest health plans. The agency this year extended the Trust Index to physicians to get a broader, more 360-degree view of the nation’s largest health plans through the eyes of those who are responsible for delivering health care to patients. The Index asks a series of questions examining various issues related to trust and assigns a numeric score from one to 100.
Overall, physician trust in the nation’s largest insurers is dismal – the average of all combined scores being 58.1 out of 100. This is slightly higher than the 51.8 that hospital leadership gave insurers when they took the survey earlier this year.
In the latest physician poll, independent Blue Cross Blue Shield plans came out ahead, followed closely by Cigna. United and Humana were consistently ranked lowest by physicians. United has for years struggled with trust issues among providers, consistently ranking among the least trusted in each of the last nine years that ReviveHealth has conducted national payor survey research among health system executives.
Key physician perspectives from the latest Payor Trust Index include:
Combined Trust Index Ratings:
- BCBS – 60.5 (compared to health system rating of 59)
- Cigna – 58.6 (compared to health system rating of 62.7)
- Aetna – 58.2 (compared to health system rating of 54.8)
- Anthem/Wellpoint – 57.6 (compared to health system rating of 46.9)
- United – 57.1 (compared to health system rating of 40.5)
- Humana – 56.5 (compared to health system rating of 51.3)
Plans Best/Worst at Enabling Delivery of High-Quality Care
- BCBS plans were identified as the best partner for enabling delivery of high-quality care (46%).
- United was most often mentioned as the worst at enabling delivery of high-quality care (26%), followed by Humana (16%), Aetna (15%), and Anthem/Wellpoint (14%).
- When considering the justifications for the “best” ratings, five of the top six criteria listed were relationship-driven – the best rankings were based on customer service, administration, and clear guidelines. Only one criterion was financially driven.
- Of the “worst” ratings, all of the top five criteria mentioned were relationship factors – payment rates were brought up as the sixth most important factor (9%).
The survey was administered online among 605 physicians (75 percent medical specialists and 25 percent primary care), representing 45 of 50 U.S. states and the District of Columbia.
ReviveHealth is the first purpose-built, integrated marketing communication firm for Health Systems, Health Services, Health Technology, and Healthy Living. The firm is the sixth largest healthcare agency in the country and its client roster includes some of the leading and largest brands in healthcare. It was named PRWeek’s 2014 Small Agency of the Year, 2015 Small Agency of the Year finalist, and 2013 Boutique PR Agency of the Year. The Agency also earned The Holmes Report’s 2014 Best Agency to Work For in America as well as Best Boutique Agency to Work For from 2011-2014. ReviveHealth has offices in Nashville, Minneapolis, and Santa Barbara, and can be found on the web at thinkrevivehealth.com and on Twitter @ThinkRevive.
For the original version on PRWeb visit: http://www.prweb.com/releases/2015/10/prweb13048446.htm