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Employers becoming less satisfied with health plans

Claims accuracy, timeliness, provider discounts and administrative fees were among factors that led to a five-percentage-point drop in satisfaction among large employers.

By Emily Berry — Posted Feb. 3, 2010

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A survey of large and small companies found declining satisfaction with insurers, with the drop specifically attributable to large employers. The survey also noted that employers continue to see driving down payments to physicians and hospitals as a priority in how they rate their insurer.

Results of the survey, conducted in 2009 by PricewaterhouseCoopers, were released Jan. 19. The survey is available at the company's Web site (link).

Overall satisfaction with health plans among large employers (those with an average of 11,000 employees) dropped from 64% in 2008 to 59% in 2009. Satisfaction among smaller employers (200 or fewer workers) held steady at about seven percentage points lower than large companies.

Most of the large employers surveyed were self-insured, so they use insurance companies for administrative services only, rather than paying the insurers to take on financial risk.

Among smaller employers, the pool was mixed between self-insured and fully insured companies, said Paul Veronneau, partner and payer practice leader at PricewaterhouseCoopers Health Industries.

After "claims accuracy and timeliness," all employers ranked "provider discounts" and "administrative fees" as the most important things their insurance companies offer. Taken together, those represent the cost of doing business with an insurer.

But the consultants who analyzed the results advised payers to look beyond those two aspects when trying to keep and win business.

Focusing on driving down reimbursement rates will get an insurer only so far, Veronneau said.

"What the insurers pay for a procedure is one factor of the cost, but how many get performed is the other," he said. "In a service industry, you can only get so cheap, and everybody recognizes that the providers are most important part of the value chain. You don't really win in cutting below a certain threshold."

Rather than trying to negotiate down what they pay hospitals and doctors, smart insurers are working to eliminate waste and fraud, and finding ways to help employers keep workers healthy and encourage physicians to manage patients' health, Veronneau said.

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