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Customers Perceive Shortfall in Medicare Advantage Plan Coverage of Mental Health and Substance Abuse Services, J.D. Power Finds

Overall customer satisfaction with Medicare Advantage plans has increased this year, thanks largely to improvements in billing and payments, cost and provider choice. However, according to the J.D. Power 2022 U.S. Medicare Advantage Study, released , some concerning trends are brewing beneath the surface of those positive headline numbers. Most notably, a majority of Medicare Advantage plan members are saying they do not have enough coverage for mental health and substance use disorder services.

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“Medicare Advantage plans have recognized that the key to improved patient outcomes is building engagement with members, encouraging the use of preventive health services and fostering great relationships with primary care providers who are leading overall care coordination,” said Christopher Lis, managing director, global healthcare intelligence at J.D. Power. “With an estimated 1.7 million1 Medicare beneficiaries living with a diagnosed substance use disorder and one in four2 Medicare beneficiaries living with a mental health condition, there is a big opportunity for Medicare Advantage plans to support more patients and families in need. Older adults have been affected by loneliness and social isolation that increased throughout the pandemic. For some health plans, coverage can be improved. For others, increasing customer understanding of mental health benefits may be the bigger opportunity as beneficiaries might be aware that some coverage is available but may not fully understand which services and medications are covered. But coverage does not always guarantee access, as finding providers who accept Medicare may be a challenge in some areas.”

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Following are some of the key findings of the 2022 study:

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  • Overall member satisfaction with Medicare Advantage plans rises: Overall customer satisfaction with Medicare Advantage plans is 809 (on a 1,000-point scale), which is up 3 points from 2021 and up 15 points during the past five years.
  • Missing the mark on mental health and substance abuse disorder services: Just 38% of Medicare Advantage plan members say they have enough coverage for mental health treatment, down from 39% a year ago. Just 27% of members say they have enough coverage for substance use disorder services. These numbers compare with 91% of members who say they have enough coverage for routine diagnostics and 89% who say they have enough coverage for preventive and wellness services.
  • Telemedicine usage declines, despite largely positive experiences: Just 24% of Medicare Advantage plan members used telemedicine during the past year, down from 35% in 2021. Among those who have used the technology, however, 48% say they are very likely to use it again, an increase of five percentage points from last year.
  • Health plan portals still show promise, but breaking inertia is hardA strong majority (82%) of Medicare Advantage members are registered for their health plan’s member portal—up four percentage points from a year ago. However, 14% have registered for the portal but never logged in. Overall customer satisfaction scores are 72 points higher (823) when customers register and log-in to the portal than when they do neither (751).

Study Rankings

Kaiser Foundation Health Plan ranks highest in Medicare Advantage plan overall satisfaction, with a score of 844. Humana (824) ranks second and Highmark (811) ranks third.

The study, now in its eighth year, measures member satisfaction with Medicare Advantage plans—also known as Medicare Part C or Part D—based on six factors (in order of importance): coverage and benefits; provider choice; cost; customer service; information and communication; and billing and payment.

The 2022 Medicare Advantage Study is based on the responses of 3,094 members of Medicare Advantage plans across the United States. It was fielded from May through July 2022.

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