Why It’s So Hard to Get a Straight Answer From Your Health Insurer
Business + Economy

Why It’s So Hard to Get a Straight Answer From Your Health Insurer

As anyone who’s spent hours on hold to dispute a billing error, customer service is not a strong suit for many health insurance companies.

One of the biggest problems: the gap between the insurance company and the health care provider. All too often, one tries to blame the other for any problems that occur, especially when it comes to billing.

Related: 3 Big Winners in the GOP Health Care Plan – and 3 Big Losers

It turns out that some insurance plans do a much better job of dealing with their customers than others. A new study published this month in Health Affairs finds that insurance plans offered directly by hospitals and health systems rather than large insurance companies have much higher customer satisfaction.

On a scale of five stars, provider-offered plans receive a full half-star higher rating on a five-star rating scale, a statistically significant finding.

Writing in The New York Times, study author and health care economist Austin Frakt says that when the plan and the hospital are the same entity, they can’t pass blame for errors off on one another. “Problems may be resolved faster; they may be less likely to develop in the first place,” he writes.

Consumers in urban areas in the northeast and the West are more likely to have access to provider-offered plans. More health systems are considering getting into the insurance business, according to a recent McKinsey report.

The trend may not take off, however, as some health systems have wound down their insurance offerings after difficulty making a profit. “Provider-offered plans may increase convenience for consumers,” Frakt writers. “But the financial risk it confers on the organizations that offer them may be more than some can handle.”