With the uproar surrounding health insurance right now, it’s no surprise that findings from the latest Trust Index from healthcare-focused PR agency ReviveHealth reveal trust in healthcare is dismal across the board, and trust in health plans is at an all-time low—but the research finds that the outrage goes beyond consumers, as doctors, health industry leaders and insurance execs alike are experiencing diminishing trust in the ever-controversial system.
Factors driving widespread distrust in health plans by provider organizations include the hassle of doing business with payors and a lack of progress toward new models of payment and care. Consumers feel slighted by health plans as well, but give higher marks to physicians and hospitals.
In addition to dissatisfaction with their healthcare coverage, it is evident that for payors, consumer-centric healthcare is simply lip service. When asked to rank 11 factors driving the transition to value, health plans selected “public sentiment about healthcare costs and coverage” dead last. Consumers’ lack of trust in the industry is perhaps best captured by the finding that nearly two-thirds of respondents would prefer “Medicare for all” over the current system.
“Consumers’ lack of trust in the industry—regardless of age, educational level, political preference or socio-economic status—should come as no surprise given the complexity of the healthcare system and how little healthcare’s central players trust each other,” said Brandon Edwards, chief executive officer of ReviveHealth, in a news release
Focusing on consumers in this year’s survey brings a new level of depth to the findings which have historically focused only on B2B aspects of health services. Key findings by audience included:
Consumers:
- On a 100-point scale, consumers’ level of trust in health plans scored 69.0.
- Consumers trust health plans least, followed by hospitals (74.2) and then physicians (79.3).
- Amongst consumer respondents who noted their healthcare had changed over the last year, 4 to every 1 believe their healthcare coverage had worsened.
Health system executives:
- On a 100-point scale, health system executives’ level of trust in health plans had an aggregate score of 52.0 out of 100.
- Health systems gave the highest scoring health plan a 68 and the lowest health plan a 36—a huge variance between best and worst rated plans.
- Contributing to the low level of trust, 63 percent of health system respondents believe further health plan consolidation would have an “entirely” or “mostly” negative affect on their business.
Health plan executives:
- On a 100-point scale, health plan executives’ level of trust in health systems scored 68.4, which is 16 points higher than health systems’ trust in health plans.
- Health plans gave the highest scoring type of provider organization 75; the lowest score was 59.4.
- More than 38 percent of health plan executives surveyed said it has gotten harder to negotiate contracts with provider organizations year-over-year.
Physicians:
- On a 100-point scale, physicians’ level of trust in health plans was only slightly higher than it was last year, scoring 55.8, but has not yet neared the high score recorded in 2015 (58.1).
- Physicians gave the highest scoring health plan 58.4 and the lowest scoring a 52.8, suggesting that physicians, as a group, see less difference in how various health plans do business with them.
“Our research shows that consumer desire is not driving the transition from volume to value-based care,” said Edwards. “If the onus continues to be placed on individuals to manage their financial responsibility for healthcare, it’s reasonable to expect physicians, health systems, and health plans must band together to close the trust gap amongst each other and their customers. That’s the call to action for our industry, and it’s an urgent imperative.”
If any one industry group needs to look inward and make operational adjustments more than the others, it is health plans. Payors received a collective failing grade in this year’s Trust Index (59.1 out of 100), attributable to a slew of factors including aggressive negotiation tactics, increased market share and narrow networks, and administrative inefficiencies.
“The difference in satisfaction among different health plans was greater than it was among any of the other industry groups,” said Dan Prince, VP of customer engagement at survey partner SMG Catalyst Healthcare Research, in the release. “While all six health plans performed poorly, Cigna received the highest aggregate score among major insurers by a very narrow margin. UnitedHealthcare received the lowest composite score for the same time period. Hospital executives, physicians and consumers have had historically low trust in health plans overall, but the results show some health insurance companies are faring better than others.”
The state of trust in healthcare is poor, and the survey results point to its continued decline
There’s opportunity, however, for industry organizations to leverage communication, amongst one another and their customers, to strengthen trust. With more—and more effective—communication between industry cohorts, the patient experience can improve. Consumer trust in the healthcare system will follow.
“Through our research, we’ve identified four core drivers of trust that must exist between these industry partners to improve overall trust in the healthcare system,” said Edwards. “With communication, consistency, compassion, and competency in play, progress is possible.”
The survey represents the first 360-degree view of trust in healthcare—digging into consumer, physician, health plan, and health system executives’ views of each other—showing the industry as a whole has a long way to go.
ReviveHealth partnered with Catalyst Healthcare Research to administer the survey again this year, conducted June 6–August 11, 2017. A total of 1,369 complete responses were collected: 604 consumers, 600 practicing physicians, 117 hospital and health system executives, and 48 health insurance executives. The ReviveHealth Trust Index measures the attributes of honesty, fairness, and reliability, and then weights the scores equally to create a composite index number between one and 100.
