SATISFACTION WITH HEALTH PLANS


A Fact Sheet on Findings
How satisfied were the families of children with special health care needs with their child's main health plan? What problems with accessing services did they report? What factors affected their satisfaction with their child's main health plan?

Methods: Families were asked about their level of satisfaction with their child's main health plan. They were also asked to rate how well their child's main health plan performs on specific issues. Variability in findings on family satisfaction was analyzed with respect to child health status characteristics, family demographic characteristics, and health care utilization patterns among the children.

Findings:

  • 41% of the families were very satisfied with the child's main health plan, 42% were somewhat satisfied, 11% were somewhat dissatisfied, and 5% were very dissatisfied.

  • 33% would definitely recommend their child's plan to other families of children with special health care needs, 41% would probably recommend, 18% would probably not recommend, and 8% would definitely not recommend their child's plan.

  • 25% would definitely not switch plans if they could, 43% would probably not switch, 22% probably would switch, and 9% would definitely switch if they could.

  • Overall, almost two-thirds (63%) of the families were somewhat or very satisfied, probably or definitely would recommend their child's plan to others, and probably or definitely would not switch plans if they could.

  • One third (37%) of the families expressed dissatisfaction on at least one of these three indicators. 13% expressed dissatisfaction on all three of these indicators.

  • One third of the families in the study had contacted their child's main health plan regarding a problem experienced in the preceding year. A quarter reported that the issue had not been resolved to their satisfaction.

  • With respect to the overall benefits provided by the child's main health plan, 22% rated them as excellent, 39% rated them were good, 28% rated them okay, and 12% rated them poor.

  • Families gave their child's health plan higher ratings for the provision of skilled and experienced primary care (80% rated
    excellent or good) and specialty care doctors (75% rated excellent or good) than for the provision of skilled and experienced other specialists, such as physical therapists, occupational therapists, and speech therapists, etc. (54% rated excellent or good).

  • Families gave their child's health plan the lowest ratings for the provision of clear information about what services are covered (53% rated okay or poor), how to access covered services (57% rated okay or poor), other services outside the plan that may be needed by the child (73% rated okay or poor), and how to file a complaint (65% rated okay or poor).

  • Families whose child was in fair or poor health, had more severe conditions, or whose health was unstable were less satisfied with their child's plan than families of children whose health status was better, less severe, and whose health care needs were stable.

  • Families of children with mental health conditions, behavior problems, or autism and families of children with allergies or
    digestive gastrointestinal disorders were significantly more dissatisfied with their child's main health plan than families of
    children with other conditions.

  • Parental satisfaction with their child's main health plan was not correlated with the frequency with which their child was seen by the primary care physician or by specialists.

  • Parental satisfaction with their child's main health plan was lower for parents who had more formal education, who were themselves in poorer health, or who had more than one child with special health care needs. There was no relation between parental income, marital status, or employment status and satisfaction with the child's health plan.

  • Parents whose child's main health plan was paid by Medicaid were more satisfied with the plan than parents who purchased their child's health coverage privately.

  • There was no relationship between parental satisfaction with the child's main health plan and whether or not the child also had a secondary health plan.

  • No differences in parental satisfaction with the child's main health plan were found based on whether the doctor most important to the child's care was a primary care doctor or a specialist. There were no significant differences in ratings of the quality of the care provided by the doctor most important to the child's care between those who were a primary care doctor or a specialist.

  • Parents whose child's plan used cost containment policies (such as having a restricted list of providers and requiring a referral for specialty care) were less satisfied with their child's plan in comparison to those whose child's plan did not have these policies.

Additional information about the survey and its results can be obtained from: www.familyvoices.org

or by contacting:

Nora Wells, Family Voices nwells@fcsn.org 1/888-835-5669

Marty Wyngaarden Krauss, Ph.D., Brandeis University krauss@brandeis.edu