Latest Consumer Reports Rankings of Health Plans Released

[Brian Anderson]

Consumer Reports has just released its new rankings of hundreds of health insurance plans with the intention of helping consumers determine which ones may be best for them.

New this year, CR evaluated private (employer-based) plans in a category called "Avoiding Overuse" that looks at how well plans perform in key areas such as avoiding inappropriate use of antibiotics and limiting imaging tests for lower back pain. Just 86 of 507 ranked private plans met CR's standards to earn an "Avoiding Overuse" designation.

168 plans met the quality threshold alone but did not meet the Avoiding Overuse criteria; 219 plans met neither the quality nor the overuse criteria. Read more at the link below, which also has links to the rankings.

Are unbiased consumer-oriented rankings like these useful when working with clients? Can they be effective to reinforce recommendations or steer people toward better plans?

Insurance Forums | Consumer Reports releases new rankings for hundreds of health plans; just 86 meet

 

[junkman]

The report is pretty much useless. Carriers pay claims per contract. The most important criteria for me are 1. Out-of-pocket 2. Network and 3. Premium. The report doesn't address those points.

It has been demonstrated many times that smaller network results in lower claims cost and consequently, lower premium. The only problem with small networks is getting any care and having access to good care when the **** hits the fan and you are really sick. That 1 issue is a REALLY big problem.

I'm a believer in HSA qualified plans with an individual OOP in the $5,000 range because that is the sweet spot at least in TN for claims. Most people (80-90%) have claims under $5,000. Why pay the insurance carrier their 20% margin to write the check for small claims? The employer can write the check via a health reimbursement arrangement or the employee can do it with the premium savings.

The HDHP structure essentially gives the small employer or the individual access to a premium structure similar self funding with the ability to pay claims as incurred and keep their cash until there are claims. Other structures have higher premiums and the money is gone as soon as premium is paid. You do have to teach your clients to fund at the proper levels or they might not have the cash when needed. Of course, those that are broke have trouble paying premiums AND claims AND saving for retirement AND saving in general but that is another issue.

Most consumer reports articles that I've read are written by people who don't have an in depth knowledge of the subject who are attempting to quantify and spreadsheet a topic. Perhaps the article is useful to get a direction or a sample of the players but I've found that they should never be used for even mid-level important decisions.