NY Ranks Health Insurers Based on Complaints

NY Ranks Health Insurers Based on Complaints

So how does your Health Insurance Company rank? Click here to find out.

“Each year, NYSID and DOH receive complaints about health insurers from consumers and health care providers. After reviewing each complaint, the State determines if the health insurer acted appropriately. If the State determines that the insurer did not act in accordance with their statutory and contractual obligations, the health insurer must resolve the problem”

According to the report, a better rank means that the health insurer had fewer upheld complaints, relative to its size. If the ratios are the same, the health insurer with the largest premium is ranked higher.

As usual the leading insurers with the most market share rank in the middle.  The #1 insurer based on membership, Empire Blue Cross, received # 6 ranking.  Highly regarded Aetna got # 8.  Using this as a gauge, highest ranked insurers such as MVP, Independent Health and Community Blue (Healthnow) ought to be the way to go. As an example, local Mid Hudson Valley privately owned MVP had 117 complaints with just 7 upheld or 6%.

The numbers would suggest that the smaller size of an insurer the better they are at customer service and reducing complaints. This is unfortunately contrary to what we are seeing in the industry.  Health Net has existed the northeast recently, GHI and HIP merged to form Emblem, Oxford was taken over by United Health Care and Empire is owned by Anthem and no longer a non profit.   We are seeing recent examples of this turned outside the region as well.  Moody’s, New York, points to recent notifications that Blue Cross Blue Shield of Delaware, Wilmington, Del., signed an affiliation agreement with Highmark Inc., Pittsburgh, and that HealthSpring, Nashville, Tenn., agreed to acquire Bravo Health, Baltimore.

So how does an MVP afford to invest in technology and new products? Regulators may frown on the big boys from swallowing them up but its a good guess that new affiliations with similarly sized small companies will be shaping the future landscape of private Health Care.