Though a majority of managed-care enrollees remain happy with the coverage they receive, a new study suggests that health plans' recent cost-cutting is eroding satisfaction and could compromise enrollees' well-being.
Rising discontent about pharmaceutical benefits stood out in the study, conducted by New York-based CareData Reports. Although 69% of the respondents were highly satisfied with their pharmaceutical benefits, that number is down substantially from 1996. That was the last time data were gathered from a similar group of enrollees, and 76% said they were highly satisfied. Satisfaction declined three to five percentage points regarding specific pharmaceutical issues, such as getting the best medications available, obtaining refills and paying higher out-of-pocket costs.
"It's a little alarming on the pharmacy side. A one- or two-point drop is significant, but something on the order of seven points is big," said Tod Cooperman, M.D., CareData's president.
Cooperman attributed the drop to curbs managed-care plans have applied to prescription pharmaceuticals. Drug sales rose 12.6% between 1996 and 1997, according to the Plymouth Meeting, Pa.-based research firm IMS America. Many plans, for example, will not cover the popular impotency drug Viagra, and others have tweaked their formularies and raised copayments (June 29, p. 162). "Although pharmacy is a well-defined area to make cuts, it could turn out to be a penny-wise, pound-foolish policy," Cooperman said. He added that pharmaceutical cuts could hurt outcomes and eventually increase medical costs.
Cooperman believes the pharmaceutical issue colored other aspects of the survey, which polled 25,505 managed-care enrollees on 138 facets of their coverage and care. Fifty-seven percent of the respondents said they were highly satisfied with their plans, down from 60% in 1996. Satisfaction with customer service declined four points to 58%. Cooperman said he believes patient frustration about specialist referrals may have caused the decline.