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2016 Trust Index Results

This year marked an important shift in our Trust Index. For the first time, we asked health plan executives to rate providers on key issues of trust. And unlike years past, we decided not to release the individual trust scores of the brands we surveyed.

We did this because: a.) rating providers is a little trickier than health plans since there are no truly national health systems that allow for national ratings; and b.) we saw an important opportunity to focus on what we’re now calling the Trust Gap between and among these foundational business relationships in healthcare, specifically health systems, health plans, and physicians.

The Trust Gap serves as our industry’s most exhaustive 360-degree examination of the environment of trust between healthcare’s key business stakeholders.

By focusing on the Trust Gap, we can begin to better understand what’s driving that gap and deploy strategies to close it.

What is interesting to note, however, are some high-level trends that rose to the surface this year for individual health plan brands, particularly among those that have historically fared well.

Throughout the 10 years that we’ve been conducting this research among hospitals and health systems, three plans have always scored among the top: Cigna, the independent Blues plans (which we score in the aggregate), and Aetna.

A couple of outliers among health plans this year were Aetna and the independent Blues. You can see the full results for this year here.

Across the board, hospital executive trust scores of health plans very modestly improved, while physician trust scores of the same plans were down, although not dramatically.

Aetna showed the single largest improvement in a year compared to any health plan in the history of the survey. Conversely, the independent Blues plans had the biggest movement down by any one plan that the survey has ever measured.

To us, this suggests that the strategies Aetna implemented in various markets across the country in a spirit of collaboration – from ACOs to innovative provider partnerships, models of care delivery, and payment – are making a marked difference in the trust that providers have in the health plan.

Given Aetna’s big move up, we were especially curious what the implications might be on the health plan if and when its merger with Humana is approved by the Department of Justice. Although not scientific, we conducted a live poll during our Trust Index webinar last week and were pretty shocked by the results.

Trust Poll

When we asked the 250 participants if they thought the Humana acquisition would have a positive, negative, or neutral impact on Aetna trust scores, 78 percent of respondents said it would have a negative impact.

Of course, there are many factors driving Aetna’s bid to purchase Humana. Yet should the merger go through, the combined company’s standing with healthcare providers should be a top-of-mind consideration for both organizations’ leaders, especially when you consider the recent gains Aetna has made.

Something else that caught our attention this year was the large delta between the best and worst rated health plans. This year’s results showed a 23-point delta between the two, with the worst-rated health plan receiving a 40.4 (on a 100-point scale) and the best-rated receiving a 63.3. We’re not talking about subtle differences in trust. We’re talking about a massive difference.

What this tells us is that the market forces at play in healthcare have serious implications for healthcare brands and their ability to partner and attract new customers. It also tells us that within each of these organizations, there are huge opportunities to be better, to communicate better, and to work together better toward the holy grail of value-based care and reimbursement.

We can’t look at this and say, “Oh, they’re all the same,” or conclude that the problems are so ubiquitous they can’t be solved.

This shotgun marriage of key B2B stakeholders has real implications on consumer attitudes toward our healthcare system and toward individual brands within it. This is not healthy for the industry or sustainable unless it is improved over time.

For years, we’ve watched the erosion of consumer trust in the healthcare system. Now that we have better insight into the Trust Gap that exists among healthcare’s key business stakeholders, we can start to close it – which we think will help improve consumer trust in the healthcare system, too.

February 8, 2018
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