Physician Groups Rank UnitedHealthcare Last Again

December 14, 2012

For the fourth year in a row, Medicare Part B has received the highest overall satisfaction score from group practice professionals and UnitedHealthcare has received the lowest score, according to the latest survey on third-party payers conducted by the Medical Group Management Association (MGMA).

Medicare Part B and UnitedHealthcare also took the top and bottom spots, respectively, with regard to other key indicators of a happy business relationship, such as timely and accurate responses to questions, the claims appeals process, and full disclosure of payment policies.

Almost 800 MGMA members rated Medicare Part B, UnitedHealthcare, and 5 other payers — Aetna, Anthem, Cigna, Coventry, and Humana — on a 5-point scale. A score of 5 indicated complete satisfaction and a 1 meant complete dissatisfaction. A score of 3 represented a neutral response.

In terms of overall satisfaction, Medicare Part B received a 3.53, which is halfway between neutral and moderately satisfied. At 2.77, UnitedHealthcare neared neutral but still registered a small degree of dissatisfaction.

Table. Physicians' Overall Current Satisfaction With These Payers

Payer Rating Average
Medicare Part B 3.53
Cigna 3.20
Aetna 3.16
Coventry 3.00
Anthem 2.99
Humana 2.83
UnitedHealthcare 2.77

Key: 1, completely dissatisfied; 2, moderately dissatisfied; 3, neutral; 4, moderately satisfied; 5, completely satisfied.

On the matter of prompt pay, Medicare Part B was number 1 with a score of 3.99. Coventry's score of 3.12 put the company last.

MGMA also asked members how satisfied they were that payers "conduct 2-way, good-faith negotiations during the contracting process." This question excluded Medicare Part B because physicians do not negotiate contracts with the federal program. None of the 6 private insurers escaped the dissatisfaction zone: Cigna took first place with a score of 2.58 and UnitedHealthcare brought up the rear with 2.38.

"They're Very Aggressive"

The MGMA began surveying its members about the performance of third-party payers in 2008. Since 2009, the association has asked members to rate the same 7 payers and posted their national ranking on its Web site.

The MGMA survey is not the only one in which UnitedHealthcare has received poor grades from physician practices. When Medscape asked physicians last year what payer they considered the worst, the biggest vote-getter — at 14% — was UnitedHealthcare. It also topped the list for the highest frequency of claims denial. However, the company received the third-highest number of votes (9%) when physicians were asked to name the best insurer.

In response to the MGMA survey, Daryl Richard, a spokesperson for UnitedHealth Group, the parent company of UnitedHealthcare, told Medscape Medical News that the insurer "is committed to simplifying administrative processes with physicians because we believe that productive, collaborative relationships between physicians and payers are important if we are going to make progress in modernizing our nation's healthcare system."

Richard said that the American Medical Association has ranked UnitedHealthcare tops in the industry for claims payment accuracy for the last 2 years in its annual report card for insurers. The company has beefed up its provider relations workforce and restructured its call center operations to improve communication about individual claims, he added.

UnitedHealth Group was the nation's largest health insurer in 2011 on the basis of premium revenue, according to the National Association of Insurance Commissioners. The provider network of UnitedHealthcare, which consists of 650,000 clinicians and 5000 hospitals, is the largest of any health insurer, according to Richard.

The sheer size of UnitedHealthcare may help explain its low status in the MGMA survey, said Todd Welter, a physician practice management consultant in Denver, Colorado, who specializes in billing and collection.

"Because it's such a big company, it's hard for some providers to navigate," Welter told Medscape Medical News. "I wonder if they're getting to the right people. As a consultant, I've always found them easy to work with."

At the same time, UnitedHealthcare "uses its market dominance as a business tool," he said. "They're very aggressive."

Because of the high volume of claims that physicians submit to UnitedHealthcare, any error rate will stand out even if it does not exceed that for a smaller insurer, Welter noted.