Assessing Health Insurance Plan Quality: Survey Development and Research Agenda

By Lawrence, R. Cayce; Peyton, Reginald M. et al. | Journal of Organizational Culture, Communications and Conflict, July 2004 | Go to article overview

Assessing Health Insurance Plan Quality: Survey Development and Research Agenda


Lawrence, R. Cayce, Peyton, Reginald M., Kamery, Rob H., Journal of Organizational Culture, Communications and Conflict


ABSTRACT

Researchers exploring theoretical relationships involving benefit satisfaction, attitudes toward the company providing the benefits, and general attitudes toward the health care industry have not considered how attitudes toward the industry might affect benefit satisfaction. A large manufacturing company commissioned a study of employee attitudes toward its health and welfare benefit plans that include measures of their attitude toward the industry as a whole. Over percent of employees responded to the survey, providing a rich source for future examination. The paper provides an overview of the survey and initial work to assess measures of the three attitudes listed above. Suggestions for developing theory in this domain conclude the paper.

INTRODUCTION

Few would argue that the healthcare industry has problems at every level. Insurers (insurance companies), providers (doctors, hospitals, clinics, etc.), employers (who provide access to insurance to the majority of individuals), government agencies (Medicare, Medicaid, TennCare, etc.) and consumers all report deep concerns about the state of the industry (Abbott, 2003a). Each participant in the chain has its own concern.

Most research and commentary focuses on the problems facing plan designers, providers, and government agencies. Researchers have written considerably less about the challenges facing companies that strive to provide their employees with competitive, high quality benefit packages (Christopher, 2001; Danehower & Lust, 1992; Tremblay, Sire & Balkin, 2000; Williams, Malos & Palmer, 2002). Abbott (2003b) suggests that benefits, particularly health insurance, are not as important as other components of total compensation but they continue to be a critical element in an attractive total compensation package.

Ultimately, human resource managers still believe that, in spite of any negative perception of the industry as a whole, prospective employees consider benefit plans as a key component of overall compensation (Christopher, 2001). Many companies find that morale decreases when employees perceive that they are paying more money for reduced benefits. If, as traditional practice suggests, benefit plans have a significant impact on recruitment, retention, and overall job satisfaction, then companies have a strong motive to assess employee perception of their benefit plan (Abbott, 2003b).

Consultants working with individual companies to design, acquire, and administer benefit plans have a direct interest in how an overall negative perception of the healthcare industry might impact their customers' evaluation of their individual benefit plans. Recently, a large manufacturing company and its benefit plan consultant decided to assess employee perceptions of the company's benefit plan and attitudes toward healthcare in general, their attitude toward the health insurance industry, and their willingness to accept enhanced benefits at an increased cost to them. The research team designed a survey specifically for the interest of the company, but it contained items that raise broader theoretical questions. This paper examines results from that study and makes recommendations about further inquiry into the relationship between broad social attitudes about healthcare and the design of company benefit plans.

LITERATURE REVIEW

The majority of the literature on benefit satisfaction comes from benefit planning practitioners (insurance companies and compensation consultants) and from human resource specialists. Since the radical changes in the health and welfare benefits industry beginning in the late 1980s and early 1990s, there has been little theoretical and empirical work in the area (Christopher, 2001;

Danehower & Lust, 1992; Tremblay et al., 2000; Williams et al., 2002). The research published since 1990 has focused on developing a benefit satisfaction construct (Danehower & Lust, 1992; Williams et al. …

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