Market Overview

HealthMine Survey: 71% of Medicare Plan Members Not Informed When Providers Drop Out of Network


HealthMine Survey: 71% of Medicare Plan Members Not Informed When Providers Drop Out of Network

Only 22% of Medicare members responded that their health plan follows up with them on the quality of care after a provider visit

PR Newswire

DALLAS, Aug. 19, 2018 /PRNewswire/ -- Seventy-one percent (71%) of Medicare health plan members say their plan does not inform them if a provider drops out of the health plan's provider network. Providers include hospitals, doctors, labs, and imaging centers.  And, just 22 percent of respondents said their health plan follows up with them on the quality of care after a provider visit.  The results are according to a HealthMine survey of 781 Medicare plan members.  

HealthMine, Inc. (PRNewsFoto/HealthMine, Inc.)

The survey also revealed that 90 percent of Medicare members said their doctor, or other professional care provider, knows them best to help manage their health.  However, only 18 percent of respondents said that their health plan provides all health information to their doctor before a visit including prescriptions, medical history, and information collected from digital health tools.

Survey data showed that 70 percent of Medicare health plan members use digital health tools, including blood pressure monitors, fitness trackers, medication/pill trackers and more. 

Questions from Survey:

Q:  Does your plan notify you if your past or current providers drop out of your network (providers include hospitals, doctors, labs, and imaging centers)?

  • Yes
  • No


Q: Does your health plan interact with you after a provider visit?

  • Only about coverage/bills/claims
  • Yes…to follow up on quality of care
  • No


Q:  Does your health plan provide all of your information to your doctor before a visit (prescriptions, medical history, information collected from your digital health tools, etc.)?

  • Yes
  • No, but would like them to
  • Not sure


Q:  Which of the following do you think knows you best to help you manage your health?

  • Doctor/other professional care provider
  • Relative
  • Health Plan
  • Friend/Home Health Aid


According to Bryce Williams, president and CEO of HealthMine, "Medicare members are inextricably connected to their doctors.  Plans are first to know about providers in the network. Plus, plans are much more than claims processors – they are the central hubs of members' health information. In this central role, plans have the knowledge to communicate with members in a timely manner about plan changes.  The Medicare Advantage plans that are at 4 and 5 Stars typically excel at member communication," he said.  

About the Survey 
The HealthMine Medicare Survey queried 781 insured age 65+ consumers with a chronic condition who are enrolled in a Medicare Advantage and/or Supplemental plan. The survey was fielded by Survey Sampling International (SSI) in June/July 2018. Data were collected via an opt-in panel. The margin of error was three percent (3%). Survey Sampling International (SSI) has been the Worldwide Leader in Survey Sampling and Data Collection Solutions, across every mode, for more than forty years.

About HealthMine 
HealthMine is the only member-centric clinical technology company with a platform built inside a Value-Based Insurance Design (VBID) health plan. It is specifically designed to identify risks earlier and close gaps in care faster. The HealthMine solution consists of Automatic Health, a clinical analytics platform, that generates insights and recommendations. It includes Opportunity Manager, an application that gives plans continuous access to data, insights, and recommended interventions generated by the clinical analytics platform, prioritized by projected revenue and cost savings opportunities and the Personal Health Assistant consumer application that empowers plan members to manage their health. HealthMine is on the web at


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SOURCE HealthMine, Inc.

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