HEALTH PLAN RANKINGS: Highlights From Newsweek
The current issue of Newsweek ranks the nation's health insurance plans, examining HMO and POS plans on three criteria: performance, defined as "keeping members healthy, treating acute illness and managing chronic conditions,"; member satisfaction and accreditation by the National Committee for Quality Assurance. The survey, conducted with the assistance of the Foundation for Accountability, received no response from several prominent health plans in many states, including Aetna U.S. Healthcare, Cigna Healthcare and Prudential. The top ten plans based on performance were:
- 1. Harvard Pilgrim Health Care, MA
- 2. Tufts Health Plan, MA
- 3. HMO Blue, MA
- 4. Blue Choice, Rochester, NY
- 5. Group Health Cooperative of Puget Sound, WA
- 6. United Healthcare of New England, RI
- 7. Kaiser Foundation Health Plan of Hawaii
- 8. Healthsource Massachusetts
- 9. Anthem Blue Cross and Blue Shield of Connecticut
- 10. United Health of Wisconsin
Plans ranking in the bottom five of the performance list:
- 92. United HealthCare of Florida
- 93. Physician's Health Plan of South Michigan (HMO)
- 94. Healthplan Southeast Inc., FL
- 95. Physicians' Health Plan of Southwest Michigan
- 96. Physicians' Health Plan of South Michigan (POS)
Newsweek also graded 62 of the nation's Medicare HMOs. Noting that as "most of the plans are new, and just beginning to track their own performance ... [t]hese rankings reflect the plan's success at treating and managing illness, but not their efforts to prevent it." The top five plans:
- 1. First Seniority, MA
- 2. Fallon Senior Plan, MA
- 3. First Seniority, RI
- 4. HIP VIP, NJ
- 5. Kaiser Foundation Health Plan, Fresno, CA
The bottom three Medicare HMOs were:
For more coverage of Newsweek's report on managed care, see yesterday's California Healthline.
You Go, Massachusetts!
The Boston Globe reports that the state of Massachusetts' prominence in the Newsweek rankings -- earning the three top spots, and four of the top ten -- can be explained by the fact that "New England is home to some of America's premier hospitals and doctors." However, the quality comes at a cost: benefits consultant Susan Connolly of William Mercer noted that Massachusetts is "among the most expensive states in the country based on per capita health care costs." Modern Healthcare data show that "[m]onthly premiums in the Boston area are nearly $100 higher for each family than the national average." The wealth of facilities and providers in the area "tends to deprive health plans of some leverage in bargaining for volume discounts with health care providers." Massachusetts HMOs, which have come "under heavy attack by angry consumers and regulation-minded politicians," warmly greeted the rankings when they were released yesterday. Harvard Pilgrim spokesperson Patti Embry-Tautenhan said, "There is a lot of negative press about HMOs and subsequent public distrust. So, I hope [the Newsweek] article and survey reassures people that, at least in Massachusetts, health care decisions are being made based on what constitutes quality care" (Pham, 9/22).
Can't Have It Both Ways
In an essay accompanying the Newsweek rankings, columnist Robert Samuelson argues that unrealistic and contradictory goals -- wanting "unlimited medical care without unlimited spending" -- are at the crux of the current debate over patients' rights and managed care. Put another way, "we want limits for society as a whole, but not for any of the individuals in it." Samuelson states, "Managed care is controversial because, in trying to control costs, it challenges the idea that more health care is always better. ... The United States almost certainly now has a surplus of both doctors and hospitals. ... Managed care has exploited the doctor surplus by negotiating lower reimbursement rates. It has done the same with hospitals and intensified pressure for underused facilities to close. This makes economic sense, but most Americans don't view health care the way they see the auto industry: they don't want their local hospitals shut." Concluding that "managed care didn't create the dilemma" of unlimited care equaling unlimited costs, and that "it would exist even if managed care disappeared," Samuelson submits that if Americans don't face the problems ahead -- such as the looming demographic impact on Medicare -- "[w]e will remain hostage to our own optimism that all things are possible" (9/28 issue).