HEALTH PLAN RATINGS: U.S. News Publishes Rankings
U.S. News and World Report used the NCQA database and methodology from the University of Chicago's National Opinion Research Center to offer "the broadest, most comprehensive state-by-state comparison of managed care plans available." The analysis broke down 271 HMO and POS plans using 28 measures related to quality of care (U.S. News release, 9/23). In composing the composite scores, NORC weighted the quality measures as follows: Prevention, 45%; Adults' access to care, 20%; Member satisfaction, 14%; Physicians' credentials, 12%; and Children's access to care, 9%. The rankings (ranging from zero to four stars) will hit the news stands Monday, but are available now at: www.usnews.com/usnews/nycu/health/hetophmo.htm. A selection of the best and worst plans in selected states:
- California: the top plan was Kaiser Foundation-Southern California, with four stars; the plan with the lowest ranking was InterValley Health Plan, with one star.
- Colorado: Kaiser Foundation-Colorado and Rocky Mountain HMO got three-stars each, while United HealthCare of Colorado came in last in the ranking, with one star.
- Florida: AvMed Health Plans of Central and North Florida took the top spots in the state with three stars; United HealthCare of Florida Choice Plus-Pensacola was at the bottom, with one star.
- Illinois: The state's only four-star plan is Health Alliance Medical Plans. Aetna U.S. Healthcare-Illinois ranked at the bottom with one star.
- Massachusetts: Fallon Community Health Plan, Tufts Health Plan, Harvard Pilgrim Health Care and Healthsource Massachusetts-Cigna finished in a virtual tie at the top, three of the state's nine four-star plans; Aetna U.S. Healthcare-Massachusetts (HMO) finished at the bottom, with two stars.
- New York: Finger Lakes-Blue Choices was the top plan, one of nine four-star plans in the state; Aetna U.S. Healthcare-New York (POS) ranked lowest, with one star.
- Texas: Kaiser Foundation-Texas was the state's top plan, with three stars; NYLCare of the Gulf Coast's HMO and POS tied for the bottom spot, with one star.
Click here to see U.S. News' honor roll of four-star plans. One surprise that emerged from the analysis was "the weak relationship between a plan's score and its accreditation status. While it may be logical to assume that plans with full or 1-year accreditation would outperform plans with lower status," U.S. News reports "it didn't work out that way" (Comarow, 10/5 issue).
In other quality assessment news, the state of Utah released a survey of 4,500 state residents that showed 75% of respondents were "completely" or "very satisfied" with their managed care plan in 1997. This number represents a 5% drop from 1996, the Salt Lake Tribune reports. The primary problem enrollees reported with their HMOs was "receiving medical care after hours, evenings and on weekends," 25% "rated the overall quality of their medical care and services as 'excellent'" and "[s]lightly more than half" of respondents "would recommend their HMO to family and friends." The survey is available at www.healthdata.state.ut.us (Wagner, 9/24). Separately, the Boston Globe reports that a survey of 1,685 Massachusetts physicians found a high degree of "dissatisfaction with the quality of mental health care provided by HMOs, as well as the managed care industry's use of financial incentives to mold physician behavior." Other physician gripes included the "quality of information HMOs give consumers, and ... the plans' ability to coordinate care between specialists and primary care physicians" (Pham, 9/24).