Health Plans
A majority of insured California residents report being satisfied with their health care experiences, but many do not receive preventive services appropriate for their age, gender or disease condition, according to a University of California-Los Angeles health policy research brief.
Researchers examined data on insured individuals age 64 and younger from the 2003 California Health Interview Survey to determine their satisfaction with health care and their use of preventive services. About 96% of the individuals rated their health care experiences as a five or higher on a 10-point scale, and nearly 4% reported low satisfaction with their health care. HMO members were more likely than PPO members or people who receive health care services on a fee-for-service basis to rate their health care satisfaction as fair or low, according to the brief.
The authors also found that Medi-Cal or Healthy Families beneficiaries whose benefits are administered by an HMO have higher screening rates for breast, colon and prostate cancer than beneficiaries whose benefits are administered by a PPO or are provided on a fee-for-service basis. In addition, residents enrolled in private or employer-sponsored HMOs have higher rates of preventive asthma care and screenings for breast and colon cancer than members of private or employer-sponsored PPOs. People enrolled in private or employer-sponsored PPOs had higher screening rates for prostate and cervical cancer than private or employer-sponsored HMO members.
According to researchers, many insured individuals are not receiving necessary health services, and some have problems accessing care. Researchers recommend that the Health Plan Employer Data and Information Set, which allows consumers to compare HMO plans' performance on different measures, be expanded to include other preventive services. The expansion might increase the use of preventive services for all types of insurance plans, the brief states (Kominski et al., UCLA Health Policy Research Brief, June 2006).