HMO QUALITY: Survey Says CA Plans Need ‘Emergency Attention’
A new Consumer Reports survey of HMO customer satisfaction levels has ranked several California plans among the lowest in the nation, the San Diego Union-Tribune reports. "California's HMOs need emergency attention," Consumers Union Policy Analyst Diana Bianco said. The report ranks 54 HMOs based on various consumer satisfaction measures, including percentage of enrollees that experienced problems accessing needed care. The measure most closely correlated with overall plan satisfaction was the plan's "ability to resolve complaints and questions." California-based Prudential, Blue Shield, Cigna Health and FHP all ranked near the bottom of the list, and Foundation Health -- integrated into Health Net in 1998 -- ranked dead last. Ron Yukelson, Health Net spokesperson, said, "I would caution consumers not to use this as their only criteria in making decisions." He was joined by other health plans in noting various weaknesses, such as over-reliance on customer satisfaction to determine care quality, in the study. On the up side, Kaiser Permanente of Southern California ranked eighth overall, "within a cluster of higher-ranked regional Kaiser plans, which are nonprofit."
Bianco said the survey should send a "strong signal" to California legislators. She noted that 26 states have passed external review legislation, and several more states have laws permitting HMO members to sue their plans. "Our state lags behind others in consumer satisfaction and protection,"Bianco said, adding, "The governor and Legislature have an opportunity to improve the situation and should act."
The Union-Tribune notes that the study comes on the heels of this week's Harvard University-Public Citizen study, which found that not-for-profit HMOs score higher than for-profits on 14 quality-of-care indicators. The new Consumer Reports study, while admittedly less comprehensive, similarly noted that the best-rated HMOs are not-for-profit plans "with years of experience," while the worst-rated are for-profits "run by hospitals or insurance companies." The survey appears in the August issue of Consumer Reports magazine (Rose, 7/15).