Kaiser ‘Staff Model’ HMO Ranks High in Patient Survey
Integrated models of health plans tend to generate fewer complaints from members, according to a survey prepared by the School of Public Health at the University of California-Berkeley. Conducted for the California Managed Health Care Improvement Task Force, the survey asked 1,200 insured adults about their complaints regarding HMOs, PPOs and a "staff model" HMOs, such as Kaiser Permanente, which own their own provider infrastructure. Of the three types, respondents said that models such as Kaiser's were "easier to manage." Those with PPOs or HMOs said they often "misunderstand their benefits," while Kaiser members did not have "such problem[s]." In addition, the survey found that Kaiser members can "generally be taken care of" when they "show up" at their doctor's office. Although the survey showed that respondents preferred the Kaiser model over PPOs or HMOs, members of the staff model HMO did have complaints about "not receiving the most appropriate care" and experiencing delays in receiving treatment. In addition, Kaiser's "closed model," which requires patients to stay within the Kaiser network, poses "a problem for some members." Helen Schauffler, the study's author and a health insurance policy expert, called the Kaiser model "much easier to manage [than most HMOs]" because it does not "have a gatekeeper" and patients do not "need approvals for treatment" (May, Silicon Valley/San Jose Business Journal, 1/15).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.