MANAGED CARE: Statewide Survey Gives Low Marks to Area HMOs
A recent survey of California physician organizations and hospitals rated eight of the state's largest HMOs as "less than adequate," the Sacramento Bee reports. Jim Lott, a spokesperson for the Healthcare Association of Southern California, said, "No health plan -- not one -- is performing adequately in collaborating and cooperating with hospitals and physicians" (Fisher, 6/28). The Healthcare Association of Southern California was a co-sponsor of the "2000 HMO Performance Assessment Survey Report" along with the Pacific Business Group on Health and the California Association of Physician Organizations (Metinko, Contra Costa Times, 6/27). Responses from 154 hospitals and 85 physician groups were tallied to evaluate Aetna U.S. Healthcare, Blue Cross of California, Blue Shield of California, CIGNA, HealthNet, Maxicare, PacifiCare and United Healthcare (Sacramento Bee, 6/28). Of the eight plans, hospitals and physicians gave top numbers to PacifiCare. Blue Cross received the lowest scores from hospitals, and physicians gave the lowest marks to Maxicare (Rose, Santa Rosa Press-Democrat, 6/28). Michael Chee, a spokesperson for Blue Cross, said, "We are aware of the issues and concerns on the provider side and we do take them seriously." He noted that the company has launched a statewide effort to improve its relationships with providers. Maxicare is also "redesigning its systems to be more user-friendly," Dr. Alexander Bokar, the company's medical director, said. All plans surveyed scored their highest marks in the area of payment, with most respondents reporting that the plans pay monthly capitation rates with "adequate" accuracy and timeliness. Areas of greater concern included plans' effectiveness at communicating with doctors and hospitals, including their slow responses to questions, insufficient notice about benefit changes and an unwillingness to resolve conflicts. Bobby Pena, vice president of communications for the California Association of Health Plans, said, "We're all aware of the problems. The only way we're going to solve these problems and improve the system is to get together and talk it out" (Sacramento Bee, 6/28).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.