NEWSWEEK: Takes Industry’s Pulse, Ranks Plans
In a story accompanying its third annual ranking of the nation's HMOs, the current issue of Newsweek takes a look at the current state of the managed care industry. Despite the conventional wisdom that portrays "HMOs as greedy leviathans that profit by denying patients life-saving treatment," the magazine reports that "[s]ometimes HMOs actually work. The trouble is, they don't work consistently." Arguing that "skimpy benefits are only part of the problem," experts like Lynn Etheredge of the Jackson Hole Group said, "The future of the managed care industry depends on public trust and confidence. The industry has blown that." Newsweek's comprehensive survey, conducted with David Lansky of the Foundation for Accountability in Portland, OR, gave top honors to Harvard Pilgrim, which was singled out for its innovative HIV counseling program.
By The Numbers
An accompanying Newsweek poll of 750 adults indicates that patients in managed-care plans are roughly as satisfied with their health care as those in non-managed care plans. Fifty-eight percent of managed care enrollees were "very satisfied" and 32% "mostly satisfied" with their "overall quality of health care." Sixty-eight percent were very satisfied and 24% mostly satisfied with their "relationship with [their] family doctor or primary care physician," and 51% very satisfied and 34% mostly satisfied with their "access to medical specialists." Newsweek reports that "[t]hose levels of satisfaction are not significantly lower [than] those in traditional health plans." When asked their opinions on proposed laws to regulate HMOs, 92% of managed care enrollees said they would support the "right to choose any family doctor or primary care physician," with 44% willing to pay up to $500/year more and 34% not willing to pay more for such a right. Seventy-nine percent favored a law guaranteeing direct access to medical specialists without a referral, with 42% willing to pay an additional $500 annually versus 38% not willing to pay more. And 83% would support the right to sue their health plans for the denial of coverage, with 40% saying they would pay a premium increase of up to $500, while an equal number would not be willing to pay more. The margin of error for the poll is +/- 4 percentage points.
Stand Up And Be Counted
Newsweek concludes that providing more information to consumers could go a long way toward solving the problems facing the managed care industry. However, the article states, "most health plans aren't compiling the information that consumers need. Worse, many are dodging scrutiny altogether. Some of the largest plans in the country, including Aetna U.S. Healthcare, CIGNA, PacifiCare and Prudential, declined to participate in Newsweek's survey and are dropping out of others. ... Look at HMOs that are willing to step forward and be judged, such as those on our ranking. As other companies realize they're being watched, our choices can only improve" (9/28 issue).
The managed care industry is embarking on an intensive image-rehabilitation campaign with a host of new television commercials from some of the industry's biggest players, today's Wall Street Journal reports.
- Aetna U.S. Healthcare "today launches a $7 million national campaign" that features testimonials from thankful patients who say, "I can tell you about gratitude," and "I can tell you about regaining hope."
- Kaiser Permanente is hitting California, Seattle, Atlanta and Portland, OR, with $10 million in ads that assure patients "their fate will be 'in the hands of doctors' and not insurance administrators."
- The Coalitional for Affordable Quality Healthcare (made up of Aetna, PacifiCare Health Systems, Wellpoint Health Networks, the Blue Cross and Blue Shield Association and the Health Insurance Association of America) will feature ads that tout the expanded preventative services and lower costs that come with HMO membership. The ads come from Goddard Claussen ad agency, known for their Clinton-health-plan-killing "Harry and Louise" spots. The tagline promises "the Health Care You Want at a Price You Can Afford."
The Journal reports that the "ads are timed to hit hard at negative perceptions ... [at a] time of year when millions of workers around the country sign up for health coverage for next year." In a addition to an "uphill" credibility battle, advertising executive Joseph Bruce of Eisner and Associates warns that HMOs run the risk that "some legislator is going to stand up in some public forum asking ... why aren't they spending this money on delivering better health care for the average American?" (Jeffrey, 9/21).
In Louisville, KY, a poll of 350 local physicians indicates that "managed care plans do only an adequate job of providing for patients." The Louisville Courier-Journal reports that doctors gave insurers a "C-", according to Dr. James Redmon Jr., chair of the Jefferson County Medical Society's board of governors. Redmon said "most health plans are 'doing an acceptable job,' but that too often 'their performance falls below acceptable standards.'" According to the medical society, health insurers are "better at guarding money than at providing for the needs of patients." Managed care industry representatives "question[ed] whether the results were representative of the opinions of physicians in Jefferson County ... [b]ut they also said they viewed the survey not as a slam against the managed care industry but as an opportunity to communicate with the doctors." The Courier-Journal reports that the survey only obtained "a response rate of about 18%." The margin of error was +/- 4 percentage points, but for some plans the margin was as high as 24.4 points due to a low number of responses. "Eight of the 13 plans surveyed drew fewer than 30 responses" (Kaukas, 9/21).