Surveys Seen as Aid to Paring HMO Costs : Health: By polling workers on their satisfaction, employers hope to reduce the number of plans and to better monitor quality.
Employers will increasingly use consumer satisfaction surveys to help winnow down the list of health maintenance organizations they offer their workers, the president of the California Business Group on Health said Tuesday.
The surveys are critical because employers will want to reduce the number of HMOs to simplify the administration of health-care benefits, Bank of America Vice President Clark Kerr told a group of HMO representatives meeting in Los Angeles.
Health-care consultants say employers also believe that by trimming the number of options they can better monitor quality.
Employee satisfaction, the cost of providing a plan and the number of employees enrolled will be factors determining which plans are eliminated, Kerr added.
Bank of America has dropped seven HMOs and will likely eliminate more of the remaining 32 it offers employees, he said. Consumer satisfaction was a factor in deciding to eliminate the seven, he added.
The panel discussion on consumer surveys was not the only cautionary news the delegates attending the Group Health Assn. of America’s annual meeting were given this week. The association is the major professional organization of the nation’s HMOs. Results of a survey presented Monday showed a wide gap between what the HMO executives said they were doing to improve quality and how their efforts were perceived by doctors associated with the HMOs and employers that buy their services.
The focus on HMO quality comes as the number of patients served by HMOs continues to grow modestly but also as HMOs are increasingly seen as a disappointment among employers who hoped they would lower health-care costs and improve quality. The most common complaint from employers is the inability to get the information they need from HMOs to judge quality.
More employers and more HMOs are directly surveying the members of the plans. In a small number of HMOs, the survey results are used to help determine bonuses for doctors.
Kerr said a group of 10 San Francisco Bay Area employers sponsored joint surveys of their workers enrolled in a total of 73 health plans in 1987 and 1989. The companies included B of A, Bechtel, Chevron and Wells Fargo. The survey will be repeated, with the possible inclusion of Southern California aerospace employers TRW and Hughes Aircraft, he said.
The employers have used the data to make decisions and are considering giving specific, detailed information about how specific plans rank to workers, Kerr said. “If companies present these performance charts to workers, it is going to make a difference in enrollment,” he added.
The biggest differences in the perceptions of plans’ quality were not between HMOs and the traditional fee-for-service indemnity plans but among the HMOs themselves, he explained. “We had some real stars and some real dogs,” he said.
For example, he said, when enrollees were asked if they could get medical advice over the telephone from their medical plan within 15 minutes, 27% of fee-for-service patients said yes and 34% of HMO patients said yes. But the range among HMOs was between 59.5% and 9.1%.
