Little HMOs Win Big in Consumer Survey : Health care: Smaller plans in California come out on top in first comprehensive study to be made public.
Much like the shopper who prefers the friendliness and convenience of the neighborhood grocer to the giant supermarket, many health care consumers apparently think smaller is better, according to a survey released Wednesday.
Small health maintenance organizations such as little-known Health Plan of the Redwoods got higher marks than larger, better-known rivals such as Kaiser Permanente and PacifiCare Health Systems in the first comprehensive consumer “report card” of California health plans to be made available to the public.
The survey conducted by the Bay Area Business Group on Health, an insurance-purchasing coalition of 20 major California employers, involved 27,000 employees and retirees of 10 large California-based corporations, including Chevron Corp., Hughes Aircraft Co. and Rockwell International Corp.
The survey is part of a broader, fast-growing movement among corporate America to collect more information about the performance of health care plans so consumers can comparison-shop for health care as they do for automobiles or stereos.
Many medical specialists view consumer surveys as a useful, if imperfect, way of measuring the quality of health insurance plans. Some caution that while consumers may be quite capable of evaluating an HMO’s customer service personnel or doctor’s office waiting times, they are not necessarily good judges of the quality of medical care they receive from physicians.
Although BBGH has been conducting HMO surveys for five years, it, like many large corporations conducting similar surveys, had not previously made results public.
Like a student’s report card, the BBGH survey gave the health plans letter grades of A, B or C. Unlike a student’s report card, C was the lowest grade possible; the group chose not to give out Ds and Fs.
Health Plan of the Redwoods, a mere sapling among California’s HMO giants, had the most satisfied members, notching straight A’s in four satisfaction categories. Of the 17 HMOs surveyed, it was the only one to receive an A+ in any category.
The Santa Rosa-based HMO, with just 85,000 members, contracts mostly with small employers--wineries, high-technology firms and the like--in Sonoma, Marin and Mendocino counties, marketing director Chuck Gardner said.
“Being smaller places us closer to the patient,” he said. “We try to encourage our doctors to maintain that one-to-one patient-doctor relationship.”
Tracy Rodriguez, associate director of BBGH, said smaller regional plans have tended to rate higher in previous surveys.
“On the other hand, some of these smaller plans are more expensive and aren’t offered by large employers who want a statewide network,” she said. She noted, however, that the price gap among the HMOs has been narrowing.
Kaiser Permanente, a giant HMO frequently touted as a national model of low-cost, quality care, ranked in the middle of the pack for both its Northern and Southern California regions. Kaiser, however, got A’s from its members on the quality of its preventive and health improvement programs.
Dr. Joel Hyatt of Kaiser-Southern California said the survey results highlight areas that Kaiser recognizes as weaknesses of its vast network.
“In this heated marketplace, there are things we need to do to improve,” he said. Hyatt noted that Kaiser was one of several health plans that worked with the San Francisco-based business group to develop the survey.
Overall, the survey found that HMOs excelled in health education and preventive health services, such as stop-smoking programs or childhood immunization rates. It also found that members of less-restrictive health plans, known as preferred-provider organizations, were more satisfied with their doctors and the quality of physician specialists.
BBGH members said they will use the results to evaluate the health plans they offer workers; they will also use the data to prod HMOs to improve problem areas.
The survey, administered by management consultant William M. Mercer, was sent to employees and retirees of 10 organizations. Other participants included Bechtel, the California Public Employees Retirement System, the Federal Reserve Bank of San Francisco, Fireman’s Fund, the University of California and Union Bank.
Grading the HMOs
The Bay Area Business Group on Health, a private insurance purchasing coalition, surveyed 27,000 employees and retirees of 10 major California employers to measure their satisfaction with their health plans. The rankings listed below grade the health plans in four categories: an overall grade for the plan, the doctor that members see most frequently--usually a primary care physician, hospital care and the plan’s preventive care services, such as smoking cessation or injury prevention programs.
Hospital Preventive HMO Plan grade Doctor care health Aetna HMO C B A B Blue Shield B B C B Cigna B B B B California Care B B C- C FHP C B B B Foundation B A B B HP of Redwoods A+ A A A Health Net B B B B Kaiser North B C C A Kaiser South B C B A Lifeguard A A A C Maxicare C C C B Omni A B B C PacifiCare C C B B QualMed B B A C TakeCare B B B B ValueCare A A B A
Explaining the grades: According to the Bay Area Business Group on Health, HMOs that scored in the top 25th percentile received an A. Those scoring in the lowest 25th percentile got a B. Unusually high scores merited an A+, and unusualy low scores were given a C-.
Source: Bay Area Business Group On Health
