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Kaiser, Lifeguard Top Survey of HMOs

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TIMES STAFF WRITER

Members of health care giant Kaiser Permanente and a small Northern California-based health plan are the most satisfied with their medical coverage, according to a survey by a group of major California employers.

In an annual HMO “report card” released by the Pacific Business Group on Health, an insurance purchasing cooperative, Kaiser and Milpitas-based Lifeguard Inc. received grades of A for members’ overall satisfaction with their health plan and with the plan’s doctors.

The Pacific Business Group is a San Francisco-based employers consortium that jointly negotiates for medical coverage on behalf of about 2.5 million people. The group uses its size as clout with insurers to negotiate lower medical premiums and to push for improvements in service. Employers in the group include Bank of America, Chevron, Lockheed, Pacific Telesis and the University of California.

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None of the other 10 health plans received A grades for overall member satisfaction. However, members of all but three health plans gave their doctors an A rating.

Only two HMOs--CaliforniaCare, a Blue Cross of California subsidiary, and the MetLife HMO--failed to receive an A grade in either measure of overall member satisfaction. (The MetLife plan was renamed MetraHealth after a recent merger.)

Most of the plans received A or B grades in preventive health care services--an area in which HMOs claim to place more emphasis than traditional health insurers. The lowest marks in preventive health care were recorded by Aetna’s Southern California HMO, which received Cs in preventive screening and counseling services.

The plans scored mostly A or B grades when members were asked how satisfied they were with their doctors.

But the members were much less satisfied with their plans’ procedures for getting referrals to physician specialists, with none of the plans earning an A.

In a separate survey of HMO members in five regions, including Southern California, researchers concluded that HMO members are generally satisfied with their medical treatment.

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More than 80% praised the HMOs for their treatment of conditions such as pregnancy, high blood pressure and asthma, but only half said they were satisfied with the HMOs’ concern for their well-being, according to a survey of 10,000 HMO members released by CareData Reports, a New York-based health care information company.

The toughest critics were usually the ones who used the HMOs the most because they were the sickest, said CareData President Tod Cooperman.

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