Health maintenance organizations won top ranking for consumer satisfaction over less restrictive forms of coverage in half the markets surveyed for a new study.
The survey of 81,000 enrollees on issues such as choice of doctors and confidence in a plan's ability to provide services gave HMOs top ranking in 10 of 20 markets in the study by the Medstat Group, J.D. Power & Associates and New England Medical Center.
"We were surprised at how well they performed, given what you read in the media" about consumer dissatisfaction with HMOs, said Dennis Becker, senior vice president of the Medstat Group, a health-care research and consulting company based in Ann Arbor, Mich.
The survey asked people in 181 health plans to rate the quality of their coverage. Overall, 11 HMOs received the highest marks. None of the ranked plans were in California. That compares with top ranking in seven markets for less restrictive types of health coverage, including traditional fee-for-service coverage. In three markets, no winner emerged or not enough plans were represented to choose one.
The study raises the possibility that legislating wider consumer choice of doctors may not necessarily improve patient satisfaction. "It's tough to regulate specific aspects of the solution," Becker said.
One legislative provision opposed by the health insurance industry would guarantee people in HMOs some coverage for visits to doctors not affiliated with their health plans. The option is known as a point-of-service plan, and many HMOs now offer the policy in response to consumer demands for more freedom to choose their doctors.
Legislation backed by President Clinton would require the point-of-service option be made available to people whose employers offer only HMO coverage.
In the survey, however, only one point-of-service plan was ranked the top plan in its market--one run by United HealthCare Corp. in the Dallas-Fort Worth market. In fact, HMOs scored slightly better on average with consumers than point-of-service plans on choice of doctors and on availability of services and specialists.
Medstat didn't make public the performance of the health plans other than to disclose the top-ranked plans in each market. It plans to sell the details of the survey to health plans and employers who buy coverage for their employees.
Agoura Hills-based J.D. Power, which acted as a consultant on the project, made its name by operating in a similar fashion with the auto industry. "By giving the measures back to the [auto] manufacturers, they knew where to concentrate," on making improvements, said J.D. Power III, chairman and founder of J.D. Power.
"It's important for [health] plans to start looking at what customers are expecting," he said.
HMOs winning top ranking in their markets were Harvard Pilgrim in Boston; HMO Illinois in Chicago; QualChoice in Cleveland and Akron, Ohio; United Healthcare Corp. and Health Maintenance Plan in Dayton and Springfield, Ohio; Priority Health in Grand Rapids and Muskegon, Mich.; ConnectiCare in Hartford, Conn.; United Healthcare in Houston and Galveston, Texas; Physicians Health Plan in Lansing, Mich.; Oxford Health Plans in New York and Care Choices in southeast Michigan.