If you want some straight answers about HMOs, this guide is just about perfect. Spragins, a health reporter for Newsweek magazine, has compiled a book that is well-organized, easy to use and answers most questions that consumers have about their health plans. Throughout the book, Spragins remains on the consumer's side, continually advising readers how they can squeeze out the best quality from their plans.
Spragins explains why cost, convenience and quality are all important factors in choosing a health plan. But, she says, quality of care "is what keeps you happy." She identifies the qualities in health plans that indicate superior performance. For example, she notes, if many of the plan's doctors aren't accepting new patients--beware. Spragins is not shy about using hard numbers to weed out which plans are better than others.
"We care tremendously, but we don't know how to judge quality," Spragins writes of consumers' struggles to choose good health coverage. "The benefits of becoming a savvy shopper are twofold: You'll get better health care and you'll send a message to the health care industry that quality counts more than anything."
The book details many of the secrets and inner workings of health plans that consumers should know about to be sophisticated shoppers. Spragins also offers advice on how to choose a doctor and how to challenge an HMO. There is a separate section on considerations for elderly people or those with chronic health problems.