NJ and IL issue HMO performance reports

The states of New Jersey and Illinois recently issued performance reports rating the HMOs in their respective states. Each state reports negative outcomes, including financial loss and performance inadequacies.

The state medical association in Illinois says that the 42 operating HMOs in its state had a net loss of $92 million. Individual HMO financial performances are listed in the 1997 Guide to Illinois Health Maintenance Organizations, issued by the Illinois State Medical Society, based in Springfield, IL. The guide includes the HMO plans’ medical expense ratios, administrative costs and profits, premium costs, utilization data, and member complaints.

According to administrators in New Jersey’s Department of Health and Senior Services based in Trenton, NJ, five out of the 27 measures studied — screening for breast and cervical cancer, providing prenatal care during the first trimester, giving checkups to mothers within 6 weeks of delivery, and immunizing children by age 2 — had below national and regional averages. The report includes information from the New Jersey HMOs, the National Committee for Quality Assurance, and results of a consumer satisfaction survey of 5,500 New Jersey HMO members.