Do you know what members really want?
Check out results of national survey
Managed care remains under attack from legislators and consumer groups. Yet health maintenance organizations (HMOs) are holding their own in the health care quality debate, according to a recent national study of health plan performance by the MEDSTAT Quality Catalyst Program. MEDSTAT Quality Catalyst is an independent consumer study by the MEDSTAT Group in Ann Arbor, MI, J.D. Power and Associates, and the New England Medical Center in Boston.
The annual survey compared consumer ratings of plan performance for HMOs, traditional fee-for-service plans, and preferred provider organizations. HMOs comprised less than 50% of the plans profiled in the study but achieved top ranking in more than 61% of the markets.
The 1998 study surveyed 81,000 plan members who were asked to rate 181 plans in 20 markets nationwide. Members evaluated 11 plan performance categories. Results show the following four categories are most important to members in determining plan performance:
o Provider choice. This was defined as an adequate number of quality physicians from which to choose and ease of making a selection. More than 17% of members surveyed said this was the most important factor in plan selection and satisfaction.
o Confidence in plan. This was defined as confidence or trust that the plan will provide needed services in the future, including serious or catastrophic health situations. Nearly 13% of members surveyed said this was the most important factor in selection and satisfaction.
o Physician care. This was defined as attentiveness of physicians, case managers, and other health care professionals working on behalf of the plan. More than 12% of members surveyed said this was the most important factor in plan selection and satisfaction.
o Time pressures. This was defined as appearance of physicians and staff being rushed or overworked. Of the members surveyed, 12% said this was the most important factor in plan selection and satisfaction.
Members viewed the following factors as less important in influencing their health plan selection and satisfaction:
· Less than 8% rated "access to care" most important.
· Less than 8% rated "customer service" as most important.
· Only 7% rated "personal cost" as most important.
· Less than 7% rated "limits on care" most important.
· Roughly 5% rated "waiting time" most important.
Case managers can access more details about the study on line at www.betterhealth.com.