Survey: HMOs Boost Customer Satisfaction

HARRISBURG, Pa. – Health maintenance organizations in Pennsylvania improved their customer satisfaction ratings in 2003, but some hospitalization rates increased, according to a state survey released Thursday.

The state’s HMOs largely performed above national averages in terms of patient access to primary care and preventive medicine, according to the survey by the Pennsylvania Health Care Cost Containment Council, an independent state agency that analyzes the finances and quality of hospitals and health care in the state.

Included in the study were the 10 major for-profit, accredited HMOs, which serve millions of Pennsylvanians.

Among the most significant improvements that HMOs made was in providing access to specialists. In 2003, 84 percent of those surveyed said they had no problem seeing a specialist, up from 77 percent in 2002.

Overall, 66 percent gave their HMO plan a good rating, up from 62 percent a year before.

“It suggests that Pennsylvanians are satisfied with the kind of care they’re getting through their HMO plan,” said council press secretary Joe Martin.

Still, 5 percent reported waiting longer than seven days to be treated for an illness or injury, up from 3 percent the year before. The report also showed higher hospitalization rates for various illnesses, including diabetes, lung disease and asthma.

Out of 10,000 customers, 121.7 were hospitalized for diabetes, up from 113.7 the year before. In addition, 4.5 were hospitalized for lung disease, up from 3.9; and 8.8 adults were hospitalized for asthma, up from 6.3.

Martin said the increasing hospitalization rates do not necessarily reflect HMO performance. For instance, he said, diabetes hospitalizations could have more to do with increasing incidence of the disease.

Instead, the hospitalization numbers should be a sign to the HMOs of places that need more attention, he said.

“It’s simply to say that we need to keep focused on this as a public health priority,” he said.

Each HMO has a closed network of physicians to whom its members can go. Those primary-care physicians must approve a member’s visit to a specialist.

More than 3.6 million Pennsylvanians were enrolled in an HMO as of Dec. 31, 2003, the council said. Most received their health care benefits through their employer or from a government-sponsored program such as Medicare.

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On The Net:

Pennsylvania Health Care Cost Containment Council: http://www.phc4.org