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Naming names: Two surveys' 'best'

MANAGED CARE October 1998. © MediMedia USA
News and Commentary

Naming names: Two surveys' 'best'

MANAGED CARE October 1998. ©1998 Stezzi Communications

Medstat/J.D. Power and CareData Reports recently released separate studies listing "best" health plans. In conducting their joint survey, Medstat, a health care consultancy, and J.D. Power, the marketing company, considered the views of physicians. CareData, meanwhile, sought consumer opinion when developing its list.

Medstat Group/J.D. Power & Associates

Thirty thousand physicians in 22 markets rated 150 health plans on such issues as administration, clinical autonomy and reimbursement. Curiously, while doctors reported widespread dissatisfaction with managed care, they ranked HMOs higher than fee-for-service plans in several markets. Physicians' biggest beef? More than 3 of every 4 told Medstat/J.D. Power that having to justify clinical decisions annoyed them more than anything else.

Market Top-ranked health plan**
Atlanta Kaiser Permanente
Baltimore-Washington National Capitol Area PPO
Boston Tufts Health Plan
Central Valley, California Blue Cross Prudent Buyer PPO
Chicago Blue Cross Blue Shield of Illinois (indemnity)
Cleveland-Akron Medical Mutual of Ohio (indemnity)
Dallas-Fort Worth Prudential HealthCare (indemnity)
Dayton-Springfield, Ohio *
Grand Rapids-Muskegon, Mich. Priority Health
Hartford, Conn. ConnectiCare
Houston-Galveston United HealthCare PPO
Indianapolis *
Kansas City, Mo.-Kan. *
Lansing, Mich. Blue Cross Blue Shield of Michigan (indemnity and PPO)
Los Angeles-Orange County Blue Cross Prudent Buyer PPO
Memphis Baptist & Physicians PPO
New York City United HealthCare
Northern New Jersey Oxford Health Plans
Philadelphia Personal Choice PPO
Phoenix Blue Choice
San Francisco Kaiser Permanente
Southeast Michigan Blue Cross Blue Shield of Michigan (indemnity)
* No single plan stood out in this market.
** Plans listed are HMOs unless noted. PPO = preferred-provider organization.

CareData Reports

CareData released two lists — one for commercial plans, the other for Medicare risk HMOs. The commercial survey evaluated satisfaction with 145 HMOs and point-of-service plans in 27 markets, while the Medicare inquiry reviewed 42 Medicare risk HMOs in 20 markets. Both examined members' perception of adequacy of care for specific conditions and preventive care, satisfaction with pharmacy benefits and reasons for joining and leaving plans. The top performers in markets where multiple plans were evaluated:

Top Medicare risk HMO Market Top commercial HMO Top commercial POS plan
Cigna HealthCare for Seniors Arizona Cigna HealthCare United HealthCare
Atlanta Kaiser Permanente Blue Cross/Blue Shield
NYLCare 65 Baltimore-Washington Free State Aetna U.S. Healthcare
Harvard Pilgrim First Seniority Boston Tufts Health Plan Tufts Health Plan
HealthCarePlan Senior Choice Buffalo
Dallas-Fort Worth Prudential HealthCare Prudential HealthCare
Kaiser Permanente Senior Advantage Denver Kaiser Permanente
Detroit Health Alliance Plan
Long Island Vytra Healthcare Oxford Health Plans
Milwaukee PrimeCare
AmeriHealth65 New Jersey
HIP VIP New York City Physicians Health Services Oxford Health Plans
Kaiser Permanente Senior Advantage Northern California Lifeguard United HealthCare
Keystone 65 Philadelphia Keystone Health Plan East
HealthAmerica Advantra Pittsburgh
Portland, Ore. Providence Health Plans
Seattle Group Health Cooperative/Kaiser
* South Florida AvMed Health Plan
Kaiser Permanente Senior Advantage Southern California
GHP Advantra St. Louis
† Not applicable.
* Only one plan in market evaluated.

SOURCES: THE MEDSTAT GROUP, ANN ARBOR, MICH., 1998; CAREDATA REPORTS, NEW YORK, 1998

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