Web report compares 14 HMOs for consumers

[Take a look at the Web site. - lvt] Web report will compare 14 HMOs for consumers BY MICHELLE GUIDO 9/24/01 San Jose Mercury News Californians who get their healthcare from HMOs can start seeing today how their plans stack up against others through the state's first report card on managed care. Beginning at 11 a.m., consumers can log on to www.hmohelp.ca.gov for a detailed report on how the state's 14 largest health maintenance organizations are performing when it comes to quality and service. The report covers topics ranging from how quickly claims are paid to how well doctors communicate with their patients. The California HMO Report Card will make it easy for consumers and employers alike to see how a particular plan ranks in prenatal care, for example, or whether it does a good job of treating patients with chronic illnesses such as diabetes and heart disease. Kaiser Permanente-North, Cigna HealthCare of California, Health Net of California and Lifeguard received some of the highest marks. First of its kind When open enrollment season begins in October, consumers have a limited time to decide whether they are happy with their health plans or wish to switch. A number of healthcare ``report cards'' are released at this time each year, but many are directed toward employers, who make choices about which plans to offer workers. The state's report card is the first to present the ratings in a Web-based, interactive comparison, said Martin Gallegos, director of the Office of the Patient Advocate, established by Gov. Gray Davis and the Legislature in July 2000 to inform and educate HMO patients about their rights. Another unique component of the report is a breakdown of how the various health plans respond to those in California who do not speak English. A table in the report card's summary shows which plans offer telephone interpreters and whether interpreters are available for appointments. It also tells whether plans offer lists of bilingual medical providers -- most do. ``That's something that is becoming more and more important to Californians who are non-English speaking but still want to get information about choosing a health plan,'' Gallegos said. A paper copy of the report will also be available for free in English, Spanish and Chinese through Gallegos' office. Five key areas The 14 providers included in the report card account for about 95 percent of California patients -- or about 20 million patients -- who get their healthcare through HMOs. In the report's summary, a chart compares the quality of the providers in five key areas. Staying healthy: how the plan rates in preventive care services. Preventive care is one of the tenets of managed care. Getting better: This includes mental health services and monitoring health risks such as high cholesterol. Living with illness: how the plan deals with patients who have chronic illnesses. Doctor communication and service: whether doctors listen carefully and spend enough time with their patients. Plan service: overall customer service. The chart rates plans based on a three-star system. No stars signals poor performance; three stars is excellent performance. None of the plans received three stars -- or no stars -- in any of the five overall categories. In all cases, they received either one or two stars, signaling room for improvement. Kaiser Permanente California spokeswoman Kathleen Barco said any tools that give consumers vital information about healthcare is a step in the right direction. ``The whole report card process has been evolving over time, and it's a really good process,'' Barco said. ``Consumers and employers need to have real information when they are making choices about a health plan.'' State agency Davis and the Legislature created the Department of Managed Health Care in 1999, after he signed a slew of healthcare reform bills. In July, that department, which houses the Office of the Patient Advocate, marked its one-year anniversary as the nation's first agency created specifically to oversee the managed-care industry. So far, the agency has created the Web site, put out a consumer guide to managed care and created an HMO Help Center to help patients navigate the healthcare system. Medical groups -- such as Sutter Gould Medical Foundation or San Jose Good Samaritan Medical Group -- are not HMOs, and the state agency doesn't include them in its report card. Beth Capell, a spokeswoman for Health Access, a coalition of patient and consumer groups, said almost 80 percent of consumers who get their health insurance on the job have a choice of plans. ``For those consumers, this is going to be a real help,'' she said. ``We can see from this that there is work to be done. But we're very much looking forward to this as a tool to help us improve.'' IF YOU'RE INTERESTED Paper copies of the report card are available in English, Spanish and Chinese by calling the Office of the Patient Advocate at (213) 897-0579. Contact Michelle Guido at mguido@sjmercury.com or (408) 295-3984. ~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~