News Release | Measuring the Quality of Pennsylvania's HMOs | MCPR 2004

MCPR 2004 - Measuring the Quality of Pennsylvania's Commercial HMOs - News Release

FOR IMMEDIATE RELEASE

Contact: Joe Martin, Communications Director
717-232-6787 or

PENNSYLVANIA HMOs RATE HIGH ON PREVENTIVE CARE, MEMBER SATISFACTION

Harrisburg, PA - April 6, 2006 - All Pennsylvania HMOs performed better than the national HMO average in cholesterol screening after acute cardiovascular events, using beta blockers after heart attacks, and providing the recommended childhood immunizations, according to a new report by the Pennsylvania Health Care Cost Containment Council (PHC4). Pennsylvania HMOs also achieved higher member satisfaction rates than the national average, with 87% reporting no problems in receiving the care they felt they needed.

"While Pennsylvania HMOs, on average, improved their scores from the prior year in 11 of the 17 'Staying Healthy' categories, they performed better than the national average in 15 of these measures," said Marc P. Volavka, Executive Director of PHC4. "The two areas below the national average were advising smokers to quit and colorectal cancer screening."

Measuring the Quality of Pennsylvania's Commercial HMOs is PHC4's seventh report about the quality of care that HMO networks offer. The report, which includes data from Calendar Year 2004, combines clinical results, preventive measures and member satisfaction information to give purchasers, policymakers and consumers a more complete picture of how well HMOs serve their members.

According to 2004 member satisfaction surveys, Pennsylvania HMOs, on average, outperformed their national counterparts in all the member satisfaction measures for which a national average was available. Furthermore, over half the plans reported an increase from the prior year in the percent of plan members who gave their HMO the highest satisfaction rating.

Other findings:

Hospitalization Rates: There were significant decreases in HMO hospitalization rates since last year for: adult asthma (down 19.1%); pediatric asthma (down 14.3%); pediatric ear, nose and throat infections (down 32.0%); chronic obstructive pulmonary disorder (down 15.9%); and diabetes (down 9.6%). However, there was a significant increase in the HMO hospitalization rate for high blood pressure (up 7.4%).
Prostatectomy: While the in-hospital complication rate after prostatectomy decreased 28.3% from 2003 to 2004 for HMO members, the in-hospital complication rate after prostatectomy increased 7.4% during the same period for fee-for-service plan members.
Hysterectomy: While the in-hospital complication rates after abdominal and vaginal hysterectomies both decreased from the prior year for HMO members (down 13.1% and 21.2%, respectively), both rates were still higher than the rates for fee-for-service plan members.
Neck and Back Surgeries: Neck and back surgeries were 9.6% more likely to be performed in an inpatient setting for HMO members than for fee-for-service plan members.
Breast Cancer Procedures: Breast cancer procedures were 9.9% more likely to be performed in an inpatient setting for HMO members than for fee-for-service plan members.

PHC4 is an independent state agency charged with addressing the cost and quality of health care in Pennsylvania. Copies of the new report are free and are available on the PHC4 website at http://www.phc4.org or by calling PHC4 at 717-232-6787.

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