MCPR 2005 - Measuring the Quality of Pennsylvania's Commercial HMOs - Key Findings
Enrollment in commercial managed care organizations has been steadily decreasing, from 39.2% of Pennsylvania residents age 0-64 years in 2000 to 25.9% in 2005.
On average, Pennsylvania HMOs outperformed their national counterparts in all the member satisfaction measures for which there was a national average available.
All Pennsylvania plans reported an increase from the prior year in the percent of plan members who gave their HMO the highest satisfaction rating when this information was available.
Pennsylvania HMOs on average improved from the prior year in 12 of the 15 "Staying Healthy" measures.
Diabetes hospitalization rates for HMO members decreased 14.2% statewide from 110.0 per 10,000 adult members with diabetes in 2004 to 94.3 in 2005. However, some individual plans' adjusted rates decreased by up to 42.4%, while other plans' adjusted rates increased by up to 11.5% during the same time period. Adjusted hospitalization rates for the HMO plans in 2005 ranged from 65.9 to 133.6 per 10,000 adult members with diabetes.
Statewide HMO hospitalization rates for the following conditions printed in this report increased significantly compared to last year:
Gastrointestinal infections increased 16.6% from 3.4 per 10,000 members in 2004 to 3.9 in 2005.
Adult ear, nose and throat infections increased 24.0% from 2.1 per 10,000 adult members in 2004 to 2.6 in 2005.
Pediatric ear, nose and throat infections increased 46.4% from 4.7 per 10,000 pediatric members in 2004 to 6.8 in 2005.
Chronic obstructive pulmonary disease (COPD) rates increased 24.4% from 3.8 per 10,000 adult members in 2004 to 4.7 in 2005.
Adult asthma rates increased 24.4% from 7.2 per 10,000 adult members in 2004 to 8.9 in 2005.
Pediatric asthma rates increased 9.0% from 13.4 per 10,000 pediatric members in 2004 to 14.6 in 2005.
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