Virginia Health Information releases HMO quality and satisfaction reports

Virginia Health InformationOct 13 2009

Virginia Health Information (VHI), a nonprofit health information company, reports HMO quality and satisfaction reports at www.vhi.org.

HMOs have over one million members in Virginia. From October to January many members choose their health insurance plan for the upcoming year. VHI is an independent source of HMO information to help consumers compare HMOs on both costs and quality. The measurements include whether members get the right care for diabetes, heart disease, asthma and other conditions. Satisfaction scores show whether members are satisfied with their doctor, the care members received and how quickly they get the care they need.

Virginia HMOs performed better than the U.S. averages on 60 percent of quality measures. Virginia HMOs also improved their scores in 74 percent of the measures in VHI's report. "When HMOs improve quality, their members are the winners," says Michael Lundberg, VHI's Executive Director.

HMOs had very high scores for many measures:

• 93 percent of persons with asthma received asthma medications
• 93 percent of adults saw a doctor for preventive or other care
• 93 percent of pregnant women had care during their first trimester (1st 6 weeks) of pregnancy they were enrolled in an HMO
• 92 percent of members said their doctors always communicated clearly, listened to them and spent enough time with them

Some measures need improvement:

• 69 percent of women had breast cancer screening -- this rate has improved very little since 2004
• 82 percent of women were screened for cervical cancer -- a rate lower now than in 2004
• 62 percent of men had colorectal cancer screening -- too low but improving each year

Cost and financial information includes the average monthly premium for members and spending on medical care and administrative expenses:

• Monthly premiums per member per month averaged $287. The lowest amount was $238, highest $321-- a difference of 34 percent
• 5 HMOs have profit/loss ratios over 10 percent
• 4 HMOs had profit/loss ratios of less than 1 percent