[Source: Health and Life Sciences Law Daily, August 7, 2007]
The Hartford Courant (8/7, Levick) reports that Consumer Reports ranked HMOs and PPOs based on a survey of its readers. The Courant writes, "The national rankings of 'preferred provider' plans, known as 'PPOs,' show companies that are major players in Connecticut haven't budged much in the rankings since the magazine's last report in 2005. There wasn't much movement in rankings of HMOs either in the September issue of the magazine, expected to hit newsstands today -- well in advance of the fall enrollment season." The Courant reports that "Anthem Blue Cross and Blue Shield in Connecticut, which came in second in the previous rankings of PPOs, topped the new rankings of 46 PPOs with an overall reader satisfaction score of 83." Connecticut PPOs offered by Aetna were rated 73 overall, and Cigna was rated at 72.
In its summary of the ratings, Consumer Reports (Sept. 2007) writes, "Only 67 percent of our readers said they were completely or very satisfied with their plan; that's up slightly from our total in our 2004 survey of HMOs and PPOs (64 percent). That rate is only average compared with what we've found when we've done consumer satisfaction surveys of other services. ... Why isn't satisfaction with HMOs and PPOs higher? Problems getting an appointment to see a doctor were reported by 10 percent of our readers, 21 percent had to deal with billing errors, 25 percent said they had a problem with their primary-care provider, and 36 percent who called a plan representative for assistance said they had trouble getting the help they needed." In a summary of its methodology, Consumer Reports (Sept. 2007) writes, "A nationally representative on-line survey of 2,905 respondents between the ages of 18 and 64 was designed by Consumer Reports and fielded by Knowledge Networks in May 2007. The sample excluded U.S. residents covered by Medicare or Medicaid. For the full sample, the sampling error was 2.43 percent at the 95 percent confidence level."
Consumer Reports examines growth in healthcare costs. Separately, the magazine examines the broader issue of health insurance and healthcare costs. In an overview, Consumer Reports (Sept. 2007) writes, "From escalating medical debt to postponed retirement, our exclusive national survey of working-age adults shows the depth of jitters even for those lucky enough to have insurance through their jobs or families."
In another story, Consumer Reports (Sept. 2007) reviews the growth in healthcare costs despite the advent of managed care, writing, "Back in the 1990s, employers and insurance companies embraced the idea that 'managed care' could simultaneously save money and improve quality. Employees were put into HMOs, which in turn used their burgeoning membership numbers to force doctors and hospitals to cut their prices or lose access to patients." Consumer Reports also highlights pushback from patients and doctors, noting that breast-cancer patients "sued and got some state legislatures to pass laws requiring health plans to cover $80,000 bone-marrow transplants," and "doctors and hospitals joined forces and, in many cases, successfully pushed back against managed care's demands for deep discounts to their fees."
In a third story, Consumer Reports (Sept. 2007) criticizes Medicare Advantage programs, noting that now, "about 20 percent of Medicare beneficiaries nationwide find themselves right back at square one: poring over confusing HMO rules, being restricted to certain doctors and hospitals, and coping with unanticipated high co-pays and deductibles."
Finally, Consumer Reports (Sept. 2007) examines the growth of medical bills among the insured, writing: "Between 2001 and 2005, the percentage of middle-income families -- those who earn between $40,000 and $80,000 for a family of four -- who had job-based health coverage dropped four percentage points. Half lost benefits because their employers dropped health insurance altogether or quit offering dependent coverage." However, "15 percent gave up their employer-based insurance because they could no longer afford the premiums."
