Are you looking to choose an HMO or make changes to your existing coverage? The 2006 Performance Report for Utah Commercial HMOs and Medicaid & CHIP Health Plans, released today by the Utah Department of Health’s (UDOH) Health Data Committee and Division of Health Care Financing, evaluates the quality of performance and member satisfaction of selected Utah health plans covering nearly 940,000 members across the state.

“Since 1996, these reports have provided useful information to Utah’s health service purchasers, health policy makers, individual consumers, and health plans,” said Keely Cofrin, Ph.D., HMO Health Program Manager, UDOH.

Measures included in the report come from data collected by the health plans as well as a consumer satisfaction survey. Participating commercial HMOs include Altius Health Plans, CIGNA Health Care of Utah, HealthWise, SelectHealth and UnitedHealthcare. Four Medicaid plans also participated: Healthy U, Molina Healthcare, Select Access and the Fee for Service Plan. Finally, two Children’s Health Insurance Program (CHIP) plans are represented in the report: Public Employees Health Program and Molina HealthCare of Utah.

The first major section of the report describes how Utah’s HMOs are doing in different areas of health care. Results show that commercial HMOs are performing above national averages in the areas of getting needed care, getting care quickly and customer service. Though childhood immunizations have improved in recent years, primary care and well-child visits for older children are below national average. Utah’s commercial HMOs also scored lower than national averages on several performance measures, including adolescent immunizations and colorectal cancer screening.

Medicaid HMOs performed better than national average scores on several performance measures including: timeliness of prenatal care, childhood immunizations and infant well-child visits. Some areas in which Medicaid HMOs need to improve are well-care visits for children 3 to 6 and adolescents, and chlamydia screenings in women.

The second part of the 2006 Performance Report describes the results of the Consumer Assessment of Health Plans Survey (CAHPS), conducted in the spring of 2006. A total of 1,546 parents of children enrolled in commercial HMOs answered the survey, including 1,870 parents in Medicaid health plans and 1,323 parents in CHIP HMOs. The survey measured what parents thought about the health care and services their child received from the health plan in the past year.

Medicaid health plans scored above national averages for nearly all customer satisfaction measures. Commercial health plans exceeded national averages in measures such as getting needed care and customer service, but were much lower in ratings of health care received and health plan overall.

As in past years, Utah’s CHIP HMOs performed very well. For example, CHIP HMOs were above national averages for nearly all customer satisfaction measures represented in the report. One area needing improvement is customer service provided to CHIP enrollees.

Dr. Cofrin noted, “Other questions on the survey indicate that enrollees are most concerned about cost issues, such as co-pays, deductibles and premium costs.”

All of the above-reported findings are statistically significant at 95% confidence level. For more information about the report, please go to http://health.utah.gov/myhealthcare/healthplan/HmoPerformance2006.pdf

# # #