Fw: Some big U.S. HMOs get poor grades in report card

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Sent: Wednesday, September 18, 2002 11:36 PM

Subject: Some big U.S. HMOs get poor grades in report card

Some big U.S. HMOs get poor grades in report cardBy Kim DixonCHICAGO, Sept 18 (Reuters) - Some of the nation's biggest publicly traded health plans got poor grades in a report card of HMOs issued on Wednesday, although the overall quality of medical care was said to be rising.Local units of Humana Inc. <HUM.N>, Health Net Inc <HNT.N> and PacifiCare Health Systems Inc. <PHSY.O> were among the health maintenance organizations ranked lowest in key gauges of medical care such as controlling blood pressure and detecting breast cancer.Still, the performance of managed care groups improved at the nation's HMOs over the past three years, according to the nonprofit National Committee for Quality Assurance, which released the report."These gains will save lives and money," said Margaret O'Kane, NCQA's vice president.Cigna Corp.'s <CI.N> New England plans and Anthem Inc.'s <ATH.N> New Hampshire plan were among those ranked in the top 10 in key health measures.Some key findings: over the past two years, chicken pox vaccinations rose 11 percent, cervical cancer screening increased 8 percent, and effective cholesterol control jumped 23 percent.Nearly 70 percent of all HMOs, insuring about 28 percent of Americans, report data to NCQA.For that reason, NCQA cautioned against labeling any plan "the worst" because the health plans that report are likely among the best performers.If all health care providers performed best medical practices, 22 million sick days could be averted and 6,000 deaths prevented each year, the report said.REGIONAL VARIATIONSMost of the big publicly traded HMOs report their data. Some plans had wildly different results depending on region. For example, Cigna's New York and Georgia units ranked in bottom 10 in overall consumer satisfaction, along with Health Net's Pennsylvania plan.No local units of the big for-profit HMOs made it to the top 10 in pleasing patients.Cigna ranked in the top 10 health plans in early screening for cervical cancer and controlling blood pressure.In controlling blood pressure, UnitedHealth Group Inc.'s <UNH.N> Texas and Midwest units, PacifiCare's Texas divisions and Health Net's Pennsylvania and New York plans ranked in the bottom 10.UnitedHealth Group is the biggest U.S. health plan, insuring 17 million members, followed by Aetna Inc. <AET.N>, Cigna, WellPoint Health Networks Inc. <WLP.N> and Anthem.About 50 million Americans suffer from high blood pressure and experts say aggressive treatment, through diet changes and medications, is often warranted.NCQA began tracking data on HMOs six years ago to show employers how insurers measure up against each other. Employers pay to get the data each year to compare plans."Measurement is something that has not been part of medicine in the past," iel , vice president of the American Diabetes Association, told a news conference in Washington monitored by telephone.Federal legislation to make HMOs more accountable -- and specifically to let patients sue HMOs for coverage denial -- has languished for several years. The industry scaled back restrictions on access to care after a public backlash. 09/18/02 17:32 ET