Study Shows Wide Disparity in Managed Health Care
Ratings of hundreds of HMO plans show striking dissimilarities, according to a new study released by the National Committee for Quality Assurance (NCQA). The report covers 329 health plans that voluntarily submitted information on more than 50 healthcare services. These plans cover about 37 million of the 58 million Americans enrolled in managed care plans.
The report gives no composite rating for each plan nor does it judge which plans are the best. Instead, it identifies dozens of procedures and standards, and ranks them on performance. The semi-confidential ratings data - meant for large employers - are not available directly to consumers. The findings include:
- The average plan nationwide offered breast cancer screening to women aged 52-69 every two years, but plan discrepancy ranged from 30% to 90%.
- On nearly every measure, health plans in New England did the best job. Those in Arkansas, Mississippi and other South-central states did the worst. New England also scored the highest on member satisfaction surveys.
- For patients who suffer heart attacks, 62% of the plans prescribe beta blockers. But plans ranged from 15% to 100% in prescribing them. (NCQA, 202/955-3500)
Docs Lag Behind Execs in Using Interactive Technology
Although healthcare professionals are increasingly looking to interactive technology to help improve care and control cost, physicians are responsible for an "interactive technology lag factor." Physicians are slower to adopt most new media than healthcare execs, particularly the Internet, e-mail and CD-ROM, according to the 1997 American Interactive Healthcare Professionals Survey, released by the New York-based research firm, FIND/SVP. But this trend won't last for long, according to Tom Miller, VP of FIND/SVP, who projects annual growth rates of physician usage to be 25% to 43% for physicians and 20% to 23% for executives.
The study also highlights key discrepancies in physician Internet usage, such as:
- 43% of physicians report using the Internet for professional reasons. However, 26% report using a "technology proxy," someone who goes online for a particular physician.
- 61% of physicians will be using the Internet for professional reasons by mid- to late-1998. But this growth will be stifled if physicians' confidence in online information accuracy, timeliness and objectivity is not resolved.
- 57% of physicians believe that the Internet enhances their own access to practice-related information, but only 34% feel similarly about their patients' access to medical information. (FIND/SVP, 800/965-4636)
Medical School Admissions Should Diversify, Study Finds
Students admitted to medical schools under "special consideration" fared as well as students who possessed high GPAs and Medical College Admission Test (MCAT) scores, according to a recent UC Davis School of Medicine study. The study was primarily prompted by a controversial decision by the University of California's Board of Regents to bar ethnicity as a criterion for admission at all of their schools.
To study "special consideration" students (who don't meet required GPAs and MCAT scoring criteria), UC Davis had 20 percent of its students admitted to the school who had a GPA leas than 3.0 and/or an MCAT average score of less than 10. During the 20-year period, researchers matched each "special consideration" student with a student who met the regular admission criteria. The special consideration admissions comprised 53.5% minority students, while 19% of regular admission were minority students. The findings were reported in an October issue of The Journal of the American Medical Association.
The researchers found that:
- 94% of special consideration students graduated vs. 97% regular admission students.
- Regular admission students were more likely to receive honors or an A grade on courses, but there was no difference in the failure rate among the two groups.
- There was also no difference in the completion of residency training or evaluation of performance. (JAMA, 312/464-5374)
Ohio HMOs Face Losses, New Provider Systems Gain Market Strength
A new report finds that many Ohio HMOs are losing money in the face of reduced premium revenues, while provider systems in several parts of the state have strengthened their market position, achieving greater efficiency.
The report, released late last month at the "1997 Annual Convention of the Ohio Association of Health Plans in Columbus," was authored by Allan Baumgarten, an independent healthcare consultant on industry policy and finance, and funded by the Integrated Healthcare Division of SmithKline Beecham.
The report found:
- Ohio HMOs lost, on average,.4% on revenues of $2.6 billion in 1996. HMOs like CIGNA, Anthem, Kaiser and HMO Health Ohio suffered severe losses.
- HMO premium revenues fell by almost 2% in 1996.
- HMO enrollment in the first half of 1997 increased only by 2.5% after growing 15.8% last year.
- Much of the new growth is in Medicare and Medicaid HMO plans. Thirteen HMOs now sell Medicare products to Ohio seniors. That growth will lead to reductions in hospital admissions and shorter stays. (Allan Baumgarten, 612/925-9121)