Thursday, December 16, 2004

(Salt Lake City, UT) – As the year draws to a close, many Utahns are considering their choices for a health maintenance organization (HMO) or making changes to their health coverage. The 2004 Performance Report for Utah Commercial HMOs and Medicaid & CHIP Health Plans, released today by the Utah Department of Health’s Health Data Committee and Division of Health Care Financing, measures the quality and performance of selected Utah health plans covering nearly 900,000 members across the state. Measures included in the report come from data collected by the health plans as well as a consumer satisfaction survey. Participating commercial HMOs were: Altius Health Plans, Cigna Health Care, IHC Health Plans, Regence HealthWise, and UnitedHealthcare of Utah. Four Medicaid plans also participated: Healthy U and Molina HealthCare of Utah, both HMOs, as well as the two plans administered by the Utah Department of Health, IHC Access and the Fee for Service Plan. Finally, two Children’s Health Insurance Program (CHIP) plans are reporting publicly for the first time: Public Employees Health Program and Molina HealthCare of Utah. The first major section of the report describes how Utah’s HMOs are performing in different areas of health care. Results show that commercial HMOs as a group are performing above national averages in providing appropriate medication for people with asthma and cholesterol screening for people with diabetes. Over the past five years, the rate of children in the above HMOs who are fully immunized by their second birthday has increased 20 percent. Utah’s commercial HMOs scored lower than the national average on several measures including: management of antidepressant medication, controlling high blood pressure among adults, and adolescent immunizations. Measures that show five-year improvements in the Medicaid population include: prenatal care, controlling high blood pressure, and adolescent immunizations. One important area HMOs serving Medicaid clients could improve in is the frequency of postpartum visits by mothers. Adolescent well-care in the Medicaid population has risen, but not very quickly and rates continue to lag behind national benchmarks for Medicaid plans. More attention needs to be paid to well-care for children over 3 years of age. The second major section of the 2004 Performance Report presents the results of a consumer satisfaction survey conducted in the spring of 2003. This year the survey was sent to parents of children enrolled in participating HMOs. Parents of 1,945 commercial enrollees, 2,758 Medicaid enrollees, and 1,847 CHIP enrollees participated in the survey. In addition, the survey was administered to parents of 2,562 children with chronic conditions. Parents of children enrolled in the Medicaid plans indicated high levels of satisfaction in areas such as getting care when it was needed, communication with personal doctor, getting care quickly, and helpful office staff. However, customer service ratings for three of the Medicaid plans are below national benchmarks. Commercial plan ratings of getting needed care and helpful office staff were at or above national standards. Parents of children enrolled in commercial HMOs were less satisfied with claims processing, customer service, and getting care quickly. CHIP plans received higher ratings than their national counterparts on every satisfaction measure, sometimes outscoring national benchmarks by more than 30 percent. The 2004 survey was conducted by mail (7,300) followed by telephone (1,812) interviews for non-respondents. All of the above-reported findings are statistically significant at 95 percent confidence interval level. For a copy of the report, which includes graphics that depict the performance measures and survey outcomes, visit http://health.utah.gov/hda/ 7:57:01 AM