Friday, March 17, 2000

Web site rates HMO coverage, performance

Washington Post

        Consumers are often exhorted to check out a prospective health plan before choosing one. But how? A Web site ( unveiled last week by the National Committee for Quality Assurance (NCQA) provides a good place to start.

        NCQA, an independent, non-profit group that accredits about half the nation's 650 health maintenance organizations, plans to include preferred provider organizations (PPOs) in July.

        The report cards provide information about plans' clinical performance, the quality of their physicians, the extent of preventive care and the ease of access to appointments and other clinical services. Consumers can check out a plan by typing in its name and the state in which it operates. In a format similar to restaurant reviews, plans receive stars that rank their performance in five areas, with four stars the best.

        The report cards have serious limitations. Consumers who want to know, for example, how well a plan cares for people with diabetes or asthma must rely only on the number of stars in the rating for “Living with Illness” category. That doesn't tell you much about specifics, such as the number of diabetics who receive eye exams to check for complications or the adequacy of asthma treatment.

        But the report cards do provide baffled consumers with, at least, a place to start.


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