Ranking the Health Plans

Article excerpt

Newsweek's annual survey gauges how well HMOs are serving their members

For newsweek's third annual ranking of managed-care plans, we surveyed more than 200 plans about practices that are known to improve families' health. Our rankings cover both classic health-maintenance organizations (whose members receive all their care from physicians within a network) and point-of-service plans (which cover some out-of-network services). We gauged performance in three areas--keeping members healthy, treating acute illness and managing chronic conditions--both for adults and for children. Working with the Foundation for Accountability, an Oregon-based nonprofit group, we monitored several measures of care within each of those categories.

We graded the plans on a curve. The one that performed best in a given category received a perfect 100 percent and the worst received a zero. So the letter grades in the columns below represent each plan's standing in relation to the others that provided information. The discrepancies were sometimes large. For example, the proportion of pregnant women who get prenatal care during their first trimester was as high as 99 percent in some plans, while in others it was only 38 percent.

The letter grades in the first column (Plan Ranking) represent each plan's overall performance. …