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Thursday, Sep. 24, 1998
Three South Texas HMOs fare well in study
Mercy, Principal, Humana all rated above state average
By JEFFREY TOMICH
Staff WriterSouth Texans enrolled in health maintenance organizations gave health plans in the region high marks for customer satisfaction and quality of care in a recent membership survey.
Survey results are contained in a 48-page report, ``Comparing Texas HMOs 1998,'' prepared by the state Office of Public Insurance Counsel, an independent state agency that represents consumer interests on insurance matters.
Mercy Health Plans, which has 8,850 HMO members in Webb, Jim Hogg and Zapata counties, was the top-rated HMO among three surveyed in the South Texas region. It received a rating of 8.3 on a scale of 10.
Principal Health Care, purchased Aug. 12 by Minnesota-based United Healthcare, received a rating of 8.1. With the acquisition, United now has about 37,000 HMO members in its Corpus Christi service area, according to spokeswoman Betsy D'Acierno.
Representatives of United Healthcare's downtown Corpus Christi office say they're familiar with the report but haven't had time to fully review it in the midst of the transition.
Humana, with close to 10,000 HMO members in the Corpus Christi area, got a 7.7 overall rating, still above the state average of 7.6. The plan's members gave it a below-average rating for getting specialist referrals, however.
Ross McLerran, a Humana spokesman, said the managed-care company supports consumer access to information about health plans if the information is presented in context and can't be misunderstood. He didn't refer specifically to the OPIC's report.
``We prefer to share information to the consumer and the employer in a controlled environment that includes explanation of how we are using the results to truly improve the health of our members,'' McLerran said.
The 75th Texas Legislature directed OPIC to issue annual report cards comparing HMOs in the state.
More than 10,000 HMO members in 34 health plans were surveyed in seven regions of Texas. The 25-county Corpus Christi-South Texas region included the Coastal Bend, Rio Grande Valley and Laredo.
The members were asked questions regarding numerous aspects of their plan: Did they get appointments quickly when they needed them? Did doctors explain things in a way they could understand? Were they treated with courtesy and respect by office staff?
Several health plans with HMO membership in Corpus Christi weren't included in the survey, including Prudential, Cigna and NYLCare. Plans were selected for the survey based on market share within each service area, according to the OPIC.
Geoff Wurzel, executive director of the Austin-based Texas Association of Health Plans, said the results show Texans enrolled in HMOs are happy with their health plans, their physicians and the care they receive.
``This is not to say that everything is perfect in health plans,'' Wurzel said. ``But it does tell us that the anecdotal horror stories perpetuated by anti-managed-care special interest groups are exaggerated and not indicative of the overall high quality of health care in Texas.''
Public Insurance Counsel Rod Bordelon said the report is a guidebook for consumers and employers to use when they are choosing a health plan.
``I think it's an invaluable tool to use in comparing how the various HMOs did with respect to quality of care as measured by the patients themselves,'' he said.
Bordelon said consumers should follow up by asking questions before deciding on a managed-care provider. That's particularly important if a health plan has merged or been acquired by another.
A list of footnotes on Page 1 of the report reveals the vast changes the industry has undergone just this year. Aetna acquired NYLCare in July; United Healthcare bought Principal in August; and Humana purchased PCA Health Plans of Texas earlier this month.
Health care consolidation and its effect on consumer choices underscores the need for useful information, Bordelon said.
``It's always going to be a moving target. There's always going to be changes,'' he said. ``That's why this report will be put out on an annual basis and hopefully over time will be even more relevant.''Post your comments about local news eventsFront Page || Main Index || News || Business || Texas || South Texas Outdoors || Birdwatching || Sports || Entertainment || Selena || Education || South Texas Attractions || World Wide Web