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Life Health > Health Insurance > Life Insurance Strategies

N.J. Updates HMO Report

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New Jersey’s health maintenance organizations have held steady in most performance categories, but their customer satisfaction measures fell somewhat in 2006, according to the state’s latest ranking.

The 11th annual HMO report card, issued by the Department of Banking and Insurance, found little or no change in 10 of 12 clinical performance areas, the exceptions being control of high blood pressure and cholesterol management of heart patients. DOBI attributed those declines, however, to changes in measurement standards by the National Committee for Quality Assurance, the system on which it bases the report card.

Other clinical areas evaluated were testing for breast cancer, testing for cervical cancer, check-ups for new mothers, immunization for children, management of medicine for depression, medication of children with asthma, post-hospitalization care for mental illness, blood-sugar testing for diabetics, beta blocker treatment after a heart attack and eye exams for diabetics.

In customer satisfaction, the percentage of consumers who rated their HMO at least a 9 on a scale of 0 to 10 dropped from 36% to 33%, while the percentage who said they never had a problem getting the doctor or specialist they needed tumbled from 76% to 44%.

The proportion who were satisfied with claims processing dropped from 47% to 43%, and those who rated their quality of care at least a 9 fell from 49% to 44%.

The state’s HMOs posted big gains in 3 other customer satisfaction areas. The proportion who said they received care quickly rose from 43% to 58%, while ratings of personal doctors increased from 52% to 60%, and good communications by doctors increased from 59% to 68%. DOBI cautioned, however, that some changes in customer satisfaction could have resulted from changes it made in its questionnaire from last year’s survey.

All 6 HMOs in the report-Aetna, AmeriHealth, CIGNA, Health Net, Horizon and Oxford-posted declines in 5 or more of the clinical performance measures, with each reporting decreases of at least 6% for 1 or more measures. CIGNA, Health Net and Oxford reported the strongest improvements for 2007, each posting improvements in 5 of the 12 clinical performance measures.

The 2007 New Jersey HMO Performance Report is available on the Web by going .


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