The Utah Department of Health released its 10th annual performance report for Utah HMOs, including commercial plans and Medicaid and Children's Health Insurance Program (CHIP) health plans.
The 2006 results show that commercial HMOs are performing above national averages in providing needed care, getting care quickly and customer service.
The report focused on health plans covering nearly 940,000 members across the state.
"Since 1996, these reports have provided useful information to Utah's health service purchasers, health policy makers, individual consumers and health plans," said Keely Cofrin, HMO health program manager.
Of the five commercial plans rated by the Utah Health Data Committee, Altuis and SelectHealth performed the best.
"SelectHealth has a great electronic records system and that gives them an advantage," Cofrin said. "Data collection has a lot to do with it."
Regence HealthWise (Blue Cross Blue Shield) fell below the statewide averages in most of the categories in which it submitted data.
But Kathleen Murphy, spokeswoman for Regence HealthWise, said it did not focus on providing information that would have given a fuller picture, because HMOs are a small part of its business.
For its 32,668 members, its HMOs are closed to new enrollees, and more customers are signing up for preferred provider organizations.
"Fewer than 8 percent of our medical members are in HMOs," she said. "Because of that, Regence has decided not to invest in expensive collection techniques that skew the results favorably."
The plans were above the state average when it came to appropriate testing for children with throat infections and use of imaging studies for low back pain.
The health department also collected data from Altius Health Plans, CIGNA Health Care of Utah and UnitedHealthcare.
Four plans for Medicaid patients also participated: Healthy U, Molina Healthcare, Select Access and the Fee for Service Plan. Two plans offered under CHIP are represented in the report: Public Employees Health Program and Molina HealthCare of Utah.
Medicaid HMOs fared better than national average scores on several measures, including timeliness of prenatal care, childhood immunizations and infant well-child visits.
But Medicaid HMOs fared poorer when it came to checkups for children ages 3 to 6 and adolescents, and chlamydia screenings in women.
Healthy U ranked above the Medicaid national and state averages in four consumer satisfaction measures, including the overall quality of the health plan, health care, personal physicians and customer service.
"We are thrilled that our customers have rated us as the top Medicaid health plan overall, and number one in customer service, for the last two years," said Russ Elbel, quality improvement manager for Healthy U.
Elbel credited the showing to training staff to better answer benefit and claims questions, promote use of recipients' benefits and offer services in more languages.
Utah's CHIP HMOs scored well, coming in above national averages for nearly all customer satisfaction measures.
One area that needed improvement was customer service provided to CHIP enrollees.
"Other questions on the survey indicate that enrollees [for all kinds of plans] are most concerned about cost issues, such as co-pays, deductibles and premium costs," Cofrin said.
chamilton@sltrib.com
Checkup for providers
* The Utah Department of Health's 10th annual performance report for health maintenance organizations in the state rated plans on quality of care, customer service and other measures. Commercial plans and Medicaid and Children's Health Insurance Program health plans were included.
* To view the report, visit http://health.utah.gov/myhealthcare/healthplan/HmoPerformance2006.pdf.
