Consumer Reports rates the different HMOs, PPOs : FRANCINE KNOWLES
By: Health Insurance
Submitted: 2009-08-24 10:37:23 | Word Count: 449
As the health care reform debate grows more heated, a new Consumer Reports survey shows annual out-of-pocket insurance premium costs have skyrocketed 38 percent from two years earlier.
The survey, which included more than 37,000 respondents and which was used to rate HMO and PPO plans, found that the median premium cost is $1,829, up $500. Respondents in HMOs paid less for premiums than people in PPOs, $1,466, compared with $2,003. Among PPO members who were seriously ill, 69 percent paid $1,000 or more on bills, compared to 47 percent of seriously-ill people in HMOs who said they paid that much.
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Among 41 PPO plans rated, Blue Cross and Blue Shield of Illinois received a score of 80 ranking it third, based on survey respondents' experience with the plans. Among 35 HMO plans, Blue Cross Blue Shield of Illinois/Blue Advantage HMO received a score of 76, ranking it 21st.
Among national PPO plans, United Healthcare ranked 39th, UniCare 38th, Cigna 37th and Humana 35th. All had scores below 73.
The highest scoring PPO plan was Anthem Blue Cross and Blue Shield of Connecticut, and the highest scoring HMO plan was Group Health of Idaho and Washington.
Plans were rated based on care from doctors, choice of doctors, percentage with problems getting access to care, access to doctors, billing, customer service and other factors.
Sixty-four percent of respondents said they were "very" or "completely" satisfied with their current plan, while 27 percent said they were "fairly well" satisfied, and 10 percent said they were dissatisfied. Overall satisfaction scores were similar for HMO and PPO enrollees.
Eighty-four percent of survey respondents were in an employer-based plan, which they could keep under most health reform proposals now before Congress, Consumer Reports said.
Among all respondents, 18 percent said they had trouble getting to see a plan doctor at some point during the year.
The survey found that 24 percent of people in PPOs reported billing problems, compared with 11 percent of HMO members. Thirty-three percent of PPO members who reported having a serious illness had billing problems, compared to 11 percent of seriously-ill HMO patients.
The survey results and rankings are in the September issue of Consumer Reports.
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