HMOs: responding to bad report cards

Abstract

Differentiating one health plan from another is becoming increasingly difficult. But a plethora of report cards on plans' performance are now available to help purchasers pick and choose managed care for their members. When a health plan receives a low score--or a score lower than its competitors, be it ever so slight--does it respond appropriately? Are leaders adequately following up to determine the significance of the scoring, rectify the problem--and communicate that to purchasers? Is quality improvement an outcome of publishing report cards? TQL spoke with health plan leaders, healthcare consultants and purchasers to find out what some plans are doing--and what many should be doing.