Managed Care On-Line™: Surveys |
National Study Finds Seven of 10 Physicians Are Anti-Managed Care; HMOs Still
Rank Highest Among Physicians in Several Markets
Press Release - Sept. 14, 1998
Nearly seven of 10 physicians consider themselves "anti-managed care," according to a national
study conducted by The MEDSTAT Group and J.D. Power and Associates which
surveyed nearly 30,000 physicians about 150 health plans in 22 markets. While
physicians expressed dissatisfaction with managed care in general, HMOs in
several markets ranked higher than non-managed care plans. This finding is
consistent with that from the enrollee study of plan performance conducted by
The MEDSTAT Group and J.D. Power and Associates earlier this year.
"Physicians provide a unique perspective of health plan performance," said Ron
Conlin, partner, J.D. Power and Associates, "because physicians have
experiences with plans that are not available to consumers and employers. In
fact, the study shows that physicians tend to be much tougher evaluators of
health plans than enrollees," he added.
The top-ranked plan in each market is identified in Table I attached.
Physicians Desire Autonomy
Results of this study clearly indicate that physicians want to operate with
maximum independence and minimum interference from health plans. More than 75%
of responding physicians indicated that "having to justify my clinical
decisions to others is annoying." In addition, half of the physicians reported
"being profiled on utilization and satisfaction makes me mad," and 42%
indicated that they feel "costs of care should never be considered in making
clinical decisions." "These results highlight the enormous challenge facing the
healthcare industry -- reducing costs while being held increasingly accountable
for the quality of care provided," said Dennis Becker, Senior Vice President,
The MEDSTAT Group. "And, the industry must do this in partnership with
physicians who, for the most part, are extremely independent, and many of whom
are not concerned with cost considerations," he added. Impact On Consumers
Physician ratings of health plan performance are important to consumers for two
reasons. First, physicians can identify those plans that are applying too much
pressure to reduce costs at the expense of quality care. Almost one-third of
responding physicians indicated that "being pressured to withhold specific
patient services that could improve care" is a serious problem with the plans
they work with. Second, when physicians are unhappy with a plan's performance,
they will stop contracting with that plan -- resulting in consumers having to
change providers or obtain services outside their network, often at higher
costs. The study reveals that half of the physicians who are dissatisfied with
a plan's overall treatment of physicians would "probably" or "definitely"
remove the plan from their practice. Impact On Physicians
The push to integrate cost consciousness with quality is taking its toll on
physicians. As a result, physician morale is sinking across the nation. The
study reveals that not only do 36% of physicians indicate their morale is low,
but perhaps more importantly, 53% indicate it has gotten worse over the past
year. In fact, more than 46% of respondents indicated they "often think about
leaving clinical practice." What's Most Important To Physicians?
The study identifies five major factors that drive physicians' ratings of plan
performance. The two most important are Satisfaction With Financial
Reimbursement and Administration. The other three factors are: Limits On Care,
Policies Impacting Quality Of Care, and Support Of Clinical Practice. The
opportunity for improvement is significant. For example, in the administrative
area, 29% of physicians indicated that getting help with appeals for denied
claims was a "major hassle," and 27% indicated the same about the paperwork
burden.
The MEDSTAT Quality Catalyst Program is conducted by The MEDSTAT Group in
alliance with J.D. Power and Associates and New England Medical Center.
The MEDSTAT Group specializes in the strategic application of healthcare
information and offers knowledge-based systems, research, and consulting
services for improving the quality and total value of healthcare. Headquartered
in Ann Arbor, Michigan, with offices nationwide, the company serves clients
across the entire healthcare spectrum -- purchasers of healthcare benefits,
providers of care, managed care and insurance organizations, state government,
federal policymakers, and federal and pharmaceutical researchers. The MEDSTAT
Group is a Thomson Healthcare Information company.
J.D. Power and Associates is one of the world's premier marketing information
firms and is well-known for its expertise in the area of customer satisfaction
measurement. Internationally-recognized as the "voice of the consumer" and for
its role in transforming how the automotive industry views quality, J.D. Power
and Associates has extended its expertise to other industries, including
healthcare.
The Boston-based New England Medical Center has an extensive background in
surveying the physician population through its Primary Care Outcomes Research
Institute, directed by Sheldon Greenfield, M.D., and Sherrie Kaplan, Ph.D.,
M.P.H. The team is renowned in the arenas of healthcare and quality of care
research, complex statistical analyses, and patient involvement in healthcare.
New England Medical Center is the newest member of Lifespan Health System.
This press release is provided for editorial use only. Charts and graphs
extracted from this press release must be accompanied by a statement
identifying The MEDSTAT Group as the publisher, and The MEDSTAT Quality
Catalyst(TM) Program as the source. No advertising, marketing, or other
promotional use can be made of the information without the express prior
written consent of The MEDSTAT Group.
Table I
The 1998 MEDSTAT Quality Catalyst Program
Top-Ranked Health Plan Among Physicians
Market Top-Ranked Health Plan And Type(a)
Atlanta Kaiser Permanente HMO
Baltimore-Washington National Capital Area Plan PPO
Boston Tufts Health Plans HMO
Central Valley, California Blue Cross Prudent Buyer PPO
Chicago Blue Cross Blue Shield of Illinois FFS
Cleveland-Akron Medical Mutual of Ohio FFS
Dallas-Fort Worth Prudential HealthCare FFS
Dayton-Springfield, Ohio (b)
Grand Rapids-Muskegon, Michigan Priority Health HMO
Hartford, Connecticut ConnectiCare HMO
Houston-Galveston United HealthCare PPO
Indianapolis (b)
Kansas City (b)
Lansing, Michigan Blue Cross Blue Shield of Michigan
FFS/PPO
Los Angeles-Orange County Blue Cross Prudent Buyer PPO
Memphis Baptist & Physicians PPO
New York City Area United HealthCare HMO/POS
Northern New Jersey Oxford Health Plans HMO/POS
Philadelphia Personal Choice PPO
Phoenix Blue Choice HMO
San Francisco Bay Area Kaiser Permanente HMO
Southeast Michigan Blue Cross Blue Shield of Michigan FFS
(a) HMO = Health Maintenance Organization
POS = Point-of-Service plan
PPO = Preferred Provider Organization
FFS = Fee-for-service plan
(b) No single plan scored significantly above other plans in this
market, or the major plan(s) in the market are not adequately
represented.
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CONTACT: The MEDSTAT Group Andree Joyaux, 734/913-3295
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