consumer ratings, which are compiled from surveys filled out by patients, and clinical performance measures, which are ratings on quality conducted by outside experts. Read on to find out where you can get access to both.
How can I find a high-quality health plan?
The quality of health plans varies widely. A study published by the National Committee for Quality Assurance (NCQA) found significant differences in the ways health maintenance organizations (HMOs) provide access to care, keep people healthy, treat illness, deliver high-quality service, and satisfy patients. For example, many studies show that treating heart attack patients with beta blocker drugs saves lives.
The NCQA found that in some health plans, most heart attack patients got beta blockers, while in others, fewer than one in three did. The NCQA provides a detailed, online ranking of over 600 health plans in the United States. The plans are scored and ranked by customer service, clinical performance, and accreditation. To find NCQA’s reports, go the site to see a free “report card” on any health care plan they have reviewed, or call 1-888-275-7585.
You are probably looking for a type of health plan that best fits your needs in terms of cost, benefits, and access to particular doctors. Whichever type you choose, what’s most important is to understand your plan options and how they affect your choice of providers. After all, your health plan determines your choice of doctors, which types of services you will receive (for example, some plans cover more preventive care than others), where you will receive your care, how quickly you will receive it, and how much you will pay.
Ask these questions when choosing a health plan:
- Do members rate the plan highly on things that are important to me?
- Does the plan provide preventive services to help keep people well?
- Does it do a good job of helping them get better when they are sick?
- Is the plan accredited?
- Does the plan have the doctors and hospitals I want or need?
- Does the plan provide the benefits I need?
- Do the doctors, pharmacies, and other services in the plan have convenient times and locations?
- Does the plan meet my budget?
Where can I find out how a particular health plan is rated?
To find out what other consumers think of a particular health plan, look for the survey compiled by the Consumer Assessment of Healthcare Providers and