Health Plans Rated by Consumer Reports

Aug. 8, 2005 -- Readers of Consumer Reports have rated their health insurance plans for the magazine.

Here are the scores of the five HMOs (health maintenance organizations) ranked highest by readers for overall satisfaction:

• Kaiser Permanente, Northwest (Ore., Wash.): 84
• Capital District Physicians' Health Plan (N.Y.): 83
• Independent Health (Western N.Y.): 83
• Blue Choice (Excellus BCBS, Rochester, N.Y. area): 82
• Group Health Cooperative (Id., Wash.): 81

Here are the scores of the five PPOs (preferred provider organizations) ranked highest by readers for overall satisfaction:

• Independence Blue Cross Philadelphia: 83
• Anthem Blue Cross Blue Shield (Conn.): 83
• Blue Cross Blue Shield (Ala.): 81
• Blue Cross Blue Shield (Mass.): 81
• Empire Blue Cross Blue Shield (N.Y.): 81

Differences From General Public

About 35,000 Consumer Reports readers participated in the survey.

The magazine's readers are "more affluent, more educated, and they're probably more consumer savvy" than the general public, says Donato Vaccaro, PhD, research program leader for Consumer Reports.

"This was a scientific survey, but we're not trying to be nationally representative. This is representative of Consumer Reports subscribers, and their information can help anyone make a decision about products or services," Vaccaro tells WebMD.

The magazine's ranking of health plans was based only on overall reader satisfaction. The 22-question survey covered access to doctors and medical care, choice of doctors, quality of customer support, frequency of billing problems, care doctors provided, and satisfaction with primary care doctors.

Many Expressed Satisfaction With Their Health Plan

The survey showed that 64% of Consumer Reports readers were "completely" or "very" satisfied with their health plans.

Still, 17% of participants who were in HMOs expressed difficulty in seeing doctors, and nearly a third of those in PPOs said they had had billing problems, says Vaccaro.

"In general, when you survey people about something, about two-thirds will say they're highly satisfied -- completely or very satisfied," says Vaccaro. "It's a rule of thumb in the social science world. So this is average -- 64% is not much different than 66%, right? But it's health care. So maybe you expect it to be higher. It's a matter of opinion," says Vaccaro.

'Range of Satisfaction'

"It's pretty clear that there is a range of satisfaction that occurs from the top of the list to the bottom," says Vaccaro.

Among the 35 HMOs ranked for overall reader satisfaction, there was a 14-point difference in scores between the top- and bottom-ranked HMOs. "That's definitely meaningful," says Vaccaro, noting a 15-point range in overall reader satisfaction among the list of 41 PPOs.

Regional branches of the same companies were ranked separately. "In some cases, a national plan ... will streamline the administrative tasks they're doing. But sometimes, they're more localized, so there are differences," says Vaccaro.

Magazine's Tips

Shopping for a health care plan? A Consumer Reports news release offers this advice:

• Learn the differences between HMOs and PPOs.
• Check business news about the companies you're considering.
• Ask to see the plan's list of doctors if you want to keep your current doctor.
• Call your state's department of insurance to see whether it has received any complaints about the plan.
• After signing up with a plan, report any problems with the plan to your employer.