A recent survey of employees conducted by the Bay Area Business Group on Health-a consortium of 20 large employers in California-indicates that employees in managed-care plans are generally satisfied with their medical care.
The survey shows it's possible for employers to offer managed-care plans without expecting that employee satisfaction with medical care will erode. That is often the assumption when employees move from indemnity plans to managed care.
Ten employers participated in the survey, which was conducted by William M. Mercer, a benefits consulting firm.
When asked about overall plan satisfaction, enrollees in independent practice association-model HMOs, staff HMOs and PPOs are more likely to say they are "very satisfied" than are enrollees in point-of-service and indemnity plans, the study said.
But employees' specific areas of satisfaction and dissatisfaction varied significantly depending on the type of plan in which they were enrolled.
The study found:
Mostly high satisfaction with staff-model HMOs. "Enrollees...have high overall plan satisfaction, seldom defer medical care because of cost, and benefit from health improvement programs," the study said. But they are "relatively dissatisfied with all aspects of physician care...as well as length of time spent on hold talking on the phone with their plan."
General satisfaction with IPA-model HMOs. "Enrollees are relatively young with dependent children" and are generally satisfied with their plans and their physicians, according to the study.
Low satisfaction with point-of-service plans. "Enrollees have been in these plans only a short time, often changing plans because their former plan was no longer available to them." They have low satisfaction with their plans and their physician care.
High satisfaction with PPO plans. Enrollees have the highest level of satisfaction with all aspects of physician care, but they are less satisfied with their plans overall than are HMO enrollees.
Low satisfaction with indemnity plans. "Enrollees have the lowest level of plan satisfaction, only a moderate level of physician satisfaction and are most likely to have postponed medical care because of cost," the survey said.
The Bay Area group said it would use the results, among other things, to negotiate rates and performance standards with plans. The results can also help employers consolidate plans by eliminating poor performers, the group said.
The group also developed a report card, based on the survey, which grades California HMOs. Some companies may share the report card with employees during open enrollment.