The managed-care plans that cover General Motors' employees and retirees are doing only a fair job of satisfying enrollees, providing preventive care and treating chronic illnesses, according to a new auto industry healthcare "report card."
Those are the first results of a joint effort by the Big Three automakers and the United Auto Workers union to study healthcare quality. Ford Motor Co. and DaimlerChrysler are expected to release separate reports in early 1999.
The report card includes all 129 health plans that contract with GM, which cover 1.5 million employees, retirees and dependents.
The Big Three and the UAW spent six months coordinating the project, which is based on the Health Plan Employer Data and Information Set 3.0 measures developed by the Washington-based National Committee for Quality Assurance.
The Rand Corp., a Santa Monica, Calif.-based think tank, scrutinized the data to ensure the plans were evaluated on equal criteria, Bradley said.
The plans were judged in four categories: consumer satisfaction, access and service, preventive care, and recovery from illness and treating chronic conditions. Plans got a score of 3 for significantly above average performance, 2 for average and 1 for significantly below average.
Some 65% of the plans received average scores in consumer satisfaction, while 58% were viewed as average in access and service, 69% in preventive care, and 60% in dealing with recovery and chronic conditions.
Only 19% of the plans received above average scores for consumer satisfaction.
Some 22% were rated above average for access, 17% for preventive care, and 22% for recovery and chronic conditions.
Just 16% of the plans received significantly above average scores for consumer satisfaction, while 21% did so for access, 15% for preventive care, and 19% for recovery and chronic conditions.
The five highest-rated plans weren't in Michigan, home to the Big Three. Those plans were Fallon Community Health Plan, Worcester, Mass.; Preferred Care, Rochester, N.Y.; HCP/ChoiceCare, Cincinnati; Group Cooperative of South Central Wisconsin, Madison; and Blue Choice, Rochester, N.Y.
Bruce Bradley, GM's director of managed-care plans, said there was room for improvement for the plans. He expected them to be affected by migration patterns, which would be available in early 1999.
"No health plan wants to look bad, and this will prove to be a good employee tool," he said, adding that other employers nationwide have shown interest in the report card.
In most cases, GM contracts with plans that received low scores simply because they are the best plan available in a region, a company official said.
Only two of GM's health plans received the highest scores across the board, and they were Fallon, which has 700 GM enrollees, and Preferred Care, which has 900 GM enrollees.
Blue Choice Arizona, Phoenix, had the lowest overall scores.
Seven plans operated by Cigna HealthCare of Florida, based in Fort Lauderdale, and Cigna HealthCare of Louisiana, based in Shreveport, were among those with the lowest scores. The Florida plan will start covering GM workers in January-the report card covered all enrollees-while the Louisiana plan has 2,400 GM enrollees.
David Feng, assistant director of corporate relations for Cigna HealthCare in Florida, declined comment on the report card because he had not seen it. But, he added that Cigna was among the top performers in a report card recently released by Florida's Agency for Healthcare Administration and the Foundation for Accountability, a Portland, Ore.-based research group.