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FHP Inc. Joins Other HMOs in Rating Itself

November 03, 1994|DAVID R. OLMOS | TIMES STAFF WRITER

FHP Inc., joining the growing number of medical companies supplying more information about the quality of health care, released a "report card" Wednesday grading itself on patient satisfaction, preventive care and other medical measurements.

The report from the nation's third-largest health maintenance organization comes amid a growing movement in the health care industry: releasing previously unavailable information about hospitals, doctors and insurers. Employer and consumer groups have been demanding such information to make it easier to compare the quality and costs of available medical services.

FHP, based in Fountain Valley, is among the first HMOs in California to release what it calls a quality report. About a year ago, Kaiser Permanente, the nation's largest HMO, released a report card for its Northern California region that won plaudits within the industry for its comprehensive nature. PacifiCare HealthSystems, a big HMO based in Cypress, will release its report card within 60 days, a company official said.

In its report, FHP said it surveyed 500,000 members in California and four other states and asked them to rate their doctors and the overall quality of the plan's services. It also conducted an extensive internal review of members' medical records to assess things such as prenatal care, childhood immunization rates and mammogram rates.

FHP said its survey found that 92% of its members were either "satisfied" or "extremely satisfied" with their FHP membership. The company also said its survey showed that the HMO's record on various preventive-care medical tests and procedures surpassed national averages.

For example, FHP said about 70% of members' children receive immunizations by age 2, compared to a national average of 37%. And 79% of women aged 21 to 64 had received a Pap test to detect cervical cancer during the previous three years, compared to a U.S. average of 59%.

While health care observers said FHP's report is welcome, they said one weakness is that it could be perceived as self-serving because it was prepared by FHP staff rather than an independent outside organization. The California Public Employees Retirement System, which negotiates for health care for nearly 1 million state employees and their dependents, has hired an independent company to prepare report cards on the nearly 20 health plans--including FHP--with which it has contracts.

"It gives a lot more credibility if the survey has been scrubbed and verified by an outside firm," said Tom Elkin, health care chief for CalPERS.

Some also raised questions about FHP's findings and said the data lacks sufficient detail to benefit consumers.

Geraldine Dalek, executive director of the Center on Health Care Rights, a consumer advocacy group in Los Angeles, said studies have shown that patients in most types of health plans--whether HMOs or traditional insurance plans--say they are generally satisfied with their medical care.

"The one question--'Are you satisfied?'--doesn't tell you anything," Dalek said. To be valuable to consumers, she said, health plans need to ask members more detailed questions, such as: How long does it take to get referrals to specialists? How hard is it to get an appointment? Can you get a timely response when you have a problem?

"HMOs are great when you're healthy," Dalek said. "The issue is how satisfied are people when they are not healthy. How do disabled persons feel about the program?"

In the nationwide debate over health care reform, HMOs have come under attack from physicians' groups and others who have questioned whether the insurers' emphasis on cost containment is jeopardizing the quality of care.

Westcott W. Price, FHP's chief executive, said the survey results demonstrate that "FHP has proven that quality health care can be provided at an affordable cost."

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