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How well do HMOs help members maintain good health and avoid illness?

Understanding the Table

Current performance area: Staying Healthy and Living with Illness
Compare: Selected HMOs
Source: DOH, 2005

Plans are listed in alphabetical order.

Skip Legend
Performance Compared to the New York HMO Average
Better than average Significantly better than the NY HMO average
Not different from average Not significantly different than the NY HMO average
Worse than average Significantly worse than the NY HMO average
SS Rate not suitable for comparison because of a small sample size.
NV Plan submitted invalid data.
Click here for the pdf version of the table
 
Access to Care and ServiceStaying Healthy and Living with IllnessQuality of ProvidersGrievances
ComplaintsPrompt Pay ComplaintsInternal AppealsExternal Appeals
   
HMO Childhood
Immunization
Chlamdia
Screening
(ages 21-25)
Advising Smokers
to Quit
Persistence of
Beta-Blocker
Treatment
Follow-Up After
Hospitilization for
Mental Illness
Within 30 Days
NY HMO Average 76% 45% 74% 73% 77%
Aetna Health Lower than average Higher than average Not different from average Not different from average Higher than average
Blue Choice Higher than average Lower than average Not different from average Not different from average Higher than average
BSNENY-HMO Higher than average Not different from average Not different from average Higher than average Not different from average
CDPHP Higher than average Higher than average Not different from average Not different from average Not different from average
CIGNA Not different from average Higher than average Lower than average SS Not different from average
Community Blue (HealthNow) Higher than average Lower than average Not different from average Not different from average Not different from average
Empire HealthChoice Not different from average Lower than average Not different from average Not different from average Higher than average
GHI-HMO Select Not different from average Lower than average Lower than average Not different from average Higher than average
Health Net of NY Lower than average Higher than average Not different from average Not different from average Not different from average
HIP Not different from average Higher than average Not different from average Not different from average Lower than average
IHA Higher than average Lower than average Not different from average Not different from average Not different from average
MDNY Not different from average Lower than average Lower than average Not different from average Lower than average
MVP Health Plan Higher than average Higher than average Not different from average Not different from average Not different from average
Oxford Lower than average Lower than average Not different from average Not different from average Lower than average
Rochester Area HMO (Preferred Care) Higher than average Higher than average Not different from average Not different from average Not different from average
UnitedHealthcare of NY Lower than average Higher than average Not different from average Not different from average Not different from average
Univera HealthCare Higher than average Lower than average Not different from average Not different from average Higher than average
Upstate HMO Higher than average Lower than average Not different from average Not different from average Not different from average

NOTE: Symbols show statistically significant differences between each planís score and the New York average. Statistically significant means scores varied by more than could be accounted for by chance.


New York HMOs were rated on how well they help people maintain good health and recover from illness.

Understanding The Table

The circles show how each HMO compares to the average for all New York HMOs. Look for HMOs with a Better than average in the table. These HMOs performed better than the New York HMO average. In other words, a greater percentage of members who received these services.

Childhood Immunization
Childhood immunizations prevent the resurgence of many serious infectious diseases. HMOs were rated on the percentage of 2-year-olds who were fully immunized with the following vaccines: 4 Diptheria/Tetanus/Pertussis, 3 Polio, 1 Measles/Mumps/Rubella, 3 H Influenza type B, 3 Hepatitis B, and 1 Varicella.

Chlamydia Screening (ages 21-25)
Chlamydia is the leading cause of preventable infertility and can lead to pelvic inflammatory disease. Women with chlamydial infections often do not have symptoms, so routine screening and treatment is essential. HMOs were rated on the percentage of sexually active young women who had at least one test for chlamydia.

Advising Smokers to Quit
Clinician advice to stop smoking improves the chances a smoker will quit. Smokers who quit have immediate and long-term benefits, reducing risks for many diseases and improving health in general. HMOs were rated on the percentage of members, 18 years and older, who are either current smokers or who recently quit, who received advice within the last 2 years from a health care provider to quit smoking.

Persistence of Beta-Blocker Treatment
Use of beta-blockers reduces the likelihood of dying after a heart attack. It also reduces the risk and severity of another heart attack and preserves heart function. HMOs were rated on the percentage of members, 35 years and older, who were hospitalized after a heart attack and who received beta-blocker medication for 6 months.

Follow-Up After Hospitalization for Mental Illness Within 30 Days
Adequate and timely follow-up care for patients discharged from an inpatient mental health facility helps to provide transitional care to an outpatient setting. Follow-up can prevent readmission or identify patients who would benefit from readmission. HMOs were rated on the percentage of members who were hospitalized for treatment for selected mental health disorders (such as depression or bipolar disorder) and were seen on an ambulatory basis or who were in intermediate treatment with a mental health provider within 30 days of discharge.

Keep in mind...

These measures indicate how well an HMO delivers preventive care to help members stay healthy. Evaluate the importance of each performance measure to you and your family. The Staying Healthy category is only one of eight performance areas presented.

 

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State of New York
David A. Paterson
Governor
State of New York
Department of Insurance
Eric R. Dinallo
Superintendent of Insurance
State of New York
Department of Health
Richard F. Daines, M.D.
Commissioner
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