Ohio physicians rate insurers in HMO report card twist

Medicare outscores private insurers, but that wasn't hard. Performance scores for all plans were low.

By Mike Norbut, AMNews staff. Aug. 11, 2003.

With the idea of HMO-sponsored physician and hospital report cards gaining momentum around the country, a management services organization in Ohio has given physicians a chance to turn the tables on their local insurance companies.

MaternOhio Management Services, which handles business tasks for ob-gyn practices in the Columbus area, has produced a managed care report card derived from surveys it sent to physicians. The survey asked practices to rate 10 local HMOs based on the hassles they endure during their normal course of business.

"We decided if people are going to evaluate me, I'm going to evaluate insurance companies," said Donald K. Bryan, MD, an ob-gyn in Columbus and MaternOhio medical director. "At least we can evaluate them for how we feel about how they serve us."

As opposed to report cards that are compiled by business groups and nonprofit organizations and are designed for the consumer's benefit, MaternOhio's product ranks insurers strictly from a physician's business perspective. HMOs were graded on a four-point scale, with 4 being the highest, in categories like billing, collections, patient identification cards, and precertification for medical treatments.

Medicare had the highest overall average score, but it was only 2.2. Aetna ranked second, followed by Nationwide Health Plans, Medical Mutual of Ohio, and UnitedHealthcare.

"All of the carriers have a high hassle factor," said Wayne Howlett, client services liaison for MaternOhio. "Most of the carriers were barely average or below average in many sections."