The NEWSWEEK survey is more than a popularity contest. “Magazines that survey HMOs usually focus on benefits,” says Spragins, who last year published a book titled “Choosing and Using an HMO.” “Instead of just asking, “Do you cover mammograms?’ or “Do you cover Viagra?’ we try to ask, “How well are you doing making people healthy?’ " Answering that question requires a lot of specifics. Does a plan coordinate the efforts of various specialists? How does it manage chronic childhood conditions, such as asthma? What percentage of its Medicare patients drop out each year? Spragins says the goal isn’t so much to identify the best HMO in the country as to help consumers find the HMO best suited to their needs. “If you’re a middle-aged person with a family history of heart disease or have a baby in need of immunization, you need to pick a plan that is tailored to you,” she says.
For Spragins, who spent four years as a commercial banker before turning to journalism, the HMO survey–now in its third year–has become a source of great professional satisfaction. “Whenever I tell people I meet what I’m working on, they’ll immediately pop out an HMO name or two and ask, “What about this one?’ " she says. “It shows you how hungry people are for information.” But there’s some frustration, too. Despite eager participation from many HMOs, Spragins says she still can’t believe that some of the larger companies–including Oxford, Prudential and CIGNA–didn’t participate this year. “They say they have too many surveys,” she says, “but you have to wonder if they’re ducking scrutiny because they think their scores wouldn’t be high. It’s inexcusable not to let your members know how you’re doing.” See for yourself if your HMO makes the grade–or would rather keep its performance to itself.
Our consumer guide goes beyond the survey. In an accompanying article, we report on successes and failures of health plans around the country, drawing lessons about how to make managed care work. And columnist Robert Samuelson assesses the prospects for creating a health-care system that everyone would love. Fall is always the season for making health-care decisions. Here’s to making them wisely.
