HMO's ranked by Adult Member Satisfaction

The 1999 Florida Legislature passed legislation that directs the Agency for Health Care Administration (AHCA or Agency) to publish a health maintenance organization (HMO) report card.

HMOs are required to report to AHCA data that are indicators of access and quality of care, such as measures of chronic disease management, preventive health care, and prenatal care.



For all indicators, five dots designate the best rank possible and one dot designates the lowest rank.

Commercial Health Plans	Ratings for Adult Member Satisfaction
New health plan (*) Not measurable/small population (**) Not reported (***)	Overall Plan Satisfaction	Ease in Getting to See a Specialist	Ease Getting Needed Care, Tests, or Treatment	How Well Providers Communicate with Members	Getting Help from Customer Service
Aetna Health, Inc.
AvMed, Inc.
Capital Health Plan, Inc.
CIGNA Health Care of Florida, Inc.
Citrus Health Care, Inc.	*	*	*	*	*
Florida Health Care Plan, Inc.
Great-West Healthcare of Florida, Inc.	**	**	**	**	**
Health First Health Plans, Inc.
Health Options, Inc.
Humana Medical Plan, Inc.
Neighborhood Health Partnership, Inc.
Preferred Medical Plan, Inc.
The Public Health Trust of Dade County/JMH Health Plan
Total Health Choice, Inc.
United Healthcare of Florida, Inc.
Vista Healthplan, Inc.
Vista Healthplan of South Florida, Inc.

EXPLANATION OF RATINGS AND DATA SOURCES

Health plan ratings are assigned for each indicator using benchmarks based on the overall distribution of results (scores) for all the health plans rated and the average score for the indicator. For each indicator, plans are assigned a rating as follows:

	1 or more standard deviations above the average score
	0.5 standard deviations above the average score
	Within 0.5 standard deviations (above or below) of the of the average score
	0.5 standard deviations below the average score
	1 or more standard deviations below the average score

If a health plan had a score exactly equal to a standard deviation benchmark, the health plan is assigned the higher ranking. For all indicators, five dots designate the best rank possible and one dot designates the lowest rank.

Descriptions of the data sources for the indicators used to rank plans are described below. In addition, results for each health plan showing their individual scores for each indicator are available in the Ratings & Scores section. The average score and a prior average, if available, are reported for each indicator.

Member Satisfaction

The University of Florida's Bureau of Economic and Business Research conducted a survey of health plan members on behalf of AHCA between October 2004 and January 2005. Members of commercial, Florida Healthy Kids, and Florida Medicaid health plans were polled by telephone to obtain a representative sample ³ A total of 12,619 surveys were completed. Adults were asked about their satisfaction with their personal health care. In a separate survey, a parent, family member or guardian was asked about their satisfaction with their child's care.

The indicators reported from the AHCA survey are:

• Overall plan satisfaction
• Ease in getting to see a specialist
• Ease getting any care, tests, or treatment that the member or member's doctor believed necessary
• How well providers communicate with members. This indicator averages responses to the following:
  1. How well do they listen carefully to the member?
  2. How well do they explain things in a way the member can understand?
  3. Do they show respect for what the member has to say?
  4. Do they spend enough time with the member?

• Getting help from customer service

Member satisfaction information for Medicare plans includes three indicators described above (overall plan satisfaction, ease in getting to see a specialist, and how well providers communicate with members) and two additional indicators from a survey performed in 2003 and reported on the national Medicare Compare website ⁴. The two indicators are:

• Overall satisfaction with care
• Ease getting needed care. This indicator averages responses about:
  1. Finding a personal doctor or nurse
  2. Getting a referral to a specialist the member wanted to see
  3. Getting the care the member and their doctor believed necessary
  4. Getting care approved by the health plan without delays