MCPR 2000 - Measuring the Quality of Pennsylvania's HMOs - News Release


Contact: Joe Martin, Communications Director
717-232-6787 or


Harrisburg, PA - May 22, 2002 - When it comes to illness prevention, Pennsylvania's HMOs receive higher marks than HMOs elsewhere, according to a new government report out today. PA's HMOs had better ratings in all 16 preventive care measures covered in a new report by the Pennsylvania Health Care Cost Containment Council (PHC4), and beat their own previous marks in categories where more than one year of data was available. And for the third consecutive year, Pennsylvania HMO members were more satisfied with their care than HMO members elsewhere, with 85% reporting no problems in receiving the care they felt they needed and 65% giving HMOs the highest overall satisfaction rating.

"In general, Pennsylvania's HMOs outperformed those throughout the rest of the country on illness prevention and patient satisfaction measures," stated Marc P. Volavka, Executive Director of PHC4. "However, there are still differences among plans, particularly in the area of surgical complications. Because Pennsylvania is the only state reporting such clinical outcome results for HMO plans, this report can help purchasers and consumers ask more detailed questions, and choose more wisely among plans."

In addition, the new report, titled Measuring the Quality of Pennsylvania's Commercial HMOs, suggests that HMOs that focus heavily on preventive care may be helping to keep their members out of the hospital for related conditions. PHC4's study showed lower hospitalization rates for diabetes and hypertension for those HMOs who helped high percentages of their members control their blood sugar and blood pressure levels. Because of its unique database, PHC4 has the ability to analyze the HEDIS/CAHPS prevention and member satisfaction measures against HMO-specific inpatient clinical data. The combination of these analyses is beginning to demonstrate statistically significant relationships between prevention measures and hospitalization rates.

"An ounce of prevention equals a pound of cure," said Mr. Volavka. "In some instances, there is a statistically significant relationship between a heavy focus on prevention and lower hospital admission rates."


"The participating HMOs are to be congratulated for their involvement in this project," said Mr. Volavka. "Through their voluntary efforts, these companies are helping to report meaningful performance data about health care in Pennsylvania."

An HMO is a prepaid health insurance plan that requires members to use participating doctors and hospitals, and to get referrals from primary care physicians before seeing specialists. Some point of service (POS) plan data is also included in the report; POS plans are similar to HMOs but give members some coverage for services outside the network of preferred providers. Not included in the report are Medicare HMOs, which serve older and disabled people and Medical Assistance HMOs that serve low-income individuals.

The Pennsylvania Health Care Cost Containment Council is an independent state agency that provides the public with information that can be used to improve the quality and restrain the cost of health care in Pennsylvania. Copies of Measuring the Quality of Pennsylvania's Commercial HMOs are free and can be ordered by calling the Council at 717-232-6787 or downloaded from the Council's website at