MCPR 2002 - Measuring the Quality of Pennsylvania's Commercial HMOs - News Release

For Immediate Release

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


Harrisburg, PA - March 31, 2004 - HMOs in Pennsylvania performed better than the national HMO average in various measures designed to keep members healthy, according to a new report released today by the Pennsylvania Health Care Cost Containment Council (PHC4). The statewide HMO average was higher than the national average for: enrolled children receiving the necessary immunizations; pregnant women seeing a doctor during the first three months of pregnancy; members with diabetes receiving blood glucose testing and cholesterol screening; members receiving beta-blockers after a heart attack; and controlling cholesterol levels after suffering acute cardiovascular events.

"Pennsylvania's HMOs, on average, improved their scores from the prior year in 14 out of 15 'Staying Healthy' categories," stated Marc P. Volavka, Executive Director of PHC4. "In addition, Pennsylvanians, in general, appear to be more satisfied with HMO services compared to national averages."

Pennsylvania HMO plans, on average, got higher member satisfaction scores than the national average on all six member satisfaction areas for which national averages were available. According to the 2002 Consumer Assessment of Health Plans Survey (CAHPS), 84% of PA HMO members surveyed said they had no problem getting the care, tests, or treatment they or their doctor believed necessary. All but one HMO showed improvement from 2001 to 2002 in reducing the time it took for members to see a provider following an injury or illness. The average number of complaints filed by Pennsylvania plan members dropped by 19% from 2001 to 2002.

Measuring the Quality of Pennsylvania's Commercial HMOs is PHC4's fifth report about the quality of care that HMO networks offer. Pennsylvania's HMO report goes further than other states' reports because it is the only one to combine measures on preventive care and member satisfaction with a broad mix of clinical results.

The report includes information to allow comparisons of hospitalization rates for illnesses that, with effective primary care, should not generally require a hospital stay. For example, hospitalization rates for children with asthma decreased 10.8% from 2001 to 2002 for those in Pennsylvania HMOs.

The report also includes clinical information such as procedure rates, lengths of stay, and in-hospital complications for common surgical procedures such as hysterectomy. While hysterectomy procedure rates continued to vary widely among plans, four out of ten plans had hysterectomy rates that were lower than expected in 2002. In the previous year, only two out of thirteen had lower than expected rates.

The Pennsylvania Health Care Cost Containment Council is an independent state agency charged with collecting, analyzing, and reporting information that can be used to make more informed decisions, thereby improving the quality and restraining the cost of health care in Pennsylvania. Copies of the report are free and can be ordered by calling PHC4 at 717-232-6787 or can be downloaded from PHC4's website at