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More than half of all states have developed their own HMO report cards or
list complaint-related information to help consumers compare the performance of
competing health plans in your area.
States vary in the types of quality-related managed care plan information
they make available on their websites. If your state doesn't produce its
own HMO report card or you find the information lacking, you can still give
your local health plan a checkup. The National
Committee for Quality Assurance (NCQA)—a private, not-for-profit
organization dedicated to assessing and reporting on the quality of managed
care plans—grades health plans nationally. While you can compare health
plans on NCQA's site,
you'll be able to see plan information only for those entities that have
gained NCQA accreditation. Not all health plans are accredited.
Also, the federal government puts out health plan performance report cards
on Medicare health plans. And federal government workers and retirees can check
out quality measures of health plans contracting with the Federal Employees
Health Benefits Program. Check out FEHBP guides here. Meanwhile, use the
drop-down menu below, or scroll down this page to find links to the managed
care comparison data that's available online for your state.
(Note: Many of the links on this page lead to files that appear in Adobe
Acrobat PDF format. You will need the Adobe Acrobat Reader plug-in to view
them. Download
the Reader for free now if necessary.)
Alabama
Alabama does not produce its own HMO report card, but there are a couple of other avenues to gather information.
You can examine some health plans in the state via the NCQA's Health Plan Report Card. The NCQA's tool allows users to compare plans by zip code or state, as well as certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results.
The Alabama Quality Assurance Foundation (AQAF) is a nonprofit, physician-sponsored organization that was designated as Alabama's Medicare Quality Improvement Organization by the Centers for Medicare and Medicaid Services. People with Medicare can call the AQAF's Medicare Beneficiary Helpline to request reviews of quality medical care concerns and ask for reviews of hospitals they feel pushed the patient out of the hospital too early. The AQAF also has a fast track appeal for Medicare Advantage enrollees if you receive notice from your health care provider that your skilled nursing facility, rehabilitation, or home health services are being stopped. However, the AQAF will handle your appeal only if you request one by noon of the day before coverage ends.
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Alaska
Alaska does not produce its own HMO report card. As of late 2005, the NCQA had not listed an Alaskan health plan as accredited, but to check if there is new information, check the NCQA's New Health Plan Accreditation Status List and the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results. To understand how the NCQA applies accreditation, look at its explanation of health-plan participation.
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Arizona
While Arizona does not have a report card comparing plans, it does offer consumers a "complaint ratio" of health care plans here.
You can create a report card using information provided by the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results. To find out how the health care plans are accredited by the NCQA, see the site's explanation of health-plan participation.
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Arkansas
Arkansas does not produce its own HMO report card, but you can read about health plans in the state via the NCQA's Health Plan Report Card.
You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results.
Keep in mind that the tool lets you compare only health plans that are NCQA-accredited, so you may find few or no health plans to compare in your state. See the site's explanation of health-plan participation.
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California
California's Department of Managed Health Care works with the Office of the Patient Advocate (OPA), which has several online tools to help the consumer select the best health plan. The OPA offers an HMO Report Card that lets you compare selected HMOs or all HMOs at once. A star-rating quality-based system is based on what members say about their experiences and on data culled from patient medical records. You can compare HMOs on a county basis or compare health plans on a host of health condition outcomes and preventive care measures on a range of topics. Also, scroll to the bottom of the page to link to the state's Get Help With Your HMO Web page, which assists consumers desiring to resolve problems or to file a complaint.
The NCQA also allows consumers to compare health plans in California with their own NCQA's Health Plan Report Card.
Californians can also compare HMO health plan ratings through the independent business coalition Pacific Business Group on Health's HealthScope website. The site allows visitors to compare plans across many categories of treatment and patient satisfaction.
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Colorado
Colorado's Division of Insurance offers health care information, quarterly HMO statements and information about senior health and Medicare on its website. To access information about HMO complaint ratios, check this page.
Colorado consumers also can compare health plans in the state through the nonprofit business coalition Colorado Business Group on Health. The group has developed a health plan report card on their website. The site breaks down its data into three separate reports: 1) consumer satisfaction, 2) treatment of illness and 3) preventive care. For each report, you can see past and present years' survey results.
NCQA also allows consumers to compare accredited HMO plans in Colorado with their NCQA's Health Plan Report Card.
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Connecticut
Connecticut's Insurance Department has a comparison guide of all HMOs and the 15 largest insurers that offer managed care in the state in its "A Comparison of Managed Care Organizations in Connecticut." You can also call 860-297-3900 or 800-203-3447 for a printed version of the Connecticut guide.
The NCQA also compares accredited HMO plans in Connecticut in their NCQA's Health Plan Report Card.
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Delaware
Delaware does not produce its own HMO report card, but you can compare health plans in the state via the NCQA's Health Plan Report Card. The NCQA's report card, which compares NCQA-accredited plans in Delaware, can be used to search by zip code or by state and is divided into types of health plans.
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Disctrict of Columbia
The District of Columbia does not produce its own HMO report card. However, for in-depth health plan quality comparisons of D.C.'s HMOs, check out the NCQA's Health Plan Report Card, which compares accredited plans in the district. You can search by zip code or by state and select types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Florida
In Florida, the state's Agency for Health Care Administration (AHCA) publishes an HMO report card, based on required reporting from HMOs on measures of chronic disease management, preventive health care, prenatal care and checkups for children. The AHCA also conducts an annual survey to determine HMO member satisfaction.
Florida's report is divided into Medicare HMOs, Medicaid health plans, Florida Healthy Kids health plans, and commercial HMOs. See how health plans stack up in terms of member satisfaction, various quality-of-care indicators, complaints received, financial health indicators and enrollment data with their Florida HMO Ratings and Scores Report.
Call 888-419-3456 for a printed version of the Florida guide.
To get an update on any changes in Florida's health plan since the report was issued, visit www.FloridaHealthStat.com and look under InsuranceStat.
The NCQA also compares accredited HMO plans in Florida in their NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Georgia
While it doesn't offer an HMO report card, Georgia's Department of Insurance offers Biannual HMO Complaint Comparison Page on every HMO operating in the state.
The NCQA also compares accredited HMO plans in Georgia in their NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Hawaii
Hawaii offers a Consumer's Guide to Health Plans that lets you compare the results of the state's HMOs and PPOs on members' perception of care, access to doctors, customer service and other measures. The online tool also offers consumers a worksheet, plan contact information, enrollment and other helpful data.
The NCQA also compares accredited HMO plans in Hawaii in their NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Idaho
Idaho does not produce its own HMO report card, but you can compare health plans in the state via the NCQA's Health Plan Report Card, which can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Illinois
In Illinois, the Office of Consumer Health Insurance provides an independent review of HMOs and health plan complaint information, as well as other information in its annual report. In the exhibits section of its report, the office details an HMO External Independent Review Summary, a general summary of HMO company complaint record, and, an HMO company record of complaints by classification.
The NCQA also compares accredited HMO plans in Illinois in their NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Indiana
Indiana publishes an Indiana HMO Report Card as a tool for consumers to use in comparing health plans.
The NCQA also compares accredited HMO plans in Indiana in their NCQA's Health Plan Report Card online tool. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Iowa
The Iowa Insurance Division offers an HMO report card as well as other tools such as complaint ratios for HMOs in Iowa, complaint ratios for individual health care plans in Iowa, and complaint ratios for group health insurance in Iowa.
Iowa's report card shows up as a PDF file. It allows consumers to compare plans based on a number of preventive screenings regularly performed, consumer satisfaction, customer service, claims, processing and provider turnover. The report card also offers information such as percentage of board-certified physicians on staff at each health plan and percentage of geriatrician specialists and other key stats.
The NCQA also compares accredited HMO plans in Iowa in their NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Kansas
Kansas offers consumers the state's HMO Complaint Ratio Report, which shows the number of complaints written against Kansas HMOs over a three-year period.
The NCQA also compares accredited HMO plans in Kansas in their NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Kentucky
The Kentucky Office of Insurance offers consumers a complaint ratio search engine where you can either look up a particular company or leave the company name blank and compare all the insurance companies conducting business in Kentucky.
The NCQA also compares accredited HMO plans in Kentucky in their NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Louisiana
Louisiana does not produce its own HMO report card, but you can compare health plans in the state via the NCQA's Health Plan Report Card. The NCQA report card, which compares accredited HMO plans in Louisiana, can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Maine
Maine's Bureau of Insurance offers a Health Insurance Complaint Comparison, which compares health insurers by showing "1" is average, less than "1" is better than average, and greater than "1" is worse than average. The bureau also provides general Maine insurers information; data on the number of utilization review decisions companies made that were not in favor of the covered person, and the number of reversed decisions made when an insurance company declined benefits and the consumer requested an independent external review.
The NCQA also compares accredited HMO plans in Maine in their NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Maryland
Maryland's consumer guides to state health plans let you compare selected HMOs and Point-of-Service plans or all HMOs at once against several key criteria, including access and service, staying healthy, and getting better/living with illness. The state offers different guides geared toward commercial plans, those specific to state workers and others. The guides also tell you how to interpret the results and gives information on choosing the HMO that's right for you.
Measuring the Quality of Maryland HMOs and POS Plans: 2005 Consumer Guide provides detailed comparative information about the state's HMO and POS plans. For more details on how each commercial HMO compares to the others on member ratings and clinical performance in Maryland, check out the 2005 Comprehensive Performance Report: Commercial HMOs and Their POS Plans in Maryland.
For those interested in a Medicaid HMO, Maryland's Department of Health and Mental Hygiene offers an annual Consumer Report Card on the Health Choice Health Plans, which is based on surveys of Health Choice enrollees. The report focuses on access to care, doctor communication and service, care for kids with chronic illness, keeping kids healthy, taking care of women and diabetes care.
Maryland also publishes a policy-oriented report called Maryland Commercial HMOs and POS Plans: Policy Issues that focuses on comparing Maryland's commercial HMO industry as a whole with other plans in the region or nationwide. State employees can check out Measuring the Quality of Maryland HMOs and POS Plans: 2004 State Employee Guide.
You can also use NCQA's Health Plan Report Card to compare accredited plans in Maryland. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Massachusetts
The Massachusetts Healthcare Purchaser Group, which is a coalition of private and public organizations, provides the 2004 Guide to Health Plan Performance. This guide compares selected measures of health plan performance to show quality of care and member satisfaction.
The state publishes Your Guide to Managed Care in Massachusetts, which gives helpful general information about state health plans including summaries of selected quality measures.
The NCQA also compares accredited HMO plans in Massachusetts in its NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
The state's Group Insurance Commission (GIC) publishes the GIC Health Plan and Hospital Report Card, which compares Massachusetts' health care plans. The GIC also gives more general information on how to choose a health plan.
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Michigan
Michigan's interactive HMO Consumer Guide allows you to compare selected HMOs by selected general criteria—or see how they all stack up in all categories. The guide provides information on HMO care quality, profit/nonprofit status, enrollment, complaint information and other resources. Check out the HMO complaint data in the same report that reveals the average number of complaints per 1,000 members, as well as how each plan's complaints turned out—whether they were upheld, overturned or compromised. Consumers can also access Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.
The state's Medicaid program also provides a Health Plan Quality Checkup. For more information about the Medicaid health plans, call 800-367-6557.
The NCQA also compares accredited HMO plans in Michigan in the NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Minnesota
Minnesota's Department of Health provides information on health plan quality, financial reporting, performance and enrollment here. Detailed quality reports based on NCQA data for each health plan operating in Minnesota can be obtained on the state Department of Health's Managed Care Section. There is another page available to examine quality assurance and performance measurement for particular health plans.
For NCQA's comparison of accredited HMO plans in Minnesota, use the NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Mississippi
Mississippi does not produce its own HMO report card, but you can compare health plans in the state via the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results.
Keep in mind that the tool only lets you compare health plans that are NCQA-accredited, so you may find few or no health plans to compare in your state. See the site's explanation of health-plan participation.
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Missouri
Missouri's Department of Health and Senior Services issues several annual guides designed to monitor managed care performance in the areas of women's health, children's health, cardiovascular health, diabetes, depression and member satisfaction. The Consumer's Guide: Commercial Managed Care in Missouri allows consumers to compare commercial health plans in Missouri. The Consumer's Guide: Medicare Advantage Managed Care in Missouri focuses on Medicare customers and the Consumer's Guide: MC+ Managed Care in Missouri is targeted for Medicaid users. All show up as a PDF file. The guides also provide phone numbers for all state health plans.
The NCQA also compares accredited HMO plans in Missouri in its NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Montana
Montana does not produce its own HMO report card. Moreover, as of late 2005, the NCQA had not listed a single Montana health plan as accredited. To check for any updates, look up the NCQA's New Health Plan Accreditation Status List and the NCQA's Health Plan Report Card. The NCQA's report card can be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Nebraska
Nebraska does not produce its own HMO report card. As of late 2005, the NCQA rates one accredited HMO plan in Nebraska in its NCQA's Health Plan Report Card. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Nevada
Nevada does not have its own HMO report card. But consumers can compare health plans in the state via the NCQA's Health Plan Report Card. The NCQA's report card can be searched by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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New Hampshire
While New Hampshire does not produce its own HMO report card, you can compare health plans in the state via the NCQA's Health Plan Report Card. The NCQA's report card can be searched by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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New Jersey
The 2004 New Jersey HMO Performance Report lets you compare selected health plans, or you can see how all health plans stack up. The comprehensive guide reveals many specific performance measurements, such as how well doctors communicate, how well each plan manages preventive-care programs, and how well sick members fare. You also will find phone numbers and areas/scope of service for each health plan, as well as instructions on how to file complaints and appeals.
The NCQA's Health Plan Report Card, which compares accredited plans in New Jersey, can also be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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New Mexico
Click on New Mexico Consumer Guide to Managed Care to access a gateway of consumer-friendly information about commercial, Medicare or Medicaid-managed care, including comparisons on various topics ranging from how the state's health plans handle women's health to the percentage of board-certified doctors on staff at each plan. The government also describes consumer rights and responsibilities as well as how to address complaints and grievances.
Interested in the performance of Medicaid health plans? Check out Evaluation of MCO Performance 2003.
The NCQA's Health Plan Report Card, which compares accredited plans in New Mexico, can also be used to search by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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New York
New York's Insurance Department offers several Interactive New York Consumer Guides to HMOs that let you compare health plans' performance and their costs. To see the cost of premiums, click Compare HMO Premium Rates and search by your county to produce a PDF file.
The Compare HMO Performance guide is more interactive. You can compare all health plans within a specific county, selected individual plans, or all plans at once. See how the plans stack up in terms of complaints, access to care, and six other categories. The state also offers other helpful consumer guides on its site, such as a three-year complaint ratio.
The state also offers a 2004 New York State Managed Care Performance Report that tracks the performance of New York commercial health plans and health plans serving Medicaid clients and Child Health Plus enrollees.
The New York State Health Accountability Foundation, which is a coalition of health quality improvement groups, business groups and government representatives, offers its own HMO Report Card Online. Their report card allows you to select specific HMOs or all plans to see how they stack up on a range of measures, including ability to rate treatment of certain conditions, percentage of board-certified primary care physicians and HMO satisfaction levels.
A third available HMO report card for New York is the NCQA's Health Plan Report Card, which compares accredited plans in New York. You can search by zip code or by state and can select types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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North Carolina
North Carolina no longer offers managed care report cards. The most recent guide was the 2002 Managed Care Plan Consumer Guide, which provides performance data for various preventive- and chronic-care initiatives, as well as member-satisfaction data and tallies of complaints and appeals. You also can find member and physician turnover rates for each plan. A glossary of managed-care terms, plenty of background info and contact info for all the health plans help you choose the right plan for you.
The Department of Insurance also has a Complaint Ratio search tool that lets you search for the number of grievances or concerns voiced by consumers on various types of insurance, although the department warns that the numbers do not make a distinction between valid and non-valid complaints. The state's website also has Managed Care in North Carolina: Annual Report and Analysis of 2004 Activity, which includes some company comparisons.
The NCQA's Health Plan Report Card can also be used to search health plan performance by zip code or by state and is divided into types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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North Dakota
North Dakota does not produce its own HMO report card, but you can read about health plans in the state via the NCQA's Health Plan Report Card. As of late 2005, the NCQA listed one accredited health care plan in North Dakota. The site explains how to use the NCQA report card results.
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Ohio
Ohio's Insurance Department does not publish an HMO Report Card, but it does make available a health plan complaint ratio comparison report.
Ohio consumers can compare accredited health plans in Ohio with the NCQA's Health Plan Report Card. Search by zip code or by state for different types of managed care plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Oklahoma
Oklahoma does not produce its own HMO report card, but you can learn about health plans in the state via the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results.
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Oregon
Oregon requires health plans to provide annual reports that summarize complaint data and quality-of-care initiatives such as breast-cancer screening. A thumbnail comparison of complaints lodged against all Oregon health insurers is available at Year-to-Date Complaint Report - 2004.
To compare Oregon HMO health plans, use the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results.
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Pennsylvania
To access an interactive database on the cost and quality of HMOs in Pennsylvania, check out the Commercial HMOs Interactive Database, which is created by the Pennsylvania Health Care Cost Containment Council (PHC4). This database allows four options: plan ratings, plan profile, staying healthy and prevention measures, and member satisfaction.
The PHC4, which is an independent state agency charged with addressing the problem of escalating health costs, ensuring the quality of health care, and increasing access for all citizens, issues several reports, including Choosing a Medicare Managed Care Plan: A Guide for Medicare Beneficiaries.
Interested in quality information on Medicaid managed care plans in Pennsylvania? Check out Pennsylvania's Department of Public Welfare's Pennsylvania HealthChoices Performance Trending Report, which describes the quality of care, access to care, and the ability of special needs along with their Consumer's Guide to the HealthChoices Health Plans.
Another method of researching Pennsylvania HMOs is the NCQA's Health Plan Report Card, which compares accredited plans in the state. You can search by zip code or by state and select types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Rhode Island
Rhode Island's Health Department evaluates the performance of commercial health plans in Rhode Island in its performance report, which includes plan comparisons on financial, enrollment, utilization, clinical and member satisfaction measures. The state also offers a specific guide to Medicare and Medicaid health plans in Rhode Island Medicare and Medicaid Factbook - 2003.
The Health Department also offers consumers more generalized information on consumer rights and participating providers in their Consumer's Guide to Health Plans in Rhode Island - 2001.
Another method of researching Rhode Island HMOs is the NCQA's Health Plan Report Card, which compares accredited plans in the state. You can search by zip code or by state and select types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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South Carolina
South Carolina does not produce its own HMO report card, but you can read about health plans in the state via the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results.
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South Dakota
South Dakota does not produce its own HMO report card, but you can read about health plans in the state via the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results.
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Tennessee
Tennessee does not produce its own HMO report card, but its Department of Commerce and Insurance offers consumers information about grievances and complaint outcomes that Tennessee consumers have taken up with health plans.
Tennessee's Department of Health offers an HMO directory separated into non-TennCare Plans and TennCare Plans.
You can read about health plans in the state via the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results.
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Texas
Texas offers Comparing Texas HMOs 2005, which allows you to compare health plans in your region or across the state, including consumer satisfaction (or lack thereof) with care and service, as well as complaint data. The tool also offers consumers information on market share, and financial and contact numbers for each health plan.
Moreover, the State of Texas' Office of Public Insurance Counsel and the Department of State Health Service's Center for Health Statistics has created its own Guide to Texas HMO Quality: 2005, which provides a more detailed analysis of each HMO's strengths and weaknesses regarding specific performance measures. You can decide which performance measures are the most important to you or your family and select the strongest HMO based on those factors.
To get information on Texas Medicaid programs, check out Texas Medicaid in Perspective.
Another method of researching Texas HMOs is the NCQA's Health Plan Report Card, which compares accredited plans in the state. You can search by zip code or by state and select types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Utah
The 2005 Performance Report for Utah Commercial HMOs and Medicaid & CHIP Health Plans focuses on both commercial and Medicaid HMOs. The report gives consumers information on how Utah HMOs compared in both performance measures and consumer satisfaction measures. The report also summarizes how HMOs work.
The Health Department also publishes The Performance Quality of Utah's Health Plans 2004, which gives a snapshot of quality ratings for each HMO in the state.
Another method of researching Utah HMOs is the NCQA's Health Plan Report Card, which compares accredited plans in the state. You can search by zip code or by state and select types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Vermont
Vermont publishes a consumer guide on their health care plans, Vermont Managed Health Care Plans, that describes the benefits and services of the state's four largest managed health care plans. The guide assigns scores—high, average, or low—for each plan's performance in about 20 specific areas, ranging from ease of specialist referrals to eye-disease testing for people with diabetes.
The report also provides phone numbers for the state's health plans and other important contact information, information on how to use your health plan to the greatest benefit and your rights.
Another tool to gather more information on HMO plans is an outline of the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results.
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Virginia
Virginia contracts with a nonprofit health data organization called Virginia Health Information to produce a HMO plan comparison that allows you to select one or more plans and a specific performance measurement.
For additional health plan quality comparisons of Virginia HMOs, check out the the NCQA's Health Plan Report Card, which compares accredited plans in the state. You can search by zip code or by state and select types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Washington
Washington does not have an HMO report card, but it does offer a Complaint Ratio to 2004 Premium Volume for health care plans in the state. Washington State's Medicaid program, however, offers detailed information about consumer's assessments of health plan performance. To find the most recent report, go to Washington State Medicaid: Client Satisfaction Survey Results.
For more in-depth health plan quality comparisons of Washington State HMOs, check out the NCQA's Health Plan Report Card, which compares accredited plans in the state. You can search by zip code or by state and select types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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West Virginia
West Virginia does not produce its own HMO report card, but you can read about health plans in the state via the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results.
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Wisconsin
Wisconsin offers an HMO Quality and Consumer Satisfaction Data report, which contains some HMO quality and consumer satisfaction data on eight important indicators. The state also has a guide called Managed Care Health Plans in Wisconsin, which offers complaint data on each insurance company operating in the state.
The State Medicaid program offers in-depth information about HMO quality and performance. Among the most helpful reports for consumers is the HMO specific performance report, Wisconsin Medicaid and BadgerCare HMO Report Card.
The Wisconsin Collaborative for Healthcare Quality offers an interactive search engine where you can view health care quality measures by health plan or type of provider, clinical topic or institute of medicine category.
For more HMO performance data in Wisconsin, use the NCQA's Health Plan Report Card, which compares accredited plans in the state. You can search by zip code or by state and select types of health plans. The site compares only health plans that the organization has accredited (see the site's explanation of health-plan participation) and it describes how to use the NCQA report card results.
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Wyoming
The Wyoming Insurance Department offers a Composite of Consumer Complaint Data 1999 - 2003 describing the complaint ratio data on each insurance company operating in the state. For information on how to choose Medigap insurance, go to 2005 Wyoming Buyer's Guide to Medicare Supplement "Medigap" Insurance.
As of late 2005, the NCQA had not listed a Wyoming health plan as accredited but to check if there is new information, check the NCQA's New Health Plan Accreditation Status List and the NCQA's Health Plan Report Card. You can search for health plans to compare by zip code or by state, and you can ask the tool to compare only certain types of health plans—for instance, only Medicare HMOs or only PPOs or all types of plans at once. The site explains how to use the NCQA report card results. To understand how the NCQA applies accreditation, look at its explanation of health-plan participation.
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