|HMOs Top PPOs – Members Save Money On Premiums; Customer Support
Health plan HMO members are saving money on their
premiums over those enrolled in PPOs, found a new survey. However,
annual out-of-pocket costs for plan premiums were up 38 percent from
two years ago for both those in HMOs and PPOs, found the survey by
Consumer Reports National Research Center.
Despite the comparative ‘freedom’ of a PPO,
choosing an HMO over a PPO seems like a smarter choice than in the
past, according to the survey results. "While overall satisfaction
scores were similar, respondents in HMOs paid less for premiums than
people in PPOs ($1,466 compared with $2,003) and less out of pocket on
their medical bills," the survey report said. Among PPO members who
were seriously ill, 69 percent paid $1,000 or more on bills, while only
47 percent of seriously ill people in HMOs spent that much.
The majority of the 37,481 survey participants were in
an employer-based plan, which they could keep under most health-reform
proposals now before Congress.
The median annual out-of-pocket costs for premiums
increased by 38 percent in the past two years, and only 64 percent of
those surveyed were "Very" or "Completely" satisfied with their current
health insurance plan, found the survey conducted by the Consumer
"That’s a lukewarm response and a slight drop from
the 67 percent in our 2007 report," said Mandy Walker, senior project
editor for Consumer Reports. "In terms of services we rate, that puts
satisfaction with health insurance above satisfaction with cable TV, a
perennial whipping post, but below pharmacies and real-estate agents."
The median premium cost was $1,829, survey respondents reported, an increase of about $500 since 2006.
In the past, HMO members who were seriously ill had more
trouble getting access to care, but this time there was little
difference: Of HMO members who were ill, 15 percent had problems
getting care, compared with 14 percent of PPO members, according to the
Problems With Service
People in PPOs had more trouble with their bills.
Overall, 24 percent of people in PPOs had a billing problem, while just
11 percent of HMO members had similar issues. Moreover, 33 percent of
PPO members who reported having a serious illness had billing problems
compared to just 14 percent of seriously ill HMO patients.
Twenty percent of PPO members also said they had trouble
with telephone customer support and were more likely to contact the
plan several times to get a problem solved, versus 12 percent of those
For the first time, the survey also asked subscribers
about using plan Web sites to seek information,forms, and customer
support. HMOs came out on top again, and had top notch scores for ease
of navigation, easy access to forms, and online help.
Among other survey findings:
- Respondents’ experiences with their health
insurance were far better if they were enrolled in plans at the top of
Consumer Reports’ ranking. Only 4 percent of respondents had
problems getting the care they needed in higher-rated plans.
- Eighteen percent of all respondents said that they
had trouble getting to see a plan doctor at some point during the year.
Among users of some lower-rated plans, as many as 16 percent complained
it was either difficult or impossible to get needed care.
Group Health Cooperative and Health Alliance Plan topped
the list of HMOs in the survey. Plan members reported fewer problems
getting the care they needed, and HAP members were more satisfied with
their choice of doctors and the care they received, Consumer Reports
Also among the top rated HMOs were several Kaiser
Permanente plans around the country; Preferred Care; Harvard Pilgrim
Health Care; and Independent Health.
Oxford Health Plan and Aetna Health HMO members gave the
plans lower ratings for choice of providers, the survey found. Oxford
members also reported more problems getting the care they needed, while
Aetna plan members reported more problems getting access to doctors.
Anthem Blue Cross and Blue Shield of Connecticut were
among the top-rated PPOs. Members remain very pleased with their
providers and care they received. Group Health Inc., Great-West
Healthcare and Health Net members rated choice of doctors in those
plans worse than other PPOs.
Full ratings and side-by-side comparisons of 35 HMOs and
41 PPOs are available in the September issue of Consumer Reports, and
online at www.ConsumerReportsHealth.org.