NCPA - National Center for Policy Analysis

Perceptions At Odds With Reality In Health Plan Ratings

September 13, 2000

Claims that health maintenance organizations (HMOs) give poorer quality care than other types of managed care or traditional indemnity insurance are often based on ratings of their plan by people who say they are in HMOs.

However, according to a new study from the Center for Studying Health System Change (HSC), about a quarter of people in private-sector health plans incorrectly identify whether or not they are in an HMO. And because of the negative view of HMOs in general, people's perception of the quality of care they receive is negatively affected by their belief -- even if it is wrong -- that they are in an HMO.

Researchers used a survey of 60,000 privately insured individuals who were asked to rate their health care using a number of quality indicators. The responses were checked against follow-up data gathered from health insurers, and a definitive match to a specific insurance product was made for approximately 18,000 individuals.

Comparing the data, HSC researchers found:

  • 13 percent of people who are in an HMO incorrectly thought that they were in another type of plan.
  • 11 percent of people in other types of plans incorrectly thought they were in an HMO.
  • By modest margins, consumers who thought they were in HMOs rated their care lower on most measures than did those who believed they were covered by other types of insurance.

After correcting for the erroneous identification of health plan type, researchers found that there were virtually no differences in ratings between those who actually are in HMOs and those who actually are in others kinds of insurance plans.

Source: James D. Reschovsky and J. Lee Hargraves, "Health Care Perceptions and Experiences: It's Not Whether You Are in an HMO, It's Whether You Think You Are," Issue Brief No. 30, September 2000, Center for Studying Health System Change, 600 Maryland Ave, S.W., Suite 550, Washington, D.C. 20024, (202) 484-5261.

For study text:


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