Md. HMO clients see doctors less, hospitals more, survey finds

Satisfaction was lower than national average

February 12, 1999|By M. William Salganik | M. William Salganik,SUN STAFF

Maryland HMO members are less likely to see the doctor during the year than HMO members elsewhere, but more likely to be admitted to the hospital, according to a state report released yesterday.

The Health Care Access and Cost Commission collects health data from health maintenance organizations and surveys consumers to produce two reports. A "report card" issued each fall compares Maryland HMOs and is aimed at helping consumers choose a health plan.

Yesterday's report, which compares Maryland HMOs as a group with HMOs across the country, is aimed at policy-makers. Rather than make make specific recommendations, it is designed to provide facts to legislators and others who set the rules.

John Colmers, executive director of the commission, said the relatively low number of preventive-care doctor visits "does suggest a pattern" that could be the cause of more hospitalizations.

For children ages 2 to 6, 82 percent saw a doctor during the year in Maryland, compared with 89 percent nationally. For adults ages 20 to 44, the figures were 82 percent in Maryland and 87 percent nationally.

Maryland HMOs reported 55.38 hospitalizations a year for each 1,000 members; the national rate was 53.79.

The study, the second annual "HMO policy report," also found that:

* In Maryland, 66 percent of children received recommended immunizations, compared with 64 percent nationally.

* In Maryland, 68 percent of women ages 52 to 69 received mammograms to check for breast cancer, compared with 72 percent nationally.

* In Maryland, 79 percent of HMO members were at least somewhat satisfied with their health plan, compared with 82 percent nationally.

The differences, though small, are statistically significant, Colmers said.

More important than statistical differences, he said, is comparing Maryland's performance with goals or benchmarks. For example, Maryland's childhood immunization rate is slightly higher than the national average, but at 66 percent is well below the 90 percent goal set by policy-makers.

Colmers said the first report, released last year, did not result directly in any policy changes in Maryland. "It's a slow but relentless process," he said. "As you present information to legislators, it becomes part of their process as they think about legislation. Everybody's better off by the fact that it's measured."

Pub Date: 2/12/99

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