Poor-scoring HMOs more likely to keep grades secret, study says

CHICAGO (AP) _ A widely publicized annual ``report card'' on America's health maintenance organizations may be misleading because poor-scoring HMOs are more likely than top performers to withhold

Tuesday, September 24th 2002, 12:00 am

By: News On 6

CHICAGO (AP) _ A widely publicized annual ``report card'' on America's health maintenance organizations may be misleading because poor-scoring HMOs are more likely than top performers to withhold their grades, a study suggests.

The researchers looked at an annual survey prepared by the National Committee for Quality Assurance, an HMO accrediting group.

The public has been led to believe that report card includes good and bad scores alike, said Dr. Danny McCormick, a study author and Harvard Medical School instructor. But ``that turns out not to be the case.''

Brian Schilling, spokesman for the accrediting group, said the study is a ``pretty powerful argument'' for universal, mandatory reporting by HMOs.

The private, nonprofit group grades HMOs on how well they adhere to medical practice standards. It looks at such things as heart attack treatment, annual mammograms and childhood immunizations.

Accredited HMOs are required to submit data for grading and since 1999 also have been required to allow it to be publicized. But unaccredited HMOs that voluntarily submit data can still keep their scores secret.

The study reviewed practices from 1997 to 1999. The findings appear in Wednesday's Journal of the American Medical Association.

Of 329 HMOs that allowed public disclosure in 1997, 161 _ nearly half _ asked that their scores the following year be kept secret. And of the 292 plans that allowed public disclosure in 1998, 67, or 23 percent, withdrew from public disclosure in 1999.

Plans with poor scores were at least three times more likely than high-scoring plans to withdraw from public disclosure the subsequent year.

The latest report card, released this month, said HMOs have made progress in improving patients' access to screenings and other disease prevention methods. But about 15 percent of unaccredited plans that submitted data for this year's survey asked that it be kept secret.

About 300 of the nation's estimated 500 HMOs are accredited, meaning they have passed an on-site evaluation.

Karen Ignagni, president of the American Association of Health Plans, a managed-care trade group, said the study uses outdated data. She said most HMOs report quality information publicly, either to the accrediting group or to state or local authorities.