Date: November 9, 2005
For more information contact: Eileen Mallow, Assistant Deputy Commissioner, (608) 266-7843 or eileen.mallow@wisconsin.gov

HMO Quality Care Data Now Available For Consumers

Madison, WI—In 2004, Wisconsin again ranked above the national average in consumer satisfaction concerning Health Maintenance Organizations (HMOs), according to a recent report from the Office of the Commissioner of Insurance (OCI). "I'm pleased to say that the majority of Wisconsin citizens enrolled in an HMO feel they are receiving the quality care they deserve," Commissioner Jorge Gomez said.

HMO plans are required to develop quality assurance plans to monitor the quality of the health care their members receive. Each year, the HMOs are obligated to submit a report including the collected data to OCI. The data report uses a combination of consumer surveys and health plan data to measure performance.

OCI's report includes a broad range of information including screenings, general ratings and follow-ups. OCI chooses this information because the data is representative of the care an enrollee should expect from their HMO and also allows them to compare their HMO against national and state averages.

"Consumers are faced with increasing options when choosing a health care provider," said Gomez. "It's important we have this unbiased data report available for them."

Consumers are encouraged to remember that this data is only one means to evaluate a health plan. Though it does place a lot of information in one place, it should not be the only information used to make a decision. It is important to look at many different information sources when determining what coverage is the best for them.

The information is available on the Web site at http://oci.wi.gov/hmo_info/hmodata.htm. Additional information including data about individual HMOs is available on OCI's HMO information page at http://oci.wi.gov/hmo_info.htm.

OCI publications, such as "Consumer's Guide to Managed Care Health Plans in Wisconsin," can be ordered free from the agency by writing to OCI Publications, P.O. Box 7873, Madison, WI 53707-7873, calling 800-236-8517 or visiting the OCI Web site at oci.wi.gov.

Created by the Legislature in 1871, Wisconsin's Office of the Commissioner of Insurance (OCI) was vested with broad powers to ensure that the insurance industry responsibly and adequately met the insurance needs of Wisconsin citizens. Today, OCI's mission is to lead the way in informing and protecting the public and responding to its insurance needs.