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Virginia HMOs improve quality

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Virginia Health Information (VHI), a nonprofit health information company, is publishing new HMO cost
and quality reports at www.vhi.org.

Virginia HMOs performed better than the national averages for 70% of the quality measures. Statewide, HMOs also improved overall rates from last year in over 50% of all measures.

HMO members reported higher levels of satisfaction in five of seven measures such as:

  • Members said they were more able to get the care they needed and get it quickly
  • 92% of members said their doctors spent enough time with them and listened to their concerns.

Cost and financial information includes the average monthly premium for members and spending on medical care and administrative expenses:

  • Statewide monthly premiums per member averaged $264 with the lowest HMO average reported at $230 and highest at $301
  • Individual HMO profit/loss ratios varied widely from 1.7% to over 16% and averaged over 8% statewide

Other measures fell short of what is possible:

  • The rate of women receiving mammograms dropped for the third year in a row to 69%
  • Colorectal cancer screening is improving but is still performed in just 57% of eligible adults
  • About 1 in 5 women who should have been screened for cervical cancer were not; statewide cervical cancer screening dropped to 81.7% of eligible women

Over 1.1 million Virginians are enrolled in HMOs. Many choose an HMO during their employer’s open enrollment period between October and January. VHI provides Virginians HMO information to help them choose a plan based on costs and quality. The measurements include how often members get regular checkups including prenatal care, how effectively care is provided, member satisfaction and
financial/administrative data.

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