HMOs in Westchester County charge both the highest and lowest premiums for individuals in the state, according to a recently released Regional Health Care Report Card that measures performances of both hospitals and managed care plans in the Northeast.
The annual report card, available online at www.abouthealthquality.org, provides data on the cost and quality of care received by members of commercial managed care plans and the quality of care, mortality rates, length of stay and cost of care provided to hospital patients.
The report is prepared by the New York State Health Accountability Foundation, a private-public partnership dedicated to promoting transparency in the health care system. Its founding partners are IPRO, an independent nonprofit corporation that assesses the value of consumer health care services, and the New York Business Group on Health, a nonprofit coalition of 150 businesses in the New York metropolitan area dedicated to employer health benefit issues. The foundation is directed by an advisory council of major New York area employers.
The 2008 report card shows that New York’s HMOs rank above the national average on 28 of 41 measures where nationwide comparisons exist. For inpatient hospital care for Medicare beneficiaries, New York’s hospital performance is better than the national average on 18 of 21 individual measures.
However, in patients”™ ratings of their experience and satisfaction with hospital care, acute care hospitals in New York perform below the national average on all 10 measures.Â
In Westchester, patients gave highest overall ratings for care received to Northern Westchester Hospital in Mount Kisco, where 70 percent of patients rated care at nine or 10 on a 10-point scale, and Community Hospital at Dobbs Ferry, with a 69 percent rating. Sound Shore Medical Center of Westchester in New Rochelle received the lowest rating for overall care at 42 percent.
Patients”™ giving highest ratings for care at other hospitals in the county for which data was available were: New York Presbyterian Hospital-Westchester Division, White Plains, 64 percent; Hudson Valley Hospital Center, Cortlandt Manor, 63 percent; White Plains Hospital Center, 59 percent; Phelps Memorial Hospital Center, Sleepy Hollow, 58 percent; St, John”™s Riverside Hospital, Yonkers, 53 percent; Lawrence Hospital Center, Bronxville, 52 percent, and Mount Vernon Hospital, 43 percent.
At Northern Westchester Hospital, 80 percent of patients surveyed said they would recommend the hospital to friends or family, the highest such rating in the county. Sound Shore Medical Center of Westchester received the lowest recommendation rate from patients, at 44 percent, followed by Mount Vernon Hospital at 45 percent.
Patient recommendation ratings for other hospitals in the county were: Community Hospital at Dobbs Ferry, 76 percent; New York Presbyterian Hospital, 73 percent; White Plains Hospital Center, 68 percent; Hudson Valley Hospital Center, 67 percent; Phelps Memorial Hospital Center, 66 percent; St. John”™s Riverside Hospital, 60 percent, and Lawrence Hospital Center, 59 percent.Â
Two of the eight HMOs operating in Westchester scored significantly worse than the state average for customers giving highest overall ratings for health care. They were Aetna Health, with a 67 percent rating, compared to the state average of 75 percent and national average of 74 percent, and Health Insurance Plan of New York (HIP), with a 69 percent rating. All others scored at about the state average. Â Â Â Â Â Â Â
The widely varying premium costs for HMO plans in the state are evident in Westchester. HIP had the lowest monthly premium retail rates in the state and county, at approximately $602 for individuals and $1,120 for families. The highest premiums in the state and county were charged by Group Health Inc. (GHI) HMO, at $1,751 monthly for individuals and $4,465 for families.
The report card lists these monthly rates for the other managed care plans in Westchester: Oxford, $849 for individuals and $2,548 for families; Empire, $888 for individuals and $2,664 for families; Aetna Health, $981 for individuals and $2,916 for families; CIGNA, $1,022 for individuals and $3,067 for families, and Health Net, $1,036 for individuals and $2,911 for families.
“We hope that this expanded report card helps satisfy the regional business community’s increasing need for information on health care performance and cost,” said Laurel Pickering, executive director of the New York Business Group on Health. “We also hope that our publication of this data will help draw attention to unexplained variation in hospital and HMO performance data.”
“While statewide findings are generally positive, our report card found variation in performance at the county level, sometimes even among neighboring counties,” said Dr. Clare B. Bradley, senior vice president and chief medical officer at IPRO. “We need to redouble our efforts at quality improvement in order to reduce unacceptable variation in performance.”
