To help or hinder - Which is more important in explaining a physician's willingness to recommend a health plan?

PURPOSE. To examine how specific health plan practices contribute to physic ians' willingness to recommend a health plan to a patient, and whether the relative importance of plan practices is viewed differently when patients a re seriously ill. METHODS. The Physician's Evaluation of Health Plans Project has surveyed 1, 757 generalist physicians in 16 health plans in 5 areas nationwide. Each ph ysician reported on one plan. Three multi-item scales assessed physicians' perceptions of health plan activities that facilitated or impeded high-qual ity care in the plans and the clinical capabilities of plan physicians. Reg ression analyses were used to explore relations between facilitators, barri ers, and clinical capabilities, and two global physician judgments (the phy sician's willingness to recommend a plan and their judgment that a plan pro vided lower quality for sicker patients). RESULTS. A physician's willingness to recommend a health plan is more highl y related to what plans do to facilitate care than to the barriers created by plans in managing care. However, barriers to care were substantially mor e important when evaluating health plan quality for sicker patients. CONCLUSIONS. From the physician's perspective, the relative importance of p lan strategies to manage care is different for typical patients and patient s who are more seriously ill. Efforts to collect information on health plan quality should separately evaluate care for sicker patients, in addition t o evaluating the overall performance of the health plan.