ARE ALL HEALTH PLANS CREATED EQUAL - THE PHYSICIANS VIEW

Context.-The health care market is demanding increasing amounts of inf ormation regarding quality of care in health plans. Physicians are a p otentially important but infrequently used source of such information. Objective.-To assess physicians' views on health plan practices that promote or impede delivery of high-quality care in health plans and to compare ratings between plans. Setting.-Minneapolis-St Paul, Minn. Pa rticipants.-One hundred physicians in each of 3 health plans. Each phy sician rated 1 health plan. Main Outcome Measures.-Likert-type items t hat assessed health plan practices that promote or impede delivery of high-quality care. Results.-A total of 249 physicians (84%) completed the survey. Fewer than 20% of all physicians gave plans the highest ra ting (excellent or strongly agree) for health plan practices that prom ote delivery of high-quality care (such as providing continuing medica l education for physicians, identifying patients needing preventive ca re, and providing physicians feedback about practice patterns). Barrie rs to delivering high-quality care related to sufficiency of time to s pend with patients, covered benefits and copayment structure, and util ization management practices. Ratings differed across health plans. Fo r example, the percentage of physicians indicating that they would rec ommend the plan they rated to their own family was 64% for plan 1, 92% for plan 2, and 24% for plan 3 (P<.001 for all comparisons). Conclusi ons.-Physician surveys can highlight strengths and weaknesses in healt h plans, and their ratings differ across plans. Physician ratings of h ealth plan practices that promote or impede delivery of high-quality c are may be useful to consumers and purchasers of health care as a tool to evaluate health plans and promote quality improvement.