Sj. Borowsky et al., ARE ALL HEALTH PLANS CREATED EQUAL - THE PHYSICIANS VIEW, JAMA, the journal of the American Medical Association, 278(11), 1997, pp. 917-921
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.