Do HMO members have access to the care and service they need?
Understanding the Table Current performance area: Access To Care and Service Compare: Selected HMOs Source: DOH, 2007 Plans are listed in alphabetical order.	Performance Compared to the New York HMO Average Significantly better than the NY HMO average Not significantly different from the NY HMO average Significantly worse than the NY HMO average

Access to Care and Service Staying Healthy and Living with Illness Quality of Providers Grievances

Complaints Prompt Pay Complaints Internal Appeals External Appeals

HMO	Members Rating Their HMO an 8, 9 or 10 on a scale from 0 (worst) to 10 (best)1	Members Who Received Needed Care	Members Who Received Care Quickly1	Members Ages 20-44 Seen by a Provider	Members Seen by a Provider Ages 45-64
NY HMO Average	62%	88%	86%	94%	95%
Aetna Health Inc.
BSNENY-HMO
CDPHP
Community Blue (HealthNow)
Empire HealthChoice HMO, Inc.
Excellus Health Plan, Inc. (HMO)
GHI HMO Select, Inc.
Health Net of NY, Inc.
HIP HMO
Independent Health Association, Inc. (IHA)
MVP Health Plan, Inc.
Oxford Health Plans of NY, Inc.
Rochester Area HMO, Inc. (Preferred Care)
Univera HealthCare

Consumers rated New York HMOs on how well they provide members with timely access to needed care and customer service.

Understanding the Table

The circles in the table show how each HMO compares to the average for all New York HMOs. Look for HMOs with a in the table. These HMOs performed better than the New York HMO average. In other words, they had a greater percentage of satisfied members are were more likely to be seen by a provider.

Rating of HMO
Members rated their HMO on a scale from 0 (worst possible) to 10 (best possible). The circles in the table are based on the number of members who gave their HMO an 8, 9, or 10 rating.

Members Who Received Needed Care
Members responded that they "usually" or "always" thought it was easy to get:

• Appointments with specialists.
• Care, tests or treatment members thought they needed.

Getting Care Quickly
Members responded that they "usually" or "always":

• Get appointments for regular or routine care as soon as they want.
• Get care right away for an illness or injury.

Members Seen by a Provider
Even healthy members need to see a provider to ensure medical problems are prevented or caught as early as possible. The circles in the table are based on the percent of adult HMO members who had an outpatient or preventive care visit within the past three years as reported by the HMO. A higher score means more people in the HMO have had a provider visit.

Keep in mind...

These measures indicate how well an HMO provides access to its members. Evaluate the importance of each performance measure to you and your family. One particular performance measure in this area may be more important to you than others.

Several factors contribute to why members may rate their HMO low or have problems getting needed care or receiving care quickly. While their reasons are not represented here, make a decision based on the priorities you have for your family's health care. The Access to Care and Service category is only one of eight performance areas presented.

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