How is the quality of HMO providers determined?
Understanding the Table Current performance area: Quality of Providers Compare: Selected HMOs Source: DOH, 2006 Plans are listed in alphabetical order.	Performance Compared to the New York HMO Average Significantly better than the NY HMO average Not significantly different than the NY HMO average Significantly worse than the NY HMO average NV Plan submitted invalid data.

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 Doctor or Nurse an 8,9 or 10 on a scale from 0 (worst) to 10 (best)1	Members Responding that their Doctors Usually or Always Communicate Well1	Doctors who are Certified by a Medical Board
			Primary Care	OB/GYN	Pediatric
NY HMO Average	79%	94%	86%	78%	73%
Aetna Health Inc.
Blue Choice
BSNENY-HMO
CDPHP
CIGNA Healthcare of NY, Inc.
Community Blue (HealthNow)
Empire HealthChoice HMO, Inc.					NV
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)
UnitedHealthcare of NY
Univera HealthCare
Upstate HMO

The quality, stability and availability of physicians in an HMO provider network can impact the overall quality of care delivered to HMO members.

Understanding the Table

The quality, stability, and availability of the physicians in an HMO provider network can impact the overall quality of care delivered to health plan members. New York HMOs were rated on these characteristics of their providers.

The circles 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.

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

How Well Doctors Communicate
You will find information about how members rated their HMO's quality of in-network providers or nurses (on a scale of 1-10). Members responded "usually" or "always" to questions about the quality of their HMO in-network providers, including overall service and communication such as:

• How often their doctors listened carefully to them
• How often their doctors explained things in a way they understand
• How often their doctors showed respect for what they have to say
• How often their doctors spent enough time with them during visits

Board Certification
A doctor must receive additional training and pass an exam in his or her specialty to be considered board certified. While board certification is not a guarantee of quality, it shows that the physician has the knowledge that the specialty board considers necessary. The circles in the table are based on the percent of primary care physicians, obstetricians/gynecologists (OB/GYN), and pediatricians who are board certified. A higher percentage means the HMO has more board certified physicians in the practice areas listed.

Note: There are times when it is appropriate for HMOs to contract with physicians who are not board certified, as in the case of older physicians who were trained before board certification was avilable. In addition, an HMO covering rural areas may have a lower percentage of board certified physicians, since a limited number of physicians practice in these regions.

Keep in mind...

These measures indicate how satisfied members are with their health care providers and how many providers have undergone specialized training.

The Quality of Providers category is only one of eight performance areas presented.

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