How is the quality of HMO providers determined?
Understanding the Table Current performance area: Quality of Providers 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 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	Satisfaction with Personal Doctor	Satisfaction with Provider Communication	Doctors who are Certified by a Medical Board
			Internal Medicine	OB/GYN	Pediatric
NY HMO Average	81%	93%	81%	78%	82%
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.			NV	NV	NV
Rochester Area HMO, Inc. (Preferred Care)
Univera HealthCare

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.

Satisfaction with Personal Doctor
Members rated their doctor 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.

Satisfaction with Provider Communication
Members responded that their doctors or health care provider "usually" or "always":

• Listen carefully to them.
• Explained things in a way they understand.
• Show respect for what they have to say.
• Spend enough time with them during visits.

Board Certification
To be a board certified, a doctor must receive additional training and pass an exam in his or her specialty. While board certification is not a guarantee of quality, it shows that the doctor has knowledge that the specialty board considers necessary. The chart shows the percentage of internal medicine doctors, OB/GYNs and pediatricians who are board certified. A higher percentage means the HMO has more board-certified doctors 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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