If not, try activist groups such as Families USA or Consumers Union. Many calls and letters come in there, and only a few of them ever get on the air or in print. If a certain HMO is causing trouble, the trend may show up there. If one HMO draws a lot of complaints, it may be turning doctors into double agents. While the old-line HMOs paid doctors discounted fees or on salary, the new guys play hardball.
Large bonuses go to the most frugal.
Or part of doctors' pay is withheld until the end of the year to see if they've met guidelines. If capitated doctors come in under that ceiling, they keep the difference. If they spend more, they lose money. Capitation has led to a frenzy of cost-cutting by providers who have their own bank accounts on the line. Patients who are being subjected to this danger deserve to know it, yet most HMOs keep it a secret.