The purchasers that prepared this guide want to do what they can to improve the health of individuals and the health services delivery system itself. They believe that one way to move toward that goal is to provide employees and other consumers with information that may help them make more informed health care decisions. Purchasers and others active with AFH and HIAG believe that HMOs have the greatest potential for managing health care delivery in a way that assures high quality care and the highest value for employer-employee expenditures. Keep in mind, even HMOs with lower levels of performance for specified indicators may be far superior to the performance that non-HMO plans can document concerning the same indicators. So, in the case of this HMO plan comparison, the plans listed are rated on the high end of the performance curve, and collectively deserve high levels of consideration relative to other plans where no such comparable data is available.
Some plans have or are developing additional programs focused on members with chronic disease.
During the AFH and HIAG annual review process, the HMOs were asked to submit their TWO best disease management programs. The table below shows the results of the evaluation of the HMO's disease management programs and the programs that were evaluated. It is important to note that since HMOs were asked to submit only two programs, some HMOs may have additional disease management programs other than those shown in the table below. You should check with the HMO to find out what other programs are offered. Care Coordination and Member Guidance - evaluates the capabilities of plans to guide and inform members as they seek to make choices of providers and treatment alternatives and to understand the way a plan operates.