Media Release

CONTACT: Robert J. Marshall, Ph.D. 401-222-2231
FOR: Release on June 8, 2000
DATE: June 6, 2000

State Health Department Unveils 1998 Performance Information on RI Health Plans

Go to RI Health Plan Statistics

Providence, RI – How does your Health Plan compare to others? How does it perform on financial measures and on preventive care? How often does it deny services?

These are the kinds of questions addressed by the new, Health Plan performance information released today by the Rhode Island Department of Health (HEALTH). As a result, Rhode Islanders now have better access to official information on Health Plan performance than ever before

The report presents data for 1998 on all major commercial Health Plans, as well as Medicare and Medicaid Health Plans licensed in RI. Topics include: access, availability and use of health services, plan stability, financial operations and utilization review. There's an entire section on prevention. Benchmarks enable consumers to compare measures for Health Plans with state-wide results and, in some cases, New England regional or national statistics. HEALTH posted the entire report and related materials on its website at: www.health.state.ri.us/planstats/home.htm

"It took a lot of hard work, by us and the Health Plans, to reach this point," said Dr. Patricia A. Nolan, Director of the Rhode Island Department of Health. "People can use the report to get a sense of plan performance in 1998. But today’s situation is already different without Harvard Pilgrim and Tufts. That’s why it’s important to track performance over multiple years. We expect to receive the 1999 data in June and produce an updated report in October, 2000."

Among the report’s several findings for 1998:

• Commercial Health Plans spent 87 cents out of every $1 in premiums on member health care services.
• Rhode Island’s rates on childhood immunizations, advising smokers to quit, screening for breast cancer and first trimester prenatal care all exceeded both the national and New England averages. These are key measures of preventive services.
• Denials of requests for prior authorizations occurred less than 1% of the time. Nearly 50% of member appeals succeeded.

The new report on Health Plans grew out of the 1996 Health Care Accessibility and Quality Assurance Act. In addition to reporting performance information the Act also requires the Department to certify all Health Plans in RI, oversee access and quality and investigate complaints. The statistical performance information is the last component of several to come on line. Materials previously available on the Internet (July 1999) include the general Consumers Guide to Health Plans  and the Health Plan Disclosures  which provides plan-specific information about policies and coverage.

The HEALTH website also presents information on quality of health care relating to physicians (www.docboard.org/ri/main.htm) and nursing homes (www.health.state.ri.us/ hsr/facreg/facreg.htm). For consumers without Internet access, single paper copies of the Health Plan statistics report are available by calling the Office of the Deputy Director of Health at 401-222-2231.