Media Release

For: Immediate Release
Date: March 8, 2004
Contact: Bruce Cryan (401) 222-5123

RI Health Department Evaluates Commercial Health Plans’ Performance; Premiums up, Profits down, Quality and Member Satisfaction High in 2002

RI Commercial Health Plans’ Performance Report (2002)

Today, the Rhode Island Department of Health (HEALTH) released a study detailing the performance of the state’s commercial Health Plans. RI Commercial Health Plans’ Performance Report -2002 compares results in 2002 with those of previous years and to regional and national benchmarks. Compared to their national counterparts, RI Health Plan were more profitable in 2002 (+2.2% vs. –6.7%). Premium revenues were 41% higher among RI plans ($226 per member per month vs. $160 per member per month) while medical expenses (86.3% vs. 95.9%) and administrative overhead both were less (11.8% vs. 12.9%). In addition to financial measures, the report presents eight other indicators of Health Plan performance: enrollment, utilization, prevention, screening, treatment, access, satisfaction and utilization review.

RI Health Plans performed favorably on clinical quality measures compared to Plans elsewhere. Exceptions included Diabetes Care –Blood Sugar Control, Follow-Up for Mental Illness, and Prenatal Care (Access) measures. In addition, Rhode Islanders were more satisfied with their Health Plans and their healthcare than were their regional or national counterparts. RI minorities were as satisfied as white members with their Health Plans and physicians. Fewer minorities, however, indicated satisfaction with specialists (7% fewer) and overall healthcare services (16% fewer).

"This report demonstrates an ongoing commitment to quality improvement among Health Plans in Rhode Island," said Dr. Patricia A. Nolan, MD, MPH, Director of the RI Department of Health. "Positive results occur when information about quality and other aspects of health services becomes public. Even though these data describe the situation prior to some recent changes, they continue to inform the public. A better understanding of the Rhode Island health care system helps us provide access to quality health care at a reasonable cost."

HEALTH produced the report as a direct result of the Health Care Accessibility and Quality Assurance Act, passed in 1996. Author Bruce Cryan notes that public reporting promotes accountability and helps focus improvement efforts within the Plans themselves. This report, a companion report on RI’s Medicare and Medicaid Health Plans, and other publications on hospital patient satisfaction and hospital quality are available on HEALTH’s website.