What HMO’s Won’t Tell You

| Total Words: 688

When a company enters into a contract with an HMO, employee satisfaction as well as company money is on the line. Health costs are rising annually, and employee health care is a major expense for most businesses. The following tips will help you select the best health plan for your business.

When companies out-source services, they usually monitor the supplier to ensure that it consistently supplies the goods or services which are specified in the contract. When dealing with HMOs, however, many companies ignore this basic business practice. At least once a year, compare your HMO with nationwide HMO performance measurements.

To compare HMOs, use the Health Plan Employer Data Information set, or HEDIS, available from the National Committee on Quality Assurance (NCQA) in Washington, D.C. This database has guidelines for comparing HMO performance in approximately 60 categories. Nearly all HMOs provide their own HEDIS data to prospective clients. If an HMO refuses, this is a sign of inferior performance.

Check to be sure the HMO is accredited by either the NCQA or the Joint Commission on Accreditation of Health Care Organizations in Oak Brook Terrace, Illinois....

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