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The Cost of Coverage, Minnesota Medicine, January 2000/Volume 83

Health insurance premiums are on the rise in Minnesota but declining or holding steady in other states with heavy HMO penetration. Why the difference?

“Freedom of Choice . . at a Price,” Minnesota Medicine, May 1997, Volume 80

You step up to the health plan lunch counter and the server asks, What will you have today, choice of physicians or lower premiums?”

In the past, the tradeoff was clear, you could select an HMO that offered access to a wide choice of providers, or you could save money by signing up with one of the “classic HMOs” that limited you to a much smaller panel of employed or contracted physicians. Today, it seems that all health plans promote themselves as offering broad choice. But do they?

“Who Should Own America’s Healthcare Systems?” Health System Leader, January-February 1996

“Performance measurement: a good idea in theory,” Minnesota Medicine, January 1998

The buzzing you hear is not just the late season mosquitoes or the neighbor’s snowblower, but the sound of Minnesota organizations trying to measure healthcare provider performance and patient satisfaction. Articles in this issue describe initiatives by the Minnesota Health Data Institute, the Buyers Health Care Action Group, the Healthcare Education and Research Foundation, state agencies, the Minnesota Council of Health Plans, and so on.

There is no disagreement that performance measurement is a goal worth pursuing. Everyone – providers, health plans, purchaser and consumers – supports publicly the notion of measuring quality and sharing that information, at least in some fashion. Minnesotans have seen newspaper inserts, web sites and piles of glossy folders at open enrollment time, all intended to spread the word about comparisons of quality.

“Will For-Profit Health Care Give Nonprofits a Run for Their Money?” Minnesota Medicine, April 1997.

Even with margins under pressure and their practices under increasing legislative scrutiny, HMOs are a growth industry in the United States. Nearly 100 new HMOs were formed in 1995 and 1996, reversing a trend of a declining number of HMOs. In Colorado, for example, seven new HMOs were licensed in those two years.

While this trend has bypassed Minnesota, new HMOs have entered local markets across the country. Many of them are sponsored by provider organizations and quite a few of them were formed to contract with states enrolling Medicaid recipients into HMOs and other managed care arrangements. Here is a brief description of two of those new HMOs:

“How Will Consumers Use Report Cards in Selecting Health Plans?” Managed Care Quarterly, 1995.

With a variety of new tools available to compare health plan options, what information will consumers actually act on in making their choices?