FOR IMMEDIATE RELEASE:
November 12, 2001
FOR INFORMATION CONTACT:
Kelley Elwood, 312/580-6497
HMOs Show Profit;
ISMS Guide to Help Patients with HMO
Enrollment Decisions
Chicago -- As the cost of health insurance coverage continues to be an issue of concern, the Illinois State Medical Society responded today by issuing its 2001 Guide to Illinois Health Maintenance Organizations. Significant findings indicate that HMOs are turning a profit, while the cost of premiums continues to soar.
In 2000, there were 33 HMOs operating in Illinois. Of the 28 which did at least 10% of their business in this state, the average total profits increased to 1.46% from 0.20%. The combined total profits for these HMOs was over $94 million. At the same time, the average percentage of premium dollars going toward medical care for Illinois patients decreased from 87.4% to 86.3%. The average cost of premiums per patient increased 7.3% from $1,707 to $1,832 per person, while actual enrollment has decreased by 3%.
While these figures provide some insight into the business practices of HMOs in Illinois, the guide is meant to help consumers and their employers in the decision-making process of choosing a health plan. Individual pages on each HMO are a resource to help readers make comparisons between plans. Available both online and in hard copy, the guide is designed to assist Illinois patients and businesses select a health plan during the end-of-year open enrollment period.
"There are a lot of differences between HMOs in Illinois," said ISMS President Ronald L. Ruecker, M.D. "This guide will help consumers become more informed about the choices they have, and to ask better questions of the plans and of their employers."
The guide looks at the individual plans' medical expense ratios (the percentage of the plan's total revenues spent actually providing medical care to patients), administrative expenses, premium costs and utilization data. It also includes information on complaints filed with the Illinois Department of Insurance regarding each plan.
"Those seeking HMO coverage can use the data in this guide to assess if a plan will have the financial strength to meet its commitments," Dr. Ruecker said.
The ISMS Guide also reports on each HMO's longevity, size, geographic areas of coverage and financial stability, and lists those HMOs which serve Medicare or Medicaid patients. Highlights of the ISMS-backed Managed Care Reform and Patients Rights Act, which was passed in August 1999, are also included.
The information in the guide was taken from each HMO's 2000 annual report. These reports must be filed yearly with the state Department of Insurance, and are publicly available. All HMOs were offered the opportunity to explain and comment on the information reported about it; comments received are included in the guide.
The guide is available for no charge at the ISMS site at www.isms.org or in hard copy by contacting ISMS at 20 N. Michigan Ave., Ste. 700, Chicago, IL 60602 or calling 1-800-782-ISMS.
ISMS permits and encourages reproduction of ISMS news releases with the request that ISMS is credited as the source of the information.