FOR IMMEDIATE RELEASE:
November 15, 2000
FOR INFORMATION CONTACT:
Susan Ross 312-782-1654 or 312-580-6450
ISMS Issues 5th Annual Guide to Illinois HMOs
HMOs Show Profits
Guide to Help with Managed Care Decisions
Chicago -- As issues regarding medical insurance continue to heat up, the Illinois State Medical Society responded today by issuing its 2000 Guide to Illinois Health Maintenance Organizations. Significant findings indicate that HMOs are now turning a profit and while enrollment remains stagnant, the cost of premiums went up substantially.
Regarding the distribution of funds, 12.6% of HMO income fell into administration costs and profit. With over $11 billion collected in premiums, the 12.6% represents a sizable expense for these companies. The average cost of premiums per patient has gone up 11.8%, from $1,537 in 1998 to $1,718 in 1999, while actual enrollment has not changed significantly over the same time period, 2,422,660 in 1998 to 2,455,294 in 1999.
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 was designed to assist Illinois patients and businesses in the selection of health plans during their end-of-year open enrollment periods.
"Choosing an HMO is a significant decision for patients and their families. It is equally important for the businesses that rely on HMOs to provide healthcare coverage for their employees," said ISMS President LeRoy Sprang, M.D. "Since there are so many differences among HMOs in Illinois, the Guide should help consumers become better informed about what is available, ask better questions of either the plans or their employers, and get better value for their health care dollars."
The Guide compares individual plans’ medical expense ratios (the percentage of the plan’s total revenues spent actually providing medical care), administrative costs and profits, as well as premium costs and utilization data. It also includes information on complaints filed with the Illinois Department of Insurance regarding the plans. The ISMS Guide reports on each HMO’s longevity, size, geographic areas of coverage and financial stability.
It also lists those HMOs which serve Medicare or Medicaid patients. Background on the Managed Care Reform and Patients Rights Act is included. This legislation, backed by ISMS, provides Illinois’ managed care patients extended rights. All of the provisions in the Act became effective this year.
HMO annual reports (required to be filed with the state Department of Insurance) are the source for the information. In 1999 there were 34 HMOs operating in Illinois. Each HMO was offered the opportunity to explain and comment on the information reported about it; comments received are included in the Guide.
The Illinois State Medical Society is a professional organization that represents and unifies its physician members as they practice the science and art of medicine. The Society represents the interests of member physicians, advocates for patients and promotes the doctor/patient relationship, the ethical practice of medicine, and the betterment of the public.
ISMS permits and encourages reproduction of ISMS news releases with the request that ISMS is credited as the source of the information.