FOR IMMEDIATE RELEASE:
November 30, 1999

FOR INFORMATION CONTACT:
Kelley Elwood, 312/580-6497

ISMS Issues 4th Annual Guide to Illinois
HMOs

Illinois patients and businesses selecting health plans during end-of-year open enrollment periods can get information to help in their decision from the 1999 Guide to Illinois Health Maintenance Organizations issued today by the Illinois State Medical Society (ISMS). The latest edition of the Guide includes individual pages on each HMO to help readers make comparisons between plans.

"There are many differences among HMOs in Illinois," said ISMS President Clair M. Callan, M.D. "The Guide will help health care 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 looks at the 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.

Additionally, the Guide gives highlights of the new Managed Care Reform and Patients Rights Act. This legislation, backed by ISMS, provides Illinois’ managed care patients extended rights. Most of the provisions in the Act are effective January 1, 2000.

"Patients and purchasers can look at the data provided in the Guide, assess if a plan’s profits and administrative expenses appear to be in a reasonable balance, and determine whether a plan appears to return a fair value in health care services for the dollars the plan takes in," Dr. Callan said.

"This study presents objective information on the HMOs. It provides a starting point for people reviewing HMOs and decisions on the selection of a plan," Dr. Callan said. "Patients and businesses should want to know if a plan will have the financial strength to meet its commitments."

Over 2.4 million Illinoisans counted on HMOs for their health care in 1998. HMOs are increasingly a part of living and doing business in our state.

The ISMS Guide also reports on each HMOs’ longevity, size, geographic areas of coverage and financial stability. It additionally lists those HMOs which serve Medicare or Medicaid patients.

The information in the guide was taken from the annual reports HMOs are required to file with the state Department of Insurance. There were 41 HMOs operating in Illinois in 1998. Each HMO was 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 on the ISMS site by clicking here or in hard copy by contacting ISMS at:

20 N. Michigan Aveune
Suite 700
Chicago, IL 60602

or calling 1-800-782-ISMS.

ISMS is a professional membership organization representing 16,000 physicians, practicing in all specialties statewide.

ISMS permits and encourages reproduction of ISMS news releases with the request that ISMS is credited as the source of the information.