While survey respondents were generally positive, they were increasingly negative about managed care programs, with the percentage saying managed care plans do a “bad job” serving consumers almost doubling between 1997 (21%) and 2001 (39%).
Those in “strict” managed care plans, those with many of the elements found in HMOs, were less satisfied than those in “loose” managed care plans, or traditional plans.
Two-thirds (67%) of all adults believe that during the past few years, HMOs and other managed care plans have decreased the time doctors spend with patients, up from 61% two years ago. More than half (54%) believe managed care has decreased the quality of health care for the sick, also slightly higher than the 50% in April 1999.
Six in ten (59%) believe that managed care has not made much difference to health costs (55% in April 1999), and about half (51%) of Americans believe that there is not enough regulation of HMOs and managed care.
The survey found that the most common problems were:
- delays (1%) or denials (12%) of coverage or care (together reported by 13% of all people
- and 28% of people with problems)
- difficulty seeing a physician (10% of all people; 22% of people with problems)
- billing and payment problems (13% of all people; 27% of people with problems)
Less common were problems related to communication or customer service difficulties, reported by just 8% of all people; 16% of people with problems.
Nearly a quarter (24%) reported a problem that resulted in paying more for care, with more than half of those reporting a “major” effect. Other costs cited were:
- 21% – a problem that resulted in lost time from life activities
- 14% – a problem that resulted in a decline in their health
About half of those with private insurance are still very (24%) or somewhat (32%) concerned that if they become sick, their health plan will be more concerned about saving money than providing the best treatment.