Department of Civil Service

Customer Satisfaction with Health Care Services Provided by HMOs in the New York State Health Insurance Program

More than 20 HMOs participate in the New York State Health Insurance Program, which provides health insurance coverage to State and local government employees and their dependents. In 1993, these HMOs were paid nearly $260 million in premiums for services provided to about 85,000 members of the program.

We examined certain aspects of member satisfaction with the health care services provided by HMOs. According to our random survey of selected members, the members were generally satisfied with the overall performance of their HMOs. However, about 36 percent of the members were dissatisfied with some aspect of their access to health care, such as their access to specialists. We note that the Department of Civil Service, which administers the New York State Health Insurance Program, does little to actively monitor member satisfaction with HMOs; as a result, the Department may not be aware of problems that need to be addressed. For example, because of the nature of the Department's reporting requirements, most of the grievances filed and complaints made by members against HMOs are not reported to the Department. We recommend that the Department more actively monitor member satisfaction with HMOs.

For a complete copy of 95-S-112 click here.
For a copy of the associated follow-up report click here.
For a copy of the 90-day response click here.