Department of Civil Service

Customer Satisfaction with Heath Care Services Provided by HMOs in the New York State Health Insurance Program (Follow-Up Review)

In the New York State Health Insurance Program, the Department of Civil Service administers health insurance programs for State and local government employees and their dependents. More than 20 HMOs participate in the Program, providing services to about 85,000 members. In our prior audit report 95-S-112, we examined certain aspects of member satisfaction with these services and found that the members we surveyed 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 also noted that the Department did little to actively monitor member satisfaction with HMOs; as a result, the Department may not have been aware of problems that needed to be addressed. In our follow-up review, we found that the Department has become more active in monitoring member satisfaction with HMOs. However, additional actions are still needed.

For a complete copy of Report 97-F-48 click here.
For a copy of the 90-day response click here.