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42% in California Have Gripes With Health Plans

MANAGED CARE January 1998. © MediMedia USA
State Initiatives

42% in California Have Gripes With Health Plans

MANAGED CARE January 1998. ©1998 Stezzi Communications

More than four out of ten Californians with health insurance had problems with their health plans in the last year, according to a survey commissioned by Gov. Pete Wilson's task force on reforming managed care.

Researchers at the University of California at Berkeley and the Field Research Corp. surveyed 1,200 people, then extrapolated their results to project that 6.7 million residents of the state had some kind of beef with their plans. Since only 3 percent of those with private health insurance in California have fee-for-service coverage, the results pertain overwhelmingly to managed care plans.

Of these, 1.6 million experienced delays or denials in medical treatment, received inappropriate care or had trouble getting a referral to a specialist. Still, 76 percent of respondents said they were satisfied or very satisfied with their plans; 10 percent were dissatisfied or very dissatisfied. Members of group- and staff-model HMOs registered highest satisfaction levels, while members of IPA-model HMOs were least happy with their plans.