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Few 'likes' for managed care companies

Few 'likes' for managed care companies

John Marcille

Ever since I started covering health care 20 years ago, managed care companies — HMOs back then — have had little respect from the public. I am sorry to have to point you to a new report that has managed care companies at the bottom of a list of industries in consumers’ eyes. Just below Internet service providers, TV service providers, and computer makers, and far below fast-food chains, banks, and retailers. The highest rating went to grocery chains.

The information comes from the Temkin Group, which surveyed 10,000 consumers. It uses the term “experience ratings.”

Within this despised business category, managed care, some plans have a better image than others. Will anyone be surprised that Kaiser Permanente leads the list, with Tricare a distant second? In fact, Kaiser is the only one to receive an OK rating. Others are poor or very poor. Highmark is at the bottom, just below Health Net and Medicaid.

I may be the editor of Managed Care, but I am not an apologist for the industry. It has made mistakes and worse. But I do think that managed care companies are getting a bad rap. Reasons that come to mind:

—People who get upset when their plan tells them that an expensive service is not covered are generally blaming the wrong party. In employer-sponsored plans, it is the employer who made the decision. But most people think it is the insurer or third-party administrator—the name on the plastic wallet card. My company is self-insured, but the name on the card is Independence Administrators.

—People have seen some inflammatory movies and reporting and formed opinions without all the facts. Managed care has saved consumers and employers a considerable amount of money over the years, and in many or most cases, health care companies’ policies have resulted in better care than would otherwise be the case.

—Most people have never had a major problem with their health plan. That’s because most people don’t have major health problems where coverage disputes can occur. And most of those with serious problems won’t have a major conflict with their insurer.

In any event, the likely/unlikely advent of the Accountable Care Act's going live with the sale of individual policies through exchanges is sure to spawn PR efforts by the insurers that are in that market or want to be in it. When that happens, it will probably seem as though they are all headquartered in Lake Wobegon, because they are all above average.

So read the Temkin page; it won’t take long. And ask yourself whether it makes sense, for example, that banks — which charge ever higher fees that have no relation to costs and, let us not forget, extended mortgages to millions of people who were not creditworthy—should be more favored by consumers?

People are funny.

(Here's the link to Temkin: is at http://bit.ly/yG5RM1.)