HMO hospital quality varies by region. (Short Takes).

A new study suggests that the quality of hospitals used by HMOs depends upon where members live. The study looked at the hospitals used for heart bypass surgery It found that plan members in some areas of the country get good quality hospital care, while those in other areas may use poorer quality facilities. The researchers used expected-to-actual death rate ratios for heart bypass surgery as their measure for hospital quality.

Privately insured HMO patients in California who underwent heart bypass surgery were more likely to be directed to hospitals with lower-man-expected death rates for the operation than were non-HMO patients. In Florida, however, HMO patients were no more likely to use the higher quality hospitals than were other patients.

The study, which was funded by the Agency for Health Care Policy Research, prompted the following comment by John Eisenberg, MD, AHCPR's administrator, "The nation's employers have the power to boost health care quality by selecting health plans that pay attention to information about quality. To exercise that power, they first need to act on what they already know--that price should not be the only bottom line when it comes to the health and productivity of their workers." He added, "there are many managed care plans that deliver on their promise of quality. But the issue is not just managed care or not. The issue is high-quality or not."

James A. Hawkins is Publisher of Healthcare Briefings, a newsletter available in print, on cassette, via fax, and on computer disk. He car be reached at 800/338-5486.