September 24, 2012; Source: Huffington Post
It’s almost that time of year when health care companies across the nation hold open enrollment periods for millions, and a new survey from Consumer Reports, based on findings from the National Committee for Quality Assurance (NCQA), suggests that the top private health care plans in the U.S. are run by nonprofit organizations. The NCQA “develops quality measures and accredits health insurance plans, doctors, and other organizations” and is itself a nonprofit. Its current rankings are comprised of 474 private plans, 395 Medicare Advantage plans and 115 Medicaid HMO plans.
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Dr. John Santa, director of the Consumer Reports Health Ratings Center, notes that investors create a different culture than nonprofit do: “Without shareholder concerns and other investor-related issues, nonprofit health care companies can better focus on their mission to provide care itself.” Eight of the top ten plans were HMOs. You can find the rankings of health plans in your state here.
Consumer Reports and NPQ have been critical about the hoarding behavior of nonprofit health insurers. There is often no cap, state by state, on levels of reserves, though there is a floor and many states have seen pushback on rate increases and high salaries of execs, not to mention payment of board members. Still, apparently there are perceivable differences.
The Consumer Reports survey indicates a majority of Americans prefer a community-oriented health care plan that will choose to benefit the patient over the company, and it shouldn’t be surprising that backbone of many of these plans are nonprofits. These findings may be an important data point in the ongoing debate about whether to alter the tax-exempt nonprofit status of some health insurers, such as the debate over Blue Cross Blue Shield now playing out in Michigan. It should also be an important data point in how these insurers chart their futures. If consumer attitudes are, in fact, a strategic advantage for these groups in a mixed market, shouldn’t the insurers do all in their power to eliminate any practices that are questionable on the basis of service to consumers being primary?–Aine Creedon and Ruth McCambridge