BENEFIT BEAT: SURVEY SEES CONTINUED POPULARITY OF HMOS

HMO enrollment is expected to continue to rise by the year 2000, though such plans are unlikely to become the only health plan option offered by employers, a new study finds.

"I don't think that we will wind up with a total HMO environment. I think employers will offer some choices because they want to or because they have to," said Lew Devendorf, a principal at William M. Mercer Inc. in Stamford, Conn., which conducted the survey.

In fact, the number of employers offering only one type of health care plan is projected to drop to 13% by the year 2000 from 22% currently, according to the survey.

At the same time, HMO enrollment is expected to rise to 39% of eligible employees from 31%, the survey found.

The Fax Facts survey, consisting of responses from 283 participants, also showed that while employers continue to offer a variety of health plan options, the most common combinations are an HMO, PPO and indemnity plan, or offering HMO and PPO plans.

A greater percentage of employers today are attempting to encourage HMO enrollment than two years ago, though they are still in the minority, Mercer found.

Currently, 57% of the 197 responding employers that offer an HMO do not create any incentives to enroll in that option, while 34% use either financial incentives or added communication about the plan. Mercer's 1995 Fax Facts showed only 8% were using such incentives, while 81% made no extra efforts to encourage HMO enrollment.

Employers have a variety of reasons to offer incentives, said Mr. Devendorf, one of these being some employers think high-quality, low-cost HMOs will help reduce costs and keep people healthy and at work.

Among the 84% of respondents that obtain employee feedback regarding satisfaction with their health care plans, only 34% use formal methods, such as surveys, whereas 56% rely on informal feedback. The remaining 10% use satisfaction information provided by their health plans.

Among the employers that measure employee satisfaction, all say they have made changes based on that feedback, with 51% of them negotiating new services. Other additional actions include adding a new HMO, dropping an HMO or adding performance guarantees. 1995 survey results showed that only half of the companies that solicited employee feedback had made any changes.

"I think that a higher-quality HMO can help reduce time lost at work. Purchasers today are becoming increasingly aware of quality issues that present themselves, and many employers are taking steps to ensure that the health plans they offer are high-quality health plans," said Mr. Devendorf. "It's not just a cost issue."

Further projections going into the year 2000 include slight increases in both POS offerings and enrollment, no change for PPO enrollment and a significant decrease in indemnity plan participation, to 9% from 17%.

Free copies of the Mercer Fax Facts survey are available via fax by contacting the Business Development Group by mail, 2 World Trade Center, 54th Floor, New York, N.Y. 10048, or by fax: 212-345-8483.

Coalition wins grant

CHICAGO-A grant will allow a Midwest employer coalition to measure whether members' employees are getting appropriate health care compared with other regions of the country.

The Chicago-based Midwest Business Group on Health, in conjunction with the Hospital Research and Educational Trust of the American Hospital Assn., received a $100,000 grant from the Robert Wood Johnson Foundation to benchmark health plans using a tool called the Dartmouth Atlas of Health Care.

The atlas is a computer-based database of medical treatment practices nationwide. The atlas was developed by researchers at the Dartmouth Medical School in Hanover, N.H., who concluded that the kinds of medical procedures and care one receives often depend on where a person lives (BI, Feb. 26, 1996).

"We hope to identify five sites in the community, primarily in the Midwest, where we can find a group of employers that would be willing to use Dartmouth's findings," according to Larry Boress, vp of MBGH.

These employers, in partnership with local hospitals and the medical community, would compare treatment practices with atlas data on practices in the region and elsewhere around the country.

They would then work to identify strategies aimed toward improving community health care systems.

"(The hope) is to bring together employer plans and purchasers to identify significant projects that can be done at the community level," said Mr. Boress.

The participants of the demonstration are expected to be chosen later this month, and the first meeting is scheduled to take place by the beginning of August.

Among some of the criteria included in selecting the five participants are employers that are significant in their communities, hospital executives who show an interest in reaching out to the community, and a local staff that is familiar with using the atlas, said Mr. Boress.

The Robert Wood Johnson Foundation is a health care philanthropy that supports projects to evaluate health care and how changes in the market affect it.

Wellness project

SEATTLE-The federal government and the leading trade association for managed health plans are launching a national campaign aimed at encouraging exercise and better nutrition for employees.

The U.S. Department of Health and Human Services' Centers for Disease Control and Prevention and the American Assn. of Health Plans are funding the 12-week project starting in September.

The project includes four health plans: Blue Cross & Blue Shield of Georgia, Medica Health Plans of Minneapolis, Keystone Health Plan Central of Camp Hill, Pa., and OmniCare Health Plan of Detroit.

Each plan selected a local company to work with and they will jointly target employees interested in improving their exercise and eating habits.

The employers chosen for the project, respective to the above health plans, are: Scientific Atlanta, the Star Tribune newspaper, Hershey Foods Corp. and Comerica Inc.

The initiative will involve placing a coordinator in the worksite to motivate workers to exercise or improve nutrition, explained Nicole Kerr, a registered dietitian and health communications specialist for the CDC in Atlanta.

Alternatively, a company could form a committee of workers to consult with other employees on exercise and nutrition issues, Ms. Kerr said.

It is anticipated that this wellness initiative eventually will be expanded nationwide for use by other health plans and employers.