Consumers Confused about Health Coverage

September 30, 1994
Media Contact:Gary Stephenson
Phone: (410) 955-5384

Rapid changes in the health care marketplace may fool even smart buyers into getting less than they thought they had bargained for--if part of what they bargained for was insured access to Johns Hopkins or similar major medical centers.

That's one finding suggested by a consumer assessment study recently undertaken for The Johns Hopkins Hospital and School of Medicine.

More than one-fifth (22.3 percent) of those surveyed who were covered by HMOs (health maintenance organizations) said their plans allow them to use Johns Hopkins.

However, the data indicate that many of these respondents are mistaken or confused about the terms of their coverage. For instance, seven of 46 HealthPlus respondents said they have access to Hopkins, while 30 were uncertain. In fact, HealthPlus does not routinely refer to Hopkins. Conversely, while beneficiaries of MD- IPA do have access to Hopkins, six of 43 MD-IPA respondents said they believed they did not enjoy such access.

Other responses showed that access to Johns Hopkins is viewed as a strong plus even by those who do not enjoy that coverage under the terms of their contract. 45.5 percent of HMO respondents who do not have access to Hopkins--or who are uncertain that they have such access--said their HMO would be more valuable to them if it allowed them to use Johns Hopkins.

One obvious implication of the study's results is that if a buyer wants to be sure a health plan allows her access to Johns Hopkins or any other hospital, she needs to see it in writing before signing on the dotted line.

In buying health coverage as in shopping for a car, caveat emptor.

The study was conducted by Professional Research Consultants, Inc. (PRC) of Omaha, Neb. In the study, PRC conducted telePhone: interviews with respondents in 1,507 households located in Northern Virginia, the District of Columbia, and Central Maryland. The study was designed to elicit detailed information about Mid-Atlantic region health consumers and their attitudes and perceptions.

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