ROANOKE TIMES 
                      Copyright (c) 1996, Roanoke Times

DATE: Friday, March 1, 1996                  TAG: 9603010032
SECTION: BUSINESS                 PAGE: B7   EDITION: METRO 
DATELINE: NEW YORK
SOURCE: STEVE SAKSON ASSOCIATED PRESS

FOR SMALL FIRMS, BOTTOM LINE IS TOP CONCERN IN HEALTH PLAN

A NEW SURVEY finds that many businesses don't require care to meet performance standards.

Despite a movement in big business to start choosing employee health care plans based on quality, small companies still are far more worried about the price, a new survey shows.

Because most Americans work for smaller companies, this suggests that a budding movement in industry to force accountability from health plans is not reaching most workers.

The survey's findings are particularly important because American industry is pushing its workers into health maintenance organizations and other managed care plans. The data support a key concern of many employees - that their bosses simply are looking to save money without determining if the plans are providing high quality care.

Nearly three-quarters of Americans who get their health benefits through their jobs now are in managed care plans.

The survey was done by the Washington, D.C.-based management consultant Watson Wyatt, for the Washington Business Group on Health, a group of large companies that studies health issues. Part of Watson Wyatt's business is advising companies on choosing health benefits.

The survey found:

* Of the 368 small, medium and large companies surveyed, more than 96 percent look at cost when choosing health insurance, HMOs or other managed care plans, the survey found.

* Of the small companies with 1,000 or fewer workers, 32 percent require the health plans to meet a set of performance standards specified by the employer.

* Of the large companies, those employing 10,000 or more workers, 61 percent specify performance standards. Of the medium sized employers, 60 percent have such standards.

Additionally, the survey showed small employers are even less likely to look at the most widely followed HMO ratings when they choose health plans for their employees.

For instance, just 20 percent of small companies ask if an HMO is accredited by the National Committee for Quality Assurance, an industry group that inspects HMOs and gives them its seal of approval. By contrast 57 percent of large companies use accreditation, as do 35 percent of medium sized companies.

Also, 59 percent of large companies and 6 percent of small companies examine criteria that measure factors such as the percentage of children who get immunizations, expectant mothers who get prenatal care, and women who get cervical cancer screenings and mammograms.

``The gap in information use reflects the fact that most small employers don't have the resources or time to take advantage of the new information,'' the Watson Wyatt report said.

HOW TO RATE AN HMO

Access to care and member satisfaction

Delivery of services for preventive medicine, such as childhood immunizations and screening for cholesterol, mammography and cervical cancer.

Prenatal care that helps eliminate low birthweight

Help to chronic disease sufferers, such as helping asthma patients control their illness and avoid fewer hospitalizations.

Source: Health Plan Employer Data and Information Set (HEDIS)

LENGTH: Medium:   75 lines
ILLUSTRATION: GRAPHIC:  Chart by staff (text below).