Managed Care: Satisfaction and Confidence

Managed Care Gets Mixed Reviews

Overall, the majority of Americans are satisfied with their health plan. However, managed care gets mixed reviews. Managed care enrollees are less satisfied with their health plan than individuals with traditional health insurance. When asked about specific aspects of their health plan, the only differences between managed care enrollees and others is that managed care enrollees report lower satisfaction with their ability to choose a doctor, the quality of care, and treatments received.

  • A majority of insured Americans are satisfied with their health plan (52 percent). About one-third are somewhat satisfied with their health plan (36 percent), while 1 in 10 indicates he or she is not satisfied (10 percent).
  • Americans enrolled in managed care plans are less satisfied with their current plan than are those enrolled in traditional fee-for-service plans (47 percent v. 62 percent, respectively).
  • HMO-type managed care enrollees have the lowest satisfaction with their ability to choose their own doctor (36 percent are extremely or very satisfied), PPO-type managed care enrollees are significantly more satisfied with their ability to choose their own doctor (51 percent), while fee-for-service enrollees are the most satisfied (77 percent).
  • Most Americans are satisfied with the quality of medical care they have received (59 percent). A higher proportion of fee-for-service enrollees are satisfied with the quality of care they have received (71 percent v. 58 percent of managed care enrollees).
  • There are no significant differences in satisfaction between managed care enrollees and fee-for-service enrollees with regard to general care received, cost of health insurance, health costs not covered by insurance, hospitals used, and benefits covered by health plan.

Americans in Managed Care Are Worried About the Future

  • About one-fifth of managed care enrollees report that they are not confident they will be able to get the treatments they need in the next 10 years (21 percent); only 12 percent of fee-for-service enrollees feel the same.
  • Managed care enrollees are also more concerned about future access to quality care. Twenty-six percent of all managed care enrollees report they are not confident they will have access to quality health care in the next 10 years, compared with 16 percent of fee-for-service enrollees.
  • Americans in HMO-type plans are not confident about their freedom to choose their medical providers in the future (46 percent). Only about one-third of those in PPO-type plans and one-fifth in traditional plans are not confident about that (36 percent and 23 percent, respectively).

Source: 1998 Health Confidence Survey.

Note: Plan type is categorized by the number of managed care plan design features (out of a total of four) a respondent reports as describing his or her health plan. Individuals enrolled in plans with all four plan design features are considered to be in "HMO-type" managed care plans; individuals enrolled in plans with at least one of these features are considered to be in "PPO-type" managed care plans; and individuals enrolled in plans with none of the four features are considered to be in "traditional" fee-for-service insurance plans. All respondents older than age 65 are considered to be Medicare participants.